A good consultation, and then nothing
A parent and a twelve-year-old come in for a new patient consultation. The orthodontist explains the findings, the options (fixed braces or aligners, perhaps a phase of treatment first), the length of treatment, the fee and the monthly payment option. The family is positive. They say they need to talk about it at home.
Weeks pass. The record sits with a status of 'consult done, awaiting decision'. Nobody calls, because the treatment coordinator is running the next five consultations. When someone finally checks, the family has either started elsewhere or has not decided and has forgotten half of what was said.
Early treatment for younger children adds its own delay. Families are told the next step depends on growth or timing, and without a planned follow-up, the review that was meant to happen in a few months never gets booked.
Why pending starts stall
Orthodontic decisions are family decisions, often involving a parent who was not at the appointment. The information the family needs to decide is spread across a verbal explanation, a printed fee sheet and maybe a brochure. None of it is easy to share with the other parent at the kitchen table.
- Pending starts are not listed anywhere obvious, so they are not worked.
- The family has no written summary of the options discussed.
- Questions come up at home, and ringing the practice feels like a commitment.
- Follow-up depends on one coordinator's memory and diary.
- There is no record of why families decided not to go ahead.
What a quiet pending list costs
Consultations take clinical time and are often free or low-fee. When they do not turn into starts, that time is lost. A child who would benefit from treatment may not get it because a question went unanswered. And the practice cannot tell whether families decline because of fees, timing, the option offered or simply because nobody followed up.
The pending-starts process we build
- The consultation outcome is recorded on a short form or read from your practice management system: options discussed, recommended option, fee band and payment plan offered.
- A summary goes to the family by email the same day, written from templates your orthodontists approve, with the options explained in plain terms, a link to book the records or bond-up appointment, and a way to ask a question.
- The summary is easy to forward, so the other parent sees the same information.
- Follow-ups go out on a schedule you set, stopping as soon as the family books, asks something or says no.
- Questions go to the treatment coordinator with the consultation summary attached.
- The coordinator sees a list of pending starts by age, with the next action and last contact.
- When a family declines, the reason is recorded from a short list, so patterns show up over time.
| Family response | What happens next |
|---|---|
| Books records or bond-up | Moves to active, follow-ups stop |
| Asks a question | Coordinator replies with summary in front of them |
| Wants to wait | Follow-up set for the date they choose |
| Declines | Reason recorded, no further messages |
| No response | Next follow-up, then a call task |
Recommendations and the explanation of options are your orthodontists' clinical content. We build the delivery and tracking around it.
A coordinator working from a list
The coordinator's day includes a short, prioritised list of families to speak to and why, instead of a mental note. Families have something to share and discuss at home. Pending starts no longer vanish. And after a few months, the declined reasons tell the practice something useful about fees, payment plans or appointment availability.
Does your practice see this?
- Families often leave consultations to 'think about it'.
- Nobody can quickly list who is still deciding.
- Follow-up calls depend on one person having time.
- You do not know why families decide not to start.