The way some practices address missed appointments or late arrivals might accidentally be making it worse but a lesson from social psychology can help encourage a smoother running day and better adherence to oral hygiene advice.
A common approach to patients turning up late is a sign or verbal message like this.
Perfectly reasonable. But it's likely to make the problem worse rather than better because of a phenomenon called ‘negative social proof’ that trumps rationality.
Warders at the Petrified Forest National Park in Arizona were concerned about visitors taking pieces of petrified wood home as souvenirs, eroding the park. Researchers compared the effects of different signs.
One sign appealed to reason "Please don't remove the petrified wood from the park in order to preserve the natural state of the Petrified Forest."
A second sign referred to other people's behaviour "Many past visitors have removed petrified wood from the park, changing the natural state of the Petrified Forest." So although implicitly giving a reason not to steal the petrified wood, it was also communicating that lots of people were doing it.
Compared to the control condition of having no sign, the reasonable sign resulted in a small decrease in thefts. The second sign, however, resulted in thefts rising threefold. It turned out to be actually promoting theft.
In short, when we're not sure what to do, we follow the crowd regardless of logic.
The same principle held true when encouraging hotel guests to reuse their towels. Most hotels use an appeal to reason along the lines of "Please help us protect the environment by reusing your towel." Changing this to an appeal to social proof "Most people who stay at this hotel reuse their towels" resulted in a 26% increase in people reusing their towels.
And the more like us we consider other people to be, the more we follow what they do. In the hotel study a further change to "Most people who stay in this room reuse their towels" resulted in a 33% increase over the standard sign.
Logical as it may be, highlighting prevalence of latecomers and missed appointments is likely to increase the problem because people think "Everyone else is doing it, so I'll do it too."
To use social proof beneficially, instead of emphasising the prevalence of the problem, focus truthfully on the majority of people who are already acting as you would like and how similar to the reader they are.
You can also apply our desire to conform elsewhere, for example to encourage a patient's oral self care "The vast majority of patients who have had this problem start to make time to floss and get the benefits as a result."
So as well as using logic to encourage beneficial behaviour, try also appealing to positive social norms from someone's peers. Everyone else is doing it!
