When hygienist pre-appoint their own patients to future continuing care they will instantly find out which patients are onboard who isn't . If the patient bought in to do the right oral healthcare thing and schedule their next appointment in advance, you can monitor this vital sign of patient buy in or give a warning sign your back door is open and the patients are going down stream so you can decide if you want to fix the dam or spend the damn marketing dollars to replace them. The hygienist is most responsible for creating this value which is why they have to ask the patient to schedule to come back because when a patient says no they can see exactly when and with who, their hourlong appointment message did not work on in time to adjust w response to this tasks, hence the meaning of the word responseability. The hygienist needs to own it, be measured, and held accountable. How could you expect the front office to be responsible for preappointing the hygienist patients when you obviously can't be responsible for something you don't have the authority to change. Does the front office manager have the authority to trade your hygienist from the Jets for one from Tampa so your team has the right buccaneers to find the treasure? Or does everyone just blame Dr. Ignominy who is the only one with skin in the game.