Musings of a Veterinarian

Should We Penalize Late Clients?

June 30, 2010 By: Dr. K Category: Opinion, Practice Management

Recent news out of Australia slammed physicians for instituting late fees for patients who show up more than 10 minutes late to their appointments. Many argue these physicians are implementing a double standard given how far doctors log behind during their appointments. Perhaps this is a double standard but I guarantee one argument you’ll hear from these physicians is the patient’s tardiness contributes to the physician’s tardiness.

I have toyed with the idea of implementing late fees for chronically tardy clients (and we all have them, usually know them by name, and plan accordingly). My practice runs on a busy 15-minute appointment schedule. A client’s 10-minute tardiness can throw off the entire block of appointments. I know a late fee would go over like a lead balloon and so it remains an idea droning in my temples every time a client shows up late on a busy night. It’s my fantasy revenge.

The facts against a late fee remain: Most clients are on-time or early for their appointments. Legitimate excuses happen. You can’t teach common courtesy.

I have found some of the best ways of dealing with tardiness are as follows:

  • If owner’s are more than 10 minutes late, have front desk staff politely inform them they will need to wait because the veterinarian is seeing her next appointment. It’s unfair to clients who show up on time to have to wait even longer for their appointment.
  • Squash clients who decide to “sneak” that extra pet into their 15-minute appointment. If you simply cannot fit her in without making clients with appointments wait longer, do not do it. If you do have time to look at Little Lucy’s skin condition, use the line “Fortunately I have time to see her tonight without an appointment, but just make sure to have one down the road for when we are booked solid so we make sure to address your needs.” Spin the situation toward looking out for the owner’s best interest and you’ll avoid an awkward moment. You know the saying “If you give a mouse a cookie….” Set the tone for future appointments.
  • Veterinarians must practice excellent time management given the frequently unpredictable and sometimes emergency laden appointment schedule. If a two-minute recheck and a sick exam arrive at the same time, see the recheck while the technicians triage the sick patient.
  • Apologize and offer a reschedule. Veterinarians run behind, mostly, due to surprise illnesses mentioned at annual examinations, emergencies, and sick patients who require admission. Once we are behind it’s very difficult to catch up and we find ourselves rushing through appointments. Sometimes it’s better to reschedule than make a client sit an hour in the waiting room with a labrador who has chewed through the leash, peed on the wall, and jumped on the counter during the wait.

4 Comments to “Should We Penalize Late Clients?”

  1. Perhaps late clients make veterinarians run late. But I typically see my vet about 45 minutes after my scheduled appointment–every single time, and I have 3 senior dogs With Issues, so I’m there a lot. I generally see my internist between an hour and 3 hours after my scheduled appointment. I know this, and I show up on time (ever the optimist) but I don’t expect to get out any time near when I “should.”

    If doctors or vets start charging a late fee, it should be fair to charge them for MY time, too. If the patients before me who make them late (multiple pets, emergencies, late appointments) are charged for making them late, then it’ll all balance out, right?

  2. I always schedule 2 (or 3,4, or 5) depending on how many of my animals are being seen. I don’t take sick pets for well-visits or vacs. And I let the front-desk people know when I schedule if there are issues to be addressed such as bloodwork, fecals, etc. I try to be considerate of my vet’s time and would never try to “sneak” in an extra animal when I have an appointment for another. But my vet(s) also seem to be willing to spend time answering my questions, or addressing an unforseen issue, such as this week, when she discovered a small mass I hadn’t noticed on my 11-yr.-old Lab’s foot, and decided to do a needle aspiration right then to see if it was a cyst or a possible mast-cell tumor. (Luckily only fluid & debris seen, so most likely cystic). I think frequent and considerate clients reap the benefits by the vet being willing to do the little “extras” that make the difference in a so-so vet-client relationship and a great one.

  3. Much of the decision to charge for tardiness ought to be market driven, and a component of this is local competition and the current economy. If I were the only game in town, and times were great, charging a late fee would be fine: the client’s choices are limited and the money is there. However, with lots of local competition and an economic downturn, I frankly must take what I can get and allow for the occasional tardiness. It’s not an ideal situation, but it is what it is.

    Charging a late fee in my area would be the lead balloon that you describe, and I’d be faxing the records to another clinic as soon as I finished collecting the fee. I’d rather suck it up and retain the business than slap a fee on an owner (likely an owner with a decent excuse for their tardiness) and have them walk.

  4. Oh, we’d like to and kind of charge them in our ‘mind till’ lol. When I call appts for the next day and have to leave a message, I always say “If you need to cancel or reschedule this appointment, please give us a call so we can fill the appointment time with a patient on our cancellation list. Sometimes we don’t have a list, but it’s a gentle reminder that our time is valuable, too.

    As to emails, for a while we had a statement to the effect of ‘after the initial appt followup/consultation, a fee would be charged for ’email time’ but the Dr thought that was detering clients from contacting us, so she removed the statement.


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