One Additional Appointment – What it Really Costs Your Practice

A patient comes for a try-in. You adjust the crown. Two days later, the patient calls: problem – can they come back? You have to fit them into the schedule.

Or: the patient reports discomfort, the preparation angle needs to be changed. Another appointment is required.

Or: communication with the lab was unclear, the restoration requires modification, the patient has to wait and return.

An additional appointment. No revenue is generated from it (the patient has already paid for the crown). There is a cost.

Why Additional Appointments Become Necessary

1. Imperfect Fit. You adjust the crown, but the fit isn't ideal. Occlusal contacts, marginal integrity. The patient feels discomfort. They have to return.

2. Patient's Changed Requirements After Review. The patient sees the crown but wants to change the color, height, or shape. The lab has to redo it. The patient waits and returns.

3. Communication Error with the Lab. Instructions were unclear, the lab misunderstood something, the restoration requires modification.

4. Patient Has Additional Concerns/Questions. After the try-in, a problem arises that the patient didn't notice before (e.g., sensitivity, proximity to adjacent teeth).

5. Anticipated Additional Procedure. Sometimes an additional appointment is part of the protocol (one-week check-up, occlusal adjustment), not an error – but it still incurs costs.

Breaking Down the Cost of One Additional Appointment

Practice preparation: assistant prepares materials, instruments, operative field. ~10 minutes = 7.5 PLN (assistant 45 PLN/h).

Doctor's time: problem diagnosis, modification, patient education. ~30 minutes = 300 PLN (doctor 10 PLN/min).

Assistant's time (chairside): ~30 minutes = 22.5 PLN.

Materials and operating costs: cement, polishing, cleaning. ~10 PLN.

Lost slot in the schedule: sometimes (but not always) an additional appointment occupies a slot that could have been filled by another revenue-generating procedure. ~200–400 PLN.

Total cost of one additional appointment: 300 + 22.5 + 10 + (sometimes) 200–400 = 532.5–732.5 PLN.

Conservatively, take 600–800 PLN per appointment. Take an average of 700 PLN.

If the patient requires a special recall (e.g., rescheduled from another day), add communication costs, schedule changes – +150–200 PLN. Total: 850–900 PLN per additional appointment.

If the patient requires a subsequent follow-up (post-modification check-up): add another 600–700 PLN (second additional appointment).

One additional appointment is rarely just one appointment – it's a cascading effect. On average, 1.5–2 additional appointments for each problem.

Cost of one problem: 1000–1800 PLN in additional appointments and operating costs.

Scaling: 10 Additional Appointments Per Month

A practice with 40–60 prosthodontic cases per week (160–240 annually) typically has a need for additional appointments in 20–25% of cases.

200 cases per year × 25% = 50 additional appointments per year = ~4 per month (conservatively).

For a larger practice or worse lab collaboration: 10 additional appointments per month.

10 appointments × 700 PLN = 7000 PLN/month = 84,000 PLN/year.

This is the cost of these additional appointments alone. Add indirect costs (schedule chaos, patient stress, damage to reputation).

Additional Costs: Preparation, Follow-up, Reputation

Schedule destabilization. Every additional appointment means a change in the schedule. Patient A is moved to the next day, which moves Patient B. Cascading effect. Estimated: 10% of additional appointments lead to the cancellation or rescheduling of another revenue-generating procedure. 10 appointments/month × 10% = 1 lost procedure/month = 200–300 PLN in lost revenue/month = 2400–3600 PLN/year.

Patient stress and reputation. The patient has to return. They feel that the initial work was inadequate. They fear subsequent procedures. They may not return, and if they do – the opinion of the practice declines. In our industry, referrals account for 40% of new patients. One bad review = potential loss of 2–5 new patients annually = 10,000–25,000 PLN in revenue.

Completion times. Additional appointments prolong the time from preparation to treatment completion. The patient is involved longer, waits, gets frustrated. This also affects the practice's reputation.

How to Reduce the Number of Additional Appointments

1. Digital verification BEFORE production. A lab with PID performs a digital mock-up. The dentist and patient review it before production. No surprises = fewer additional appointments.

2. Clear work instructions. A standardized instruction form instead of verbal descriptions. The lab knows exactly what to do. Fewer errors = fewer additional appointments.

3. Precise scan. Intraoral digital scan with appropriate parameters. The lab works with accurate data. Fewer surprises = fewer additional appointments.

4. Initial adjustment of the restoration in the lab. Instead of making adjustments chairside (20–30 min, discomfort, chaos), the lab adjusts before shipping. When the restoration arrives, it fits perfectly.

Result: change from 25% need for additional appointments to 5% (with PID).

200 cases annually × (25% — 5%) = 40 fewer additional appointments annually.

40 appointments × 700 PLN = 28,000 PLN saved annually just on appointments.

Adding reputation, stable schedule – savings reach 50,000+ PLN annually.