Weighing up the high cost of SMS reminders with lost practice time is a tricky balance – Adrian Dray at CareStack explores whether SMS messages can be used in a financially sustainable way and the potential alternatives.
Practice owners are absolutely right to be obsessed with reducing failed-to-attend (FTA) rates and white space in the diary. That is where profitability, stability, and patient continuity live.
So why are so many practices switching off one of their most effective tools? And what needs to change for UK dentistry?
As a patient, if you do not send me an SMS reminder, there is a strong chance I will miss my appointment. That is not a proud admission, it is reality. Life is noisy, work is busy, and most of us are conditioned to rely on short, clear prompts on our phones.
Think about how many organisations already do this well. Delivery services, subscription platforms, service providers, booking tools. they all lean on SMS to protect attendance, reduce friction, and keep revenue predictable. They understand that attention is fragmented, so reminders need to be direct and difficult to ignore.
Dental practices are no different.
What is the downside of SMS messaging?
The tension comes from SMS cost. If a practice is paying somewhere between 4p and 12p per SMS, the numbers add up quickly.
Take a typical example at 8p per message, sent through practice management software. A patient books an examination. They receive:
- An SMS confirming the appointment
- An SMS reminder one week before
- An SMS with a link to complete medical history via the patient portal
- An SMS one time password to access that portal
- A final reminder the day before
- A follow up SMS inviting them to leave a review.
By the time that journey is complete, the practice may have spent around 40p for one patient. On its own, that feels acceptable if it protects clinical time and generates a review. Translate that across hundreds or thousands of appointments each month, and it becomes a serious line on the profit and loss statement (P&L).
What are the alternatives to standard SMS reminders?
At this point, practices start searching for alternatives. Here is how the main strategies compare.
1. Switching to email reminders – rating: 3/5
Email is often ‘free’ at the point of use and feels like the obvious saving. The challenge is modern inbox filtering. Stronger spam controls, automatic categorisation, and cluttered inboxes mean reminder emails are easier to miss.
For practices with high FTA sensitivity, relying on email alone can be a calculated risk.
Tip: if you trial email only, ring fence a defined period, closely track FTA rates, rebooking behaviour, and short notice gaps, and be prepared to reverse the change quickly if performance drops.
2. Using third party messaging tools – rating: 3.5/5
Dedicated messaging platforms that connect with existing systems or use channels such as SMS and Whatsapp can improve flexibility or pricing.
Tip: check deliverability reports, confirm how patient data is processed, and review UK GDPR, data sharing, and retention responsibilities. A cheaper message that fails to arrive, or a tool that mishandles data, quickly erodes any perceived saving.
3. Choosing software with sustainable SMS pricing – rating: 4.5/5
For many organisations, the stronger long term move is to choose core software that bakes fair, transparent messaging into its model.
When a system includes a meaningful SMS allowance within the subscription, applies a low, predictable rate beyond that, and does not charge for essentials such as incoming replies or portal access codes, it becomes realistic to keep SMS switched on at scale. That means fewer empty chairs, stronger patient communication, and less anxiety about every reminder sent.
Where this is combined with integrated tools such as imaging, referrals, and reputation management, practices also reduce fragmentation and gain clearer visibility of both costs and outcomes. The higher rating reflects its balance of sustainability, control, and patient behaviour alignment.
The bigger point for UK dentistry is this. FTA reduction and diary optimisation depend on consistent, reliable communication. Turning off SMS purely because of opaque or inflated pricing puts practices at risk of empty chairs and lost trust. The smarter move is to interrogate your numbers, understand exactly how your current setup charges, and explore options that make it affordable to keep using the channels your patients actually respond to.
If SMS helps patients turn up, pay, and rebook, then pricing models should support it, not punish it.
This article is sponsored by CareStack.
