This is the question I asked Gemini on 9 Dec 2025:
"What wording would be best to use when talking to a dental patient who I am making an appointment for in a public dental clinic. This patient will not be paying for any treatment but often patients don't come to their appointments or cancel at the last minute. I would like to utilise "nudge" techniques (Richard Thaler) for helping to make sure they come."
ANSWER:
This is a classic behavioral economics challenge. When a service is free, the monetary "sunk cost" is zero, which often leads to a lower perceived value and higher no-show rates.
To combat this using Richard Thaler's Nudge Theory, you need to move the patient's psychology from Passive Compliance (taking whatever time you give them) to Active Commitment(feeling a sense of ownership and social obligation).
Here are specific scripts and techniques based on Nudge principles, broken down by the psychological trigger.
Instead of assigning a time ("Come in next Tuesday at 2 pm"), force the patient to make an active choice. When we choose something ourselves, we are statistically more likely to follow through.
Standard approach:"I have an opening next Tuesday at 10 am. Does that work?"
Nudge Wording: "I have two potential spots for you next week. I have Tuesday at 10:00 am or Thursday at 2:00 pm. Which one of those would you prefer to grab?"
Why it works: They aren't just agreeing to your suggestion; they are selecting "their" slot.
People often miss appointments not because they don't want to go, but because they fail to plan the logistics (transport, parking, childcare). You can prompt this planning process during the call.
Nudge Wording: "Okay, I have you down for Tuesday at 10am. Do you usually drive here, or will you be taking the bus?"
(If they say bus): "Great, do you know which route you'll need to catch to get here by 10?"
(If they say drive): "Just a reminder that parking can be tricky at that time-it might be best to leave 10 minutes early just to be safe."
Why it works: This forces the patient to visualize the act of getting to the clinic, moving the appointment from an abstract concept to a concrete plan.
This is one of the most powerful changes you can make. It utilizes the principle of Consistency. People like to be consistent with what they have said aloud.
Standard approach: "Okay, see you then."
Nudge Wording: "I've reserved this time specifically for you. Can I count on you to be here at that time?"
(Wait for them to say "Yes.")
Follow up: "Excellent. I'll note that down."
Why it works: A study in the UK health system found that asking patients to repeat the time back or verbally confirm "Yes, I will be there" significantly reduced no-shows. You are creating a social contract.
Since there is no financial loss for missing the appointment, you must highlight the social cost. In public dental, waiting lists are long. Use that.
Nudge Wording: "We currently have a very long waiting list of patients in pain. Since this spot is reserved just for you, please let us know if you can't make it so we can give the time to someone else who needs urgent care."
Why it works: This reframes a "cancellation" from a neutral administrative act to a negative act that hurts another person in their community.
If you are booking them while they are in the clinic (for a follow-up), do not write the appointment card for them.
Nudge Action: Hand them the blank card and a pen.
Wording: "Here is a card -could you please write down that date and time? That helps people remember it better."
If you are on the phone:
Wording: "Do you have a pen and paper handy? I'll wait a second while you grab it so you can write this down."
Here is how you might flow these together in a single conversation:
You: "Mr. Smith, regarding your filling, I have a spot on Tuesday at 9:00 am or Wednesday at 3:00 pm. Which of those two works better for you?" (Active Choice)
Patient: "Wednesday please."
You: "Done. Now, do you have a pen nearby? I'll wait while you write that down." (Write it down)
Patient: "Got it."
You: "Wonderful. Now, we have a lot of people waiting for treatment right now, so can I count on you to attend on Wednesday so this spot doesn't go to waste?" (Verbal Contract + Scarcity)
Patient: "Yes, I'll be there."
You: "Thanks, Mr. Smith. See you Wednesday."
If your clinic sends text messages, the wording there matters too.
Bad: "Reminder: Appt Tues 9am."
Good (Nudge): "Hi John, we have reserved 9am on Tues specifically for you. Other patients are waiting, so if you cannot make it, please reply CANCEL so we can help someone else."