014: 4 Essential Tips for Optimizing Your Schedule and Reducing No-Shows

STARTING SOON: NEW online masterminds group for private practitioners: practice building without the hysteria.
This group is for you if you:

1. Are ready to invest back into yourself and your business
2. Are ready to outsource the $10-15/hour tasks of your practice
3. Have big visions for your business but get stuck
4. Want help prioritizing and organizing yourself and your business
5. Want to hire clinicians and other staff
6. Want to create multiple streams of income
This group will be limited to 6 therapists who are ready to work harder and smarter, and we’ll meet 2x per month for 6 months.
Are you ready to finally invest in yourself and your business?

One of the joys of being in private practice is the ability to manage your own schedule. This enables you to have the kind of life you want. Maybe it’s a 4-hour workday, a 4-day workweek, or 3 consecutive weeks off every summer. There are also some downsides to managing your own schedule. You have to make difficult decisions about how much you’ll work (hopefully you’re making at least some of these decisions based on hitting your bottom line or income goals), what times you’ll offer to clients, and how much vacation time to take in a year.
I would recommend you first figure out how much you want to make in a year, and then break that down by how much you need to make in a week. I make my own calculations based on working 48 weeks per year, and set my weekly goals accordingly. I also use this math to determine my fees, rather than the other way around (setting your fees and then blindly accepting how much you’ll make this year). If you need to see 18 clients per week, how many days are you going to split that into? Maybe you’re used to seeing 8 or more clients in a day, but are you really doing good clinical work with that 7th and 8th client? Are you holding your value, and are your clients getting better?
Plain and simple, here’s what I recommend doing to maintain your most efficient schedule and minimize no-shows:

  1. See no more than 6 clients per day. I find 6 to be a relatively heavy day for me in private practice, and if I see 6 in a day, I’m sure to schedule myself at least an hour and a half break in between two sets of 3.
  2. Be clear and firm with your cancellation policy. You can try 24 hours, though I find 24 hours just isn’t enough time to fill that slot, and that clients are more likely to cancel last minute when they have that window. I hold my clients to a 48 hour cancellation policy and charge their credit card (which I have on file) if they cancel. Because I’m clear about this in the beginning of our work together, I’ve never ever had any client push back on it. In fact, most clients are gracious, understanding, and encourage me to charge the cancellation fee.
  3. Use a scheduling or practice management software that sends automatic appointment reminders. By doing so, I am able to go for weeks and sometimes a couple months without any no-shows or even late cancellations. For those who do cancel late without an urgent reason, my clients know that I’ll hold to my policy by charging them the full fee session. Simple Practice has an appointment reminder feature that will send an email to clients 48 hours before their appointment (which is also their reminder to cancel right away if need be), and a text message 24 hours before the appointment. Afraid to spend the money on Simple Practice? For $50 a month, you can have a comprehensive practice management software that includes appointment reminders and even the ability for clients to book their own appointments. Let’s say your fee is $150 and you had a no-show that never came back and paid. You pay for 3 months of Simple Practice (or its equivalent) and it reduces your no-shows to zero. Even if the software prohibits just 1 no-show without payment, it’s already paid for itself for 3 months. What’s not to love?
  4. Offer 2 weekday evenings of appointment times. Especially if you are running or want to run an entirely fee-for-service practice, you need to offer times that best suit your working professional clients who are at the office from 9-5 with little flexibility. Hold your full fee for those slots, and stay firm. Start your evening hours at 530 PM so you give time for that first 9-5 client to get to your office on time, and then you might end the day with a 630 and a 730 slot. Then you can sleep in the next day and watch Netflix until 11 AM.

I know plenty of therapists who choose to offer a “free pass” to their clients during the first no-show or late cancellation (though they usually don’t tell the client about this until it first occurs). I think that’s a good practice to have, because we do have to think about how our business operations affect our therapeutic relationships. At the same time, you have a business to run, and you must constantly convey your value to your clients.
Experiment with your schedule, and when you find what works, stick to it. Be flexible, but stay within your own boundaries. You’re probably in private practice, after all, so you can have more time to yourself, investing in your health, family, and relationships.



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