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4 effective ways to reduce patient no-shows

Fatima Puri
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A patient no-show occurs when a patient does not show up for their scheduled appointment or is unable to complete it due to inadequate funds or other logistical issues. Patient no-shows are a large concern for medical practices, as a large number of no-shows can cause devastating financial losses.

Why do no-shows happen?

Patient no-shows happen for several reasons, but the main one is forgetfulness. Patients live busy lives and are prone to forget scheduled appointments if the appointment isn’t top of mind. Other reasons no-shows happen can include last-minute emergencies, illnesses, or lack of funds.

The real cost of patient no-shows

To get a better idea of how detrimental no-shows are to the medical industry, let’s examine the issue from a financial perspective. According to research, medical industries suffer a $150 billion loss in yearly revenue due to appointment no-shows alone. 

Here’s a breakdown of the percentage of appointments that result in no-shows for industries within the medical umbrella, according to Solutionreach:

Endocrinology: 14 percent

Dentistry: 15 percent

OB/GYN: 18 percent

Primary care: 19 percent

Ophthalmology: 22 percent

Optometry: 25 percent

Oncology: 25 percent

Neurology: 26 percent

Pediatrics: 30 percent

Dermatology: 30 percent

Sleep clinics: 39 percent

To put these numbers into an example, let’s say a small pediatric clinic has 50 appointments on the schedule every week. Each appointment brings in roughly $200. 

Of those 50 appointments, at least 30 percent result in no-shows, which is a total of 15 missed appointments per week. 

50 appointments x 30% no-show rate = 15 no-shows per week
15 no-shows per week x $200 per appointment = $3,000 weekly revenue lost due to appointment no-shows

Four ways to reduce patient no-shows

Send appointment reminders

One of the most effective ways to reduce appointment no-shows is to send appointment reminders. Sending an appointment reminder is a gentle way to remind your patients that they have an appointment on the calendar. Patients can confirm the appointment, cancel it, or reschedule on the spot so your office can eventually get them in. It’s best to send an appointment reminder at least a week in advance. From there, you can send another reminder the day before an appointment and the day of. 

You can choose whatever medium you think works best for your patients, whether it’s via a phone call, email, or texting. However, studies show that patients prefer texting to phone call reminders since it’s less evasive and quick. According to a Twilio survey, 55 percent of survey respondents said they would like to reply to reminder alerts to confirm, ask for details, reschedule, or cancel an appointment. Studies have also shown that sending reminders via text can reduce no-show rates by up to 26 percent.

Phone with notification alert bell and 55 percent
55 percent of patients would like reminder alerts to confirm, ask for details, reschedule, or cancel an appointment

While confirming an appointment doesn’t mean it won’t result in a no-show, it greatly reduces the chances of a patient forgetting their appointment.

Tell patients why they need to see you

Health literacy is a large issue in the medical field. Research shows that only 12 percent of adults in the U.S. have a high level of health literacy, according to the National Assessment of Adult Literacy. That means there is an extremely high chance that your patients are suffering from health illiteracy. Things that impact health literacy include not understanding basic medical terms or procedures, a language barrier, and difficulty using technology to access health information.

Before you schedule a patient for an appointment, make sure they understand why they need the appointment, and be sure to contact them on a channel that they know how to use (i.e., texting or a phone call.) By explaining to people why they need an appointment instead of telling them they need in, you can increase your chances of keeping patients on the calendar.

Keep a waitlist 

Last-minute cancellations can also count as a no-show because it can be hard to find a replacement when an appointment is in an hour or so. The best way to fill last-minute cancellations is to keep a waitlist of patients who couldn’t get an appointment due to zero availability. You can tell these patients that you will call them for last-minute openings. That way, even if a patient cancels last minute, you have a list of people you can call to try and fill the space.

Charge a cancellation fee

Charging a last-minute cancellation fee is becoming more common amongst medical officers. The amount offices charge for a cancellation fee varies, but patients will be more cognizant of appointments if there is money on the line. You want the cancellation to be enough that patients will see it as a deterrent, but not too much that it’ll put them off from coming to your office.

How to track your no-show rate

Calculating your no-show doesn’t require fancy software or a long amount of time. The simplest way to calculate your appointment no-show rate is to divide your number of weekly no-shows by your total number of weekly appointments. 

If your office sees 50 patients per week and 15 of those appointments result in no-shows, then your no-show rate is 30 percent.

15 no-shows per week / 50 total appointments per week = 30% no-show rate

The bottom line: No-shows can cost you thousands of dollars in missed revenue

While no amount of preparation and reminders can reduce your no-show rate to zero, taking advantage of these tips might help you significantly reduce your number of appointment no-shows.

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