RE: Determining Cancellation Policy

[Guest guest]

Well said thank you !!!

Donna B. Kimick, IBCLC, RLC

Lakeshore Lactation

www.LILCA.ORG

In a message dated 01/11/08 18:35:18 Pacific Standard Time, obrnmom writes:

I think that moms change their minds about consults for many reasons-that is not the issue raised here.The issue is: a private practice LC who has created a business for breastfeeding support has identified a trend that impacts her revenue stream, as well as patient flow.To sustain a for-profit (and 501c) business, the (slightly yucky) issue of money and fee's comes to the forefront. Without revenue, she can't keep her business going, change breastfeeding rates, support moms in pain, or make a difference. PPLC's are in it for breastfeeding and families-we have to be, ain't none of us getting rich any time soon. Yet, if we are not practical with money, time, or any of our resources, our businesses fail. We fail. There are only so many hours the LC is available to assist moms in need-and with private practice, it's ALWAYS the train wreck mom. The nature of the problem/work also requires a big chunk of time spent on the individual. A mom who calls during an already full day will have to be rerouted; to another practice, or another day. When a time slot is wasted waiting for a mom who scheduled it, then never calls or shows, it's a missed opportunity for two moms, not one. The flow is disrupted and that time slot is rendered useless for breastfeeding support. There are a whole lot of potentials for failure for that rerouted mom to consider as well. Of course, common courtesy is a factor as well-don't we deserve a simple phone call from someone in that household?I rarely get cancellations, because I am primarily home visits. However, I do have periodic no-shows for my prenatal classes, which are limited in size. If I saw a trend like yours, I would first try to ID where the problem is. Asking the moms may help, but I am not sure you will get honest answers because of their own discomfort; they may very well duck your calls, lie, or think you will preach to them. Think about your tone and delivery when setting up the appointment, is it professional like a business owner or mellow-yellow like a League Leader? It may be that the perception on the mom's end is that canceling with no call is like not showing at a support group meeting; no big deal. Something to consider.I also believe your best bet is to make a decision on your policy regarding cancellations. Then write it down, to the last detail, making changes or alterations. Read it through (out loud) until you are comfortable with it. Then, make it part of the spiel, just like you do your fee, how you work, and all the rest. Be very clear about your expectations. For example, when concluding the conversation, state:"Now, Mrs Freaked-Out, I will expect you at our office tomorrow morning at 9am. I have reserved this spot for you only, so if something happens and you can't be here then, you or a family member need to let me know by 6am so I can use it for another mom if needed. We have to charge a cancellation fee of $25 for no call/no shows so it's better to just leave me a message or shoot me an email." (Sometimes it's easier to say "we". It implies that this is a group policy which always seems more acceptable. I use "we" a lot-particularly when dealing with refund issues. The "we" in my group is made up of me, myself and I <g>. In addition, the words "something happens" gives her an out so she doesn't have to explain if she doesn't want to. "Family member" is another out if she is feeling cowardly).And then follow through with your words and policy. This is your gig, you can choose when to be flexible. If a mom calls at 7 instead of 6 are you going to be hardcore? Probably not. But having it straight in your mind first, then communicating your expectations clearly should help reduce waste and help allow you to make positive change in your community.

Altman RN, IBCLC, LCCEAll The Bestwww.feedyourbaby.com

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[Guest guest]

THANK YOU DENISE!!!

You have hit the nail on the head with what I was thinking when I

originally posted, just couldn’t put it as succinctly as you did.

I DO have to balance the fact that this IS a business and I HAVE to

make it run with my background of LLL (I know, another discussion for another

time) and wanting to be able to help as many mothers as possible. You are

so right, I do see the trainwrecks and it does take a lot of time in my day to

see moms, do all the paperwork, do all the office work (plus I rent pumps as

well). When I have a no show I lose the business of 2 people…and

that hurts!

Your tip about how do I sound on the phone and is my LLL Leader

side showing through, is very valuable. I am *afraid* that I probably

don’t sound as professional as I should. I am a very bubbly and

vivacious person by nature (Ann R. here can attest to that!) and tend to sound

that way on the phone. I also do NOT have a set spiel worked out, for when

moms call (I keep changing it, nothing sounds right yet), so I suspect that

some moms feel it isn’t a big problem if they don’t show, by MY

demeanor on the phone. I will work on that, and I have cut and pasted

your ‘phone conversation’ and have changed the wording for my business

and will practice saying it this weekend J

Robyn Roche-l

IBCLC, RLC, BS-MCH:LC

Tidewater Lactation Group, Inc.

www.tidewaterlactationgroup.com

" Your Complete Source for Breastfeeding Support "

From:

[mailto: ] On Behalf Of obrnmom@...

Sent: Friday, January 11, 2008 9:34 PM

To:

Subject: Determining Cancellation Policy

I think that moms change their minds about consults for many

reasons-that is not the issue raised here.

The issue is: a private practice LC who has created a business for

breastfeeding support has identified a trend that impacts her revenue

stream, as well as patient flow.

To sustain a for-profit (and 501c) business, the (slightly yucky) issue of

money and fee's comes to the forefront. Without revenue, she can't keep her

business going, change breastfeeding rates, support moms in pain, or make a

difference. PPLC's are in it for breastfeeding and families-we have to be,

ain't none of us getting rich any time soon. Yet, if we are not practical with

money, time, or any of our resources, our businesses fail. We fail.

There are only so many hours the LC is available to assist moms in need-and

with private practice, it's ALWAYS the train wreck mom. The nature of the

problem/work also requires a big chunk of time spent on the individual. A mom

who calls during an already full day will have to be rerouted; to another

practice, or another day. When a time slot is wasted waiting for a mom who

scheduled it, then never calls or shows, it's a missed opportunity for two

moms, not one. The flow is disrupted and that time slot is rendered useless for

breastfeeding support. There are a whole lot of potentials for failure for that

rerouted mom to consider as well. Of course, common courtesy is a factor as

well-don't we deserve a simple phone call from someone in that household?

I rarely get cancellations, because I am primarily home visits. However, I do

have periodic no-shows for my prenatal classes, which are limited in size.

If I saw a trend like yours, I would first try to ID where the problem is.

Asking the moms may help, but I am not sure you will get honest answers because

of their own discomfort; they may very well duck your calls, lie, or think you

will preach to them. Think about your tone and delivery when setting up the

appointment, is it professional like a business owner or mellow-yellow like a

League Leader? It may be that the perception on the mom's end is that

canceling with no call is like not showing at a support group meeting; no big

deal. Something to consider.

I also believe your best bet is to make a decision on your policy

regarding cancellations. Then write it down, to the last detail, making changes

or alterations. Read it through (out loud) until you are comfortable with it.

Then, make it part of the spiel, just like you do your fee, how you work, and

all the rest. Be very clear about your expectations. For example, when

concluding the conversation, state:

" Now, Mrs Freaked-Out, I will expect you at our office tomorrow morning at

9am. I have reserved this spot for you only, so if something happens and you

can't be here then, you or a family member need to let me know by 6am so I

can use it for another mom if needed. We have to charge a cancellation fee of

$25 for no call/no shows so it's better to just leave me a message or shoot me

an email. " (Sometimes

it's easier to say " we " . It implies that this is a group policy which

always seems more acceptable. I use " we " a lot-particularly when

dealing with refund issues. The " we " in my group is made up of me,

myself and I <g>. In addition, the words " something happens "

gives her an out so she doesn't have to explain if she doesn't want to.

" Family member " is another out if she is feeling cowardly).

And then follow through with your words and policy. This is your gig, you can

choose when to be flexible. If a mom calls at 7 instead of 6 are you going to

be hardcore? Probably not. But having it straight in your mind first, then

communicating your expectations clearly should help reduce waste and help

allow you to make positive change in your community.

Altman RN, IBCLC, LCCE

All The

Best

www.feedyourbaby.com

Start the year off right. Easy

ways to stay in shape in the new year.

[Guest guest]

There have been lots of great answers to this question -- It's something I struggle with from time to time, but I do mostly home visits so it's not so much of an issue for me.

I typically start my phone calls about LC help with a statement about how we can handle addressing the problem: we can do a phone consult @ x$ per hour; an office visit @x$ per hour or I can come do a home visit. How payment can be made (cash, check, credit card). If it's a phone consult I usually schedule the call for at least a few hours later to give the client time to make a cc payment to my PayPal account. Because I spend a minimal amount of time beforehand on the phone with someone I don't feel so "ripped off" if they call back and cancel at the last minute or don't show-up. Usually it's not the money issue for me, but that my schedule is so tight. It seems like the few last minute cancellations I've had are always the moms I've gone out of my way to accomodate (lesson for me ;-)).

Thanks for this great discussion.

Warmly,

Dawn , LLL, IBCLC, CD(DONA)

Austin, TX