How to Handle No-shows

While it’s easy to shrug-off patients that don’t show for their appointments and to revel in the few extra minutes you may have to get other work done or to get your schedule back on track, it’s really not a good idea. No-show patients result in lost revenue, lost productivity and could open a practice up to medical malpractice risk. A recent article in AMedNews, entitled, “If patients are no-shows, doctors should ask why,” details why physicians should invest a little bit of time and money into finding out why and how it can improve their practice.

The article first suggests tracking all missed appointments immediately after they occur and utilizing an office manager or other administrative person to call each patient to ask why the appointment was missed. (This should typically only be 3 or 4 calls per day.) Specific (not general) answers should be sought. The practice should then look to see if there are any trends. (FYI, the article stated that most missed appointments occur on Fridays and that scheduling less appointments on Fridays might be a good idea.)

Calling to follow-up with no-shows not only allows a practice to find out why this is happening, it also has other added benefits: 1) it gives the patient an easy opportunity to reschedule and 2) it lets the patient know that the physician and the practice care and value the patient.

And, following-up with no-shows may alert the practice to larger problems, too. A missed appointment by a patient may occur because the patient simply decided to leave the practice due to poor treatment by a physician or other staff member. By not following-up, the practice doesn’t have the opportunity to address the issue and/or retain the patient.

Suggestions for Curbing No-shows

Charging for no-shows. The article discusses this practice and suggests that if a practice decides to charge for no-shows that it should take into account, and make exceptions for, true emergencies and/or that it should only be used for repeat offenders.

Reminding patients about appointments. While many practices call patients to remind them about their appointments, the article suggests that this might be a slightly outdated way of communicating with patients. These days, many patients might prefer an e-mail or a text reminder. Some patients may simply not check a home phone as often as they do their e-mail or text messages. Patients should be asked about the best way to communicate with them and the practice should act accordingly. All the reminder calls in the world will be of no benefit (to the patient or the practice) if the patient doesn’t like to communicate that way.

Addressing money issues. Many patients skip appointments due to financial issues. Patients on fixed incomes may not show simply because they don’t have the money for the co-pay or they might already owe the practice money. By following-up with these patients, and addressing these issues, payments can often be worked out and patients can continue to keep their appointments.

Finally, addressing no-shows can reduce a physician’s medical malpractice risk. The article describes the risky situation of a chronically ill patient who doesn’t show for an appointment, something then happens to the patient, and the practice doesn’t follow-up to reschedule, thus opening the practice to risk.

Taking a few minutes to follow-up with no-show patients is often worth the time and money, both for the patient and the practice.