Avoiding patient no-shows: you may be part of the problem

It happened again. Your scheduler set the appointment. The support nursing staff prepared for  the visit. The doctor reviewed the medical chart. And the patient doesn’t show up.

Few things are as frustrating – and costly – as the no-show. It kills relationships, complicates schedules, quashes staff morale, and costs money. All too often, offices take on attitudes and actions that not only contribute to the frequency of no-shows, but can also create an environment that accepts and encourages them. Follow these steps today and you’re on your  way to significantly avoiding patient no-shows tomorrow.


Setting a No-Show Example

Does your office consistently initiate appointment changes? Of course, doctors’ offices see rescheduling as a necessary activity in a hurried and uncertain world, seldom looking at it as no-showing the patient. Patients might not feel the same, and it can compromise the doctor/patient relationship, adding tension and distrust.

Elizabeth Woodcock, expert on medical practice operations at Woodcock & Associates, said in her May 9, 2005, article, “Dealing with Appointment No Shows,” that more than a few patient reschedules a month is too much. Further, reschedules not only accelerate the no-show problem, but also contribute to patient frustration and a lack of seriousness towards their physicians. She added, “I worked with one practice that did not realize how big a problem it was creating until a patient called to complain that she had been rescheduled three times.”

Patients learn from providers.


Creating a No-Show Culture

Is your office chronically behind on appointments? Creating an office that is efficient, effective, and professional goes a long way toward setting an environment of responsibility and mutual respect. Avoiding patient no-shows will follow. Alternately, when an office creates a culture of inefficiency, ambiguity, and irresponsibility, patients follow suit.

According to a 2009 report by Press Ganey Associates, a health care consulting firm which surveyed 2.4 million patients at more than 10,000 locations, the average time patients spend waiting to see a health care provider is 22 minutes, sometimes lasting hours. The report also noted that patient satisfaction dropped significantly with each five minutes of waiting time. If the trains are constantly running late, passengers often lose respect and find other means of transportation.


Ignoring a No-Show Policy

Do you have a no-show policy? Is it posted and enforced? You don’t need a room full of experts to tell you that avoiding patient no-shows can be achieved more effectively when you have a solid policy in place. It not only informs staff and patients, but also sets a professional tone.

The Medical Group Management Association suggests creating a written no-show and cancellation policy, publicizing it well, educating your patients on it, and most importantly, enforcing it in a timely and consistent manner.


Manage Patient Wait Times

If a patient has to wait four, five, or six weeks from scheduling an appointment to actually seeing the physician, life can get in the way. The patient can get busy, lose the paper appointment reminder, or forget about the text message they received over the course of the long wait. As such, running an efficient practice with appropriate wait times can assist in the “oops” excuse for missing an appointment.

Fair, firm, and effective policies equal a well-run practice.

You’ll never reach the point where you’re totally avoiding patient no-shows in your office, but there are concrete steps you can take that will contribute greatly toward ensuring that they are fewer and farther between.