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In this episode, Gary and Naren discuss the dreaded last-minute cancellations and appointment no shows. Gary goes into detail on how to create an ASAP list that will help you reduce these last-minute cancellations and no shows in your practice.


  • Introduction to today’s topic > 01:00
  • Learn about the upcoming MBA > 01:27
  • How to handle patients who are always canceling or not showing up > 05:19
  • Learn more about the ASAP list > 13:28
  • Learn more about the VIP list > 14:15
  • How to building your ASAP list > 16:15
  • Come join the I love Dentistry community > 20:06


Naren: Hello everyone. Welcome to another awesome episode of the less insurance dependence podcast show. This is Naren, your co-host. Today we have an amazing exciting topic for you. This was something that many, many, people wrote in and asked Gary about. We called it your ASAP list. Gary has spent a lot of time over the last 40 years in his coaching work as well as in his life smiles dental care practice figuring out how to handle patients who have a pattern of cancellations and no-shows. So, this is going to be a treat. Before I get into the podcast, I have an announcement. We have MBA coming up on July 17th and 24th, 4 p.m. To 8 p.m. Eastern. I wanted to first talk to Gary about what happened with the MBA he just got done yesterday. So, Gary good evening. How are you this evening?

Gary: Hey Naren, I’m doing great. As we’re recording this, I’m sort of feeling the afterglow of having just finished our June one-day thriving dentist MBA. Now this we needed to retitle the name because we didn’t do it in one day. We actually took three evenings. We want to try to present different formats to try to be accommodating to folks’ schedules and so we did it. A nine-hour program. We did three hours on Tuesday night, three hours on Wednesday night, and three hours on Thursday night. And man, that was fun we had so much engagement by our attendees. One of the things we do in that thriving dentist MBA workshop, the workshop is all about the ten elements of a thriving practice. We actually turn the workshop into a coaching experience and we do that two ways. We do it through exercises. So, each one of the elements, each one of them has an exercise. A simple exercise but it’s something for our doctors and office managers to do in the workshop that will allow them to take the information and apply it to their practice and the second thing we do is throughout the entire course they’re invited to submit questions and then we have specific time to have Q and A sessions to answer their questions and I know you were there the entire time there and helping me moderate it but man the engagement level was amazing and I feel like we are turning out ambassadors to go out and apply these ten elements in their practice and I felt really good about it and it was such a great experience. I can’t wait till the one in July. Now July is a little bit different. Again, we’re experimenting with formats. Same content but we’re going to do it in two sessions and two four-hour sessions. So, four hours on Friday the 17th of July and then the following Friday we’re going to complete the one-day workshop and that should be convenient for some and I just want to consider this an invitation to come join. If one of the elements of course is becoming less insurance dependent. So, if you listen to this podcast, you’re going to absolutely treasure that one-day MBA because a big part of it is all about successfully reducing insurance dependence.

Naren: Thank you so much Gary for that and I do think you’re also doing a big service because you’re not only offering this to people who don’t know anything about the 24 elements and sort of 10 elements in the 24 systems but you extended it to your coaching clients. So, they now can train every one of their team members especially the office managers with these fundamental principles of how to run thriving practice. So, kudos to you for doing that and I really appreciate it, Gary!

Gary: Man, it was fun and July we’ll have a blast with that. So, if you like attending CE where you get lots of content and you also have a great time, I think you’re going to love this. So, come join us and the pricing, because we’re doing these live streams, we don’t have airline expenses, we don’t have hotel expenses, we don’t have catering expenses and so we have cut the price to the bone and it’s very affordable. I think it’s probably the most affordable way to get six hours of CE that you could possibly take. So come join us.

Naren: Let’s jump in Gary. This is a question that I’ve seen maybe tens and tens of times maybe even a hundred times. How to handle patients who have a pattern of cancellations and no-shows?

Gary: Naren, I would love to tell you that I don’t know what you’re talking about. We don’t have cancellations and no-shows in life smiles and I would not be telling the truth if I said that. So, hey every prize, so if you feel like, oh my gosh we’re just getting deluge with cancellation no-shows and that might not be true right now, right now, in the COVID era where you’ve been shut down for 7 10 12 weeks. We’re not experiencing a high percentage of cancellation and no-shows and if we do, we’ve got a call list as long as our arm. So to get people in, but think back to February maybe beginning of March and if you are pulling your hair out because of cancellation and no-shows just know you’ve got a whole lot of company. I mean every practice has that, and I wanted to come up with some strategy to deal with it because it’s a pattern that keeps happening and it’s like what you do and we came up with something that  has worked brilliantly in our practice. It works brilliantly in our client base. Every time I share this with their clients their eyes get as big as saucers, they’re like oh my gosh why did I not think of that, why did not I think of that. So Naren, is it okay if I dive right in?

Naren: Yes please

Gary: So, let’s begin by recognizing that you have to start looking for patterns. If you have a patient that has routinely shown up for their appointments, I mean their pattern is that they’re routinely showing up and then they have an aberration and they call you in the morning for a hygiene appointment and say, Carly, I’m  so sorry I have an afternoon appointment with Kelly this afternoon for hygiene and I’m not going to be able to make it. I just got called into an emergency meeting at work. I am so sorry I know I’m supposed to give you 48 hours’ notice and I just I didn’t know until now. If I don’t go to that meeting, I’m losing my job, now Naren can we recognize that that’s different than a pattern of cancellation and no-shows?

Naren: Absolutely Gary, yes!

Gary: That’s different and I think common sense for all of our listeners prevails in a situation like that. Say of course, thank you for the courtesy of the call we understand and then we’re going to scramble to fill it, but now what do we do with George and I’m going to make it a male patient because it’s more likely to be a male patient

Naren: Yeah

Gary: I hate to say it but it is, and I am going to make this example, George, and when we look at George’s record, he shows up maybe 20% of the time that we’ve made appointments for him. If you look at it in Reverse

Naren: can I share, I’m going to put myself on the line here and

Gary: Okay George, go ahead George

Naren: so, we all have mindsets, right? We run our lives based on our mindsets, the way we think. In my mind if I have to choose between a meeting with Gary and my dental appointment, I am choosing my meeting with Gary. I’m being honest, right?

Gary: I will take that as a compliment, Naren. Unless you were a life smiles patient and then oh man I get it

Naren: So my problem is they typically ask me to book 6 months in advance. I don’t know when I’m going to have these meetings that I really want to have because I have fun in it, I enjoy it. So usually what I tell my dental office is please call me a couple of weeks before. That way I can definitely make sure that I find a time when and I don’t tell this to them when I don’t have those fun meetings like the meetings I have with Gary, so that way it’s easier for me because a week or two ahead of time all my meetings with you and now the other stuff that I enjoy is already in my calendar. Six months ago, if I asked you Gary when are we going to talk six months from now you won’t be able to tell me. So, I’m one of those patients Gary who won’t show up if you book an appointment with me six months in advance. I’m being honest.

Gary: Well let’s go back to fundamentals, Naren. Here’s the fundamental on that one

Naren: Yeah

Gary: and I want to raise my hand and say Mia culpa I’ve been part of the problem on this and let me explain what I mean. In 1982, my goodness thirty-eight years ago, I was the guy that stood up and said nobody should leave your office without making their next hygiene appoint, their next hygiene appointment, and I started teaching that in 1980 and I said they’re right in front of you and back then we didn’t have in computers and so we had to get the book out the big book the big appointment  book where the scheduling team I would have to flip the pages six months out and she’d make you an appointment and I was the guy who said nobody leaves your office without making their next appointment and I taught that from 1982 to 2007, okay? Do the math on that pretty quickly. I believe that’s 25 years.

Naren: Right

Gary: 1982 to 2007 and then I experienced in my own practice the mistake of that and how I discovered it was, I have to tell the story because it is imprinted on my mind. My office manager Stacy, we had a seven o’clock appointment and the seven o’clock appointment was Charlie Raggle. I know I’m violating HIPAA but Charlie won’t be listening to this, so I think it’s okay. Charlie’s a football coach for Chaparral High School and he was there at seven o’clock in hygiene, and I was excited I happened to be in the office that day and I was excited that Charlie was coming in because I wanted to talk to him about setting up our are coming mouthguard project that we’re going to be doing for the team and anyway 7 o’clock rolls around. No Charlie 7.05 rolls around no Charlie. 7:10 no Charlie and I walk up front and in my most emotionally intelligent manner I say Stacy, where’s Charlie? She said Gary, I knew he wasn’t coming. I said well Stacy if you knew he wasn’t coming how come you made the appointment and without missing a beat she said because you told me to and I like aha I did guilty as charged because I told Stacy nobody leaves our office without making their next appointment. She said Gary Charlie, single guy, football coach. What does he care about? He cares about football.

Naren: It’s like me like I have other things that I have fun with I would rather go to the other stuff if I have a choice

Gary: So, she said Gary I knew he wasn’t coming and right then I said this is a teachable moment for Gary. Hey Stacy let’s look at our digital schedule. Let’s look later in the week. This was a Monday. Who else isn’t coming? And she went right through the list and she identified about 10 hygiene patients that were highly likely of not coming, okay?

Naren: And knew who these people are

Gary: She knew it like I mean her instincts were amazing. So right then I made a shift I said quit reappointing everybody and what we learned after the fact that about 90% of the patients in any practice, you can appoint in advance whether it be three months, four months, for six months. But about 10% again that could vary your practice it could be 92% you for your point it could be 85 but it’s in that range, it’s in that range. In the 90% rate but for those 10% don’t pound a square peg in a round hole. Don’t pound a square peg in a round hole. Don’t try to fit near in with your noted priorities and I’m not going to try to pound you and you, I’ll call you the square peg. I’m not going to pound the square peg in the round hole

Naren: Right!

Gary: Now that’s one but now let’s go to this ASAP list. Now let’s play Naren and you’re the guy that historically 20% of the time, you’ve shown up. So, here’s what we do with you. We say Carly will say to you, hey Naren and this is after you’ve broken another appointment. We’ve no showdown another one, Carly will say Naren, I can’t make appointments for you anymore because when I make appointments you don’t show up. Now Carly has the best temperament tone of voice style to do this and nobody has ever felt insulted. They always say oh I know Carly I’m such a knucklehead, I know I know and then Carly says I get it, Naren, here’s what we’re to do. I’m going to put you on my VIP list. Now just I’ll come off the role playing for a minute. It’s actually not the VIP list it’s actually the what list and I won’t say it because we want to keep our clean lyrics rating on iTunes but it’s the other list that starts with a four-letter word list. But we are not going to tell you, we’re going to say Naren, I’m going to put you, we care about you and we know if we see on a regular basis, we accomplish two things. We keep you as healthy as possible and reduce your future dental expenses. So, here’s what I’m going to do. I’m going to put you on my VIP list. Here’s what that means: let me make sure I have your current cell number. Oh, yep that’s it, okay. Now I’m going to shoot you a text now and again. It’ll be the text message, it’ll be a text message, it’ll be the same day. It might be an hour from now, it might be two hours, it might be five hours from now. But I’m going to send you a text message and the text message is basically going to say hey we can see you for a hygiene appointment at two o’clock. If you want it, text me back. Now understand I’ve got a few other VIPs. Now they’re not quite as good a VIP as you Naren, but I’ve got a few other VIPs. So, if you want it to respond back quickly and so now, I want to knock on wood, Naren. So, my desk is made out of wood. I’m knocking on wood because I don’t want to curse myself here. As of this very moment that we’re recording this since we started doing that if we have at least an hour advan10ce notice at least an hour advance notice, we are 100% at filling that opening appointment later in the day. Now someday we will be able to say and notice I said at least no no’s because this doesn’t work for a no-show and here’s why because by the time we know you’re not coming and get the message out you don’t have time to get there for the hygiene appointment, got it?

Naren: Yep

Gary: But this applies for the patients that will give you a courtesy of a call and many will. Then we can use the ASAP list. Now here’s how you build your ASAP list. I want to be firm about this. It should have no more than 12 people on the list, 12, because if you send it to too many it will be overwhelming and if you send it to too few you might not be successful with it so 12 is the number, we tested it. 12 is the number. Half of those people, maybe six of them, will be people that would like to be seen sooner. They told you oh if someone was up call me, let me know. The other half are these chronic cancels or no showers. Now when we started this I had no idea if this was going to work but i’ve been surprised pleasantly at how often the people that fill those appointments are look at out of the chronic counsellors a no-shows because they’re like you they’re good people they just are not organized enough where their priorities aren’t sorted enough to be able to keep an appointment three four six months in advance but meanwhile you’re sitting, now this would be you, Naren because you’re busy but maybe this guy George is sitting at Starbucks. He gets a text message from Carly, Hey George turns out we can see this afternoon or two. Let me know if you want it. Hey this works George text’s back and we found, I can’t say a hundred percent but most of the time they are really loyal about keeping that appointment later in the day because it works for them

Naren: Yeah

Gary: That’s how we’ve been able to fill those short notice cancellations, very simple. It’s done with a group text that goes out and it goes out to those twelve people and it simply says hey we can see you this afternoon or if we know the hydrogen hey Kelly can see you this afternoon at two o’clock thought of you if you want this appointment text me back. Now, many times will two or three people want the appointment? We’ll go to the first one but we get two or three and then we respond back to the other two or three and say too slow next time be quicker with fingers, okay? I will keep you in my list and it’s a great way to handle those short notice cancellations. Now

Naren: I have a quick question, Gary. See I hate people when they cancel on me and I hate to not show for appointments. So, I ain’t on me. I’m very outspoken. So I literally fess up and say what, let’s mark something six months in advance but knowing me can you do me a favor can you call me a couple of weeks I had just because I know when I booked something couple of weeks ahead I am rock-solid but it’s just a little too advanced for me to kind of like for example there might be an even that I want to go a lot of things can happen in six months right. So, I don’t know if I’m breaking the system. Is this kind of one of those crazy buckets that?

Gary: You might be an exception to that because really, I want this to be the same day.

Naren: Same day, okay!

Gary: So you are probably not the right situation for this but I’m surprised at how many of our what we’re calling VIP list patients

Naren: Show up

Gary: sure love this system. They respond back and it just so happens to work for them and because we’ve got 12, it is going to 12 people.

Naren: Right

Gary: You have got a 100 percent chance in finding one, all I need is one.

Naren: one exactly

Gary: Now again some details on this. You want to send out by text. You want to send it to 12 people and the message is just a simple straightforward message that says, it turns out Kelly can see us this afternoon at 3:00 thought of you, text me back if you want it, and that has quite literally solved our short notice cancellation problem in hygiene. It’s quite literally solved it. Hey as we’re kind of coming to the finish line here, Naren I want to share something with their listeners but I want to share with our listeners. We have an I love dentistry community, Facebook community. If you’re listening to this and you’re not part of the I Love dentistry Facebook community, let me invite you to come join us. It’s a private Facebook group. It’s doctors and office managers and team members. Come join us and you can go to I Love Dentistry on Facebook and you have to request admittance it’s a closed group just say you’re a listener to the less insurance dependence podcast show. We will let you in. We will give you a secret key and will let you in and we’d love to have you join us. It’s a group. It’s all about what the name says it’s people that absolutely love dentistry and we’re there as a supportive community, lift one another up to share information and it’s a place to go to recharge your batteries when you need that and to connect with an amazing group of people that’ll be your new best friends but recently one of our community members posted something very cool. Naren you’ll remember that she said hey Gary, hey Naren I just over the weekend binge listened to a whole bunch of less insurance dependence podcasts and I can’t wait to apply this in my practice and so she discovered and I don’t know if she’s a new podcast listener or something but she discovered that she could download all of the episodes. As this one’s coming out, I think this one might be episode 91. 91 or 92 something like that, but all of those episodes can be downloaded and she kind of did like a Netflix binge listening exercise and she had all kinds of cool information she’s going to plan her practice. So if you haven’t done this, know that you can download all of the episodes, they’re free, and it’s our way to help you successfully reduce insurance dependents. We’re creating a grassroots movement. I’m all about preserving private practice dentistry and we want you to be part of that and please, if you haven’t done it already download any of the episodes, they’re all free and maybe you could be one of those binge listeners as well. Well listen. Thank you, guys thanks for, joining us we appreciate each and every one of our listeners here on the less insurance dependence podcast. Thanks so much. If you haven’t done so, there are three things you can do to support our work here. You can share less insurance dependence with your friends. Maybe some of your friends don’t know about this. Share it with them. Secondly you can jump on iTunes under less insurance dependence and write us a review. That’ll help more dentists find us. By the way, for those of you that have written recent reviews, thank you so much and then the third thing you can do is you can hit subscribe. If you hit subscribe you can do that on iTunes or Google Play. That means that every Thursday when we upload a new episode, it’ll be automatically uploaded for your listening device, for your listening convenience. Thank you so i’ll add note let me simply say thanks we consider your time to be precious and I hope we’ve shared some useful information with you today.

Gary Takacs

Gary Takacs One of Gary's most significant achievements as a dental practice management coach is transforming his own practice, LifeSmiles, from one that was infected with PPO plans, no effective marketing strategy, and an overhead of 80% to a very successful dental practice that is currently one of the top-performing practices in the US.

With over 2,200 coaching clients, Gary has first-hand experience transforming insurance-dependent practices into thriving and profitable practices.

Through his Personalized Coaching Program, Gary shares access to the systems, strategies, processes, and experience gained over 41 years of coaching dentists and transforming over 2200 practices worldwide.

Learn More:
Connect with Gary Takacs on Linkedin

Naren Arulrajah

Naren ArulrajahAs CEO of Ekwa Marketing, Naren has over a decade of experience working with dental practices and helping them attract the ideal type of patients to their practices. It is his goal to help dentists do more of the type of dentistry they love with the help and support of effective digital marketing.

Ekwa’s "Done-For-You" Digital Marketing model blends fundamental persuasion principles with an all-in-one Digital Marketing solution to help your ideal patients find you and choose you for reasons other than being on their insurance plan.

If you’re interested in finding out if Ekwa is the right fit for you and your practice, book a Free Marketing Strategy Meeting with Ekwa’s Marketing Director, Lila Stone.

Book Free Marketing Strategy Meeting:

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