Patients Missing Appointments?

Operating a medical practice can be difficult enough, let alone having to deal with patient no-shows. When a patient makes an appointment to see you, you have revenue that you can count on. When a patient fails to show up, not only does this jeopardize your finances, it also wastes your valuable time – time that could have been spent helping another patient in need. The rates of patient no-shows vary anywhere from 5- 50%, depending on the type of medical practice in question. They can also be costly to medical practices. A typical physician appointment brings in $150 and assuming you work five days a week, just two missed appointments per day results in a loss of $72,000 a year! Due to this concern, most medical practices have begun to charge fees for missed appointments. Some of the advantages of charging patients for missed appointments include the following:

• Patients will recognize that your time is valuable and it may encourage them to respect it;
• It can assure patients will show up for their appointments, knowing that there is a fine involved for those who do not;
• The charges for a missed patient appointment can aid your practice in making up for lost revenue;

How you choose to handle patient cancellations can say a lot about your practice. Will you accept an emergency? Will you require 24 hour notice? Will you charge a small fee? Before making such decisions, it is imperative to get to the bottom of why patients are missing their appointments. Here are the most common reasons for patient no-shows:

1. Financial reasons
Regardless of the fact that uninsured rates have gone down throughout the years from 41 to 28.5 million Americans, the reality is that most healthcare services end up leading to out-of-pocket costs. A missed doctor appointment may simply be a response to financial stress.

2. Fear of the unknown
Most individuals dread going to the doctor. It’s the fear of the unknown – the concern of receiving bad news or being lectured about unhealthy behaviors. After all, no one wants to be treated inferiorly and for some individuals, this can be enough to make them skip their appointments.

3. Timing
When family and work-related commitments take over, personal health can be put on hold. If appointments are booked weeks or months in advance, it can be easy to forget – particularly on a busy day. Moreover, unavoidable emergencies may lead some individuals to forget to cancel their appointments.

4. Demographics
When it comes down to it, demographic populations all differ from one another and deprived populations have a more difficult time keeping their appointments. For instance, elderly individuals may have difficulty accessing the practice, due to an unwillingness to use public transportation. Moreover, other individuals, due to language barriers, may be unclear on the policies on late arrivals.

By understanding the reasons behind missed patient appointments - forgetfulness, illness, family emergencies, or financial issues - you can begin to reduce the number of patient no-shows. Track the trends behind the reasons and find the proper solutions so that you can continue running a thriving and successful medical practice.

• Set automated phone reminders the day prior to a patient appointment;
• Display a clear no-show policy sign for new patients to see when they walk through your door;
• Reward patients who show up on time with a small discount or another form of compensation;
• Thank patients at the end of a visit and thank those who cancel and reschedule in advance;
• Send out emails a few weeks ahead of time to remind patients about their appointments;
• Keep patients’ contact information up-to-date in case you need to reach them;
• Provide patients with an option for an email or phone call appointment reminder;
• Eliminate patients who have accumulated a large amount of no-shows throughout the year;
• Keep records of each patient’s missed appointments in an attempt to inform them the importance of attending or why you have chosen to discharge them as a patient;
• Schedule appointments within an appropraiate time frame following a patient’s phone call;
• Charge patients for cancellations made on the same day as their appointments (unless it is an emergency);
• Make sure all of your staff members are aware of the protocol for missed appointments and how to deal with them;
• Schedule patients who have missed their appointments multiple times at your convenience the next time around;
• Remind patients who use public transportation to book their appointments in accordance with the transport schedule;
• Call patients back to reschedule their missed appointments;
• Send out appointment letters to patients, showing your genuine concern for their missed appointments;
• Have patients repeat back to you the day and hour of their appointment to avoid any misunderstandings;
• Allow patients to pay in advance for their next appointment, allowing them a reason to return;
• Offer rewards, such as gift cards, to loyal patients;
• Keep a list of patients who live near the area and are able to come in for short-notice appointments in case another patient misses their appointment;
• Schedule properly so that there are no long wait times in between patients;
• Look over patients handled by you and other staff members and distribute the patient load to make the best out of your schedule;
• Implement a practice management system for keeping track of patient reminders;
• Implement a system for keeping track of patients who have missed their appointments;
• Inform patients of any systems that you operate with and how they work so that they are aware they are being monitored and they understand the potential consequences of missed appointments;
• Limit appointments per patient as you see fit;
• Stay up-to-date on the latest tools that could be of great use to retaining patients;
• Develop solid relationships with patients to build trust and loyalty;

Every medical practice deals with patient no-shows in different ways. Some may choose to charge patients, while others may choose to let it go and reschedule. The most important thing that you can do with a late-arriving or no-show patient is to talk openly with them. Let them know that you appreciate their willingness to let you care for their medical needs but that their missed appointments are hurting the relationship. Inform them that your time is valuable and it is not fair to other patients who are also waiting to see you. Ask them why it is that they have missed their appointments and try to work out a solution together. If patient no-shows are starting to become a real problem, consider placing a fee on the patient’s bill. This way, they will be aware that they will be charged in the event that they do not show up for their appointment the next time around. If a patient accumulates a large amount of missed appointments throughout a shorter period of time and you are considering dismissing them, at least they will understand why you have chosen to go through with such a drastic response. At the end of the day, you will have done your job by informing them of your concerns and hopes for future appointments. After that, it will be up to them.

At all times, healthcare professionals, such as you, are working to ensure your medical practice runs as smoothly and efficiently as possible. Deciding how to handle patient no-shows can greatly impact your reputation and the way that your patients perceive you. For this reason, it is important that clear communication and honesty is a part of the overall experience when patients come in to see you. When patients walk out of your office healthier and more satisfied, it is also a great advantage for you. After all, building patient loyalty is what every medical practice strives for. Try to find a middle ground that makes sense and works for both you and your patients.