The offices I’ve worked at that run smoothly, on-time, and with the least amount of late patients are those that have a late (and no show) policy. All patients are given and sign a form explaining that if they arrive late to an appointment, they may not be able to be seen or will only have limited treatment that day (depending on how late they are). The form explains that the office respects a patient’s time so we ask to receive the same respect. Further explaining that one late patient can throw off the entire day’s schedule and it isn’t fair or respectful for the rest of the patients seen that day to not be seen at their scheduled appointment time.
 
If your office doesn’t have a late policy that the office holds to, it may be time to come up with one. Otherwise, if a patient is always late, only give the treatment you can. For instance, perio chart, take radiographs, and have an exam, but then the patient must reschedule and come back for their prophy. After a few times of a patient needing to come back to finish treatment, they might try to arrive on time.
 
When taking this approach, explain to the patient in order to complete their treatment, you really need the full scheduled time. Due to their tardiness, you are only able to do such and such, so they will need to return. Keep in mind that if you do a prophy first and have them return for radiographs, perio chart, and exam, they most likely won’t return, which is why I hold the prophy for the next appointment.
 
With this said, its important your doctor(s) and the entire office supports this approach. It’s also very important that the front office holds very strong to the late policy and never says, “This one time is okay, the hygienist will just get all your treatment completed.” Doing so only awards for poor behavior and also shows that your office policies don’t really hold true. Out of experience with this issue, and working for offices that hold strong to their late policy, I’ve noticed this approach really nips the problem in the bud.