Disclaimer: Dentist here (and programming enthusiast) The other side of the story, that nobody really talks about, is the psychological abuse that -dentists- are subjected to, by patients. As an introduction: I was above average at my uni in terms of clinical and theoretical skills, bought my own practice from a retiring dentist and always behaved 100% ethically (I'm one of those that don't overtreat at all and I bui…
If you have a certain profile of patient who often break their appointments, you can simply double-book a certain percentage of them. That is, if you need to schedule three such patients, have two come at 1 PM and the third come at 2 PM. If you expect that one will break, you'll still take care of the other two in two hours. (adjust these times if you are faster or slower) If neither of the 1 PM patients break, or especially if none of them break, somebody will have to wait for a bit. So what? You're a dentist; your time is more valuable than your patients'. If one of these patients gets pissed about this, that's two strikes against her since she is already more likely to break appointments. You don't need a patient with two strikes.
Patients who don't have insurance or who have insufficient insurance (granted, this latter situation is sometimes hard to know in advance) have to pay when they receive service. If you explain this before the work is done (since you have informative treatment plans, patients are never surprised by a bill), then someone who doesn't pay can be referred to the prosecutor for fraud.
Never run "payment plans" through your office. Always use an outside agency like CareCredit or Lending Club. If they won't loan the patient money, then you certainly shouldn't. You do have to pay these firms, so if your schedule is full then nobody gets credit. If your schedule isn't full these fees come out of the marketing budget. If you try to handle loans yourself you'll end up paying more.
Procedures that require lab work are billed on the first appointment, and the patient has to pay half in order for the case to be sent to the lab. You explain this ahead of time, and if you're using the right labs (hint: most of them are in China) you'll still make a profit if someone breaks the second appointment.
The effective dentists I've seen have set up policies that automatically handle bad patient behavior without need for argument or personal involvement. These policies can change based on your experience. You shouldn't be on the front line of implementation, however. The people you have on the phone have to be able to schedule defensively, so you won't be sitting around with no patients. The person you have handling treatment plans has to properly communicate payment terms before you begin expensive procedures. You might have to get involved with particularly evil patients, but if you don't have to address these problems for most patients you'll probably avoid some frustration. Good luck!