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Facing high patient ‘no-show’ rates? Here are five ways to ensure patients show up for their appointments

15th June 2022

Facing high patient ‘no-show’ rates? Here are five ways to ensure patients show up for their appointments

When a patient misses their appointment again, especially on the busiest day of the week, it could be frustrating for your healthcare practitioners and clinic assistants. No-shows and cancellations affect clinics both financially and operationally. Past research revealed that patient ‘no-shows’ cost the U.S. healthcare industry US$150 billion annually, and missed appointments consume an average of 14 percent of a clinic’s daily revenue. Regardless of a patient keeping to their appointment, the clinic still has to incur manpower costs and has to cover daily overheads like rent and the cost of equipment.

Aside from financial and operational reasons, the impact on patients is the main ‘cost’ of no-shows as patients do not get the care and consultation they need. High no-show rates can result in poor health outcomes. Furthermore, they can lead to reduced care quality, higher patient attrition rate and missed opportunities to care for other patients.

If clinics can reduce their no-show rates, they have increased opportunities to improve patient care and consequently reduce cost of lost revenue.

What are the reasons for no-shows?

It is inevitable to have no-shows in your clinic. Recent studies have shown that on average, one in four patients in Singapore do not show up for their appointments. There are many reasons why a patient might miss their consultation. The number one reason is simply forgetting about it. However, patients have also cited other causes, including transportation issues, arriving late, last-minute errands, emotional barriers, and sometimes it can even be a result of not getting an appointment confirmation.

The time period between the act of booking an appointment and the actual appointment, does have an impact on appointment absenteeism. According to a Canadian study, appointments booked 15 days or more in advance accounted for nearly a third of no-shows. If an appointment is booked too far in advance, patients are more likely to skip it. They either forget about it, or other obligations emerge as the date approaches.

What can clinics do to reduce no-show rate?

Here are five ways that you may find helpful in encouraging patients to show up for appointments:

  1. Set up appointment reminders
  2. Reschedule right away
  3. Keep a waitlist
  4. Identify chronic no-show patients
  5. Have a clearly written policy

1. Set up appointment reminders

Appointment reminders are an effective way to get patients to turn up and reduce your no-show rate. Most people simply forget their appointments; they do not intend to miss them. A courtesy call, email or text message might be all that is needed to remind patients to show up for their appointments. Studies have shown that appointment reminders improve no-show rates, wherein one study improved no-show rates by 10 percent.

Traditionally, staff do phone call reminders manually, which is time-consuming and ineffective – with many calls ending in voicemail. So, the question will inevitably arise: Is there a better way to remind patients about their appointments? Thankfully, this is a routine task that can be automated easily. Patient reminder automation benefits your clinic in several ways:

  1. It performs the job quickly and automatically
  2. It improves patient satisfaction
  3. It reduces the clinic's no-show rates

How it works: You specify when you would like to send the reminders (for example, sending a reminder 1-2 days prior) through the patients' preferred mode of communication (yes, you could also record patients’ preferences), stating the appoiintment details clearly. You could also include an option to reschedule the appointment, which demonstrates flexibility on your part and yet allows you to reduce the possibility of a no-show.

A simple appointment reminder like such could do wonders for improving no-show rates.

You can integrate patient reminder automation into your practice management system as an extension to your current workflow. It is a seamless and smooth experience, from appointment booking to appointment reminder.

2. Reschedule right away

When patients do not show up, do not wait to reschedule. Instead, reach out immediately and offer to reschedule to a later timeslot on the same day. Research revealed that same-day appointments are effective in getting patients to turn up.

Rescheduling no-show patients demonstrate care for your patients. Furthermore, you reduce patient attrition when you slot in their next appointment.

The quickest and most convenient way to reach patients is by utilising the reschedule feature on your Practice Management System (CMS). A CMS is suitable and essential for most types of medical practices, including general practitioner and dental, or the allied health services such as chiropractic and physiotherapy, or even that of aesthetics. A good CMS helps with appointment management and should have a rescheduling functionality that allows you to send an email or text to the patient to reschedule.

3. Keep a waitlist

A waitlist allows you to fill appointments when patients cancel at the last minute. If you have a no-show or last-minute cancellation, your staff can refer to this list and attempt to fill the slot quickly.

Waitlists also provide a treasure trove of data on patients' preferred appointment times – information which you would not have if you do not have a waitlist. The insights enable you to make data-driven decisions on doctors' schedules. And if your waitlist gets too long, it might be the right time to open up more slots in the clinic or offer slots at the next nearest clinic.

4. Identify chronic no-show patients

Patients who often fail to show up for their appointments without prior notice could be singled out for a tailored approach. After all, it is unnecessary to implement blanket-wide rigid measures when it could be the same few patients who frequently miss their appointments.

For example, the Integrated Health Information Systems (IHiS) developed a No-Show Predictive Model that uses risk profiling to identify Specialist Outpatient Clinic patients with a high risk of defaulting on their upcoming appointments, for more focused intervention. Patients with higher risk scores can be sent reminders and healthcare staff can further contact them to confirm the appointment, or if there is a need to reschedule the appointment.

Having sufficient data collected from your patient visits (or no-shows) can give you better insights, and allow you to possibly also identify such patients before they cost you further.

5. Have a cancellation policy

Have a cancellation and no-show policy clearly written and stated on your communication channels with your patients. State the policy in writing on the appointment booking platform, at the clinic front desk, and in email, phone or SMS appointment reminders. With a written policy in place, patients are clear on their commitment to the appointment, and it holds them accountable if they do need to cancel their appointments.

There is no one single policy that is applicable for everyone, which results in clinics implementing policies of multiple variations. The rule of thumb is to have your policy clearly stated and communicated to your patients prior to effecting any charges on the patients. In this way, the clinic and the practitioners can still be appropriately compensated for the reserved timeslot that could have otherwise been utilised for the treatment of another patient. At the end of the day, the policy is in place to deter no-shows and encourage patients to keep to their appointments.

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