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Physicians Practice Pearls: Getting Ahead of Yourself


How to guard against scheduling too far in advance.

Many practices offer patients checking out from office visits the opportunity to schedule subsequent appointments up to 12 months in advance. While “check out” is the most convenient time for both staff and patients to schedule regular or annual appointments, doing so can have unintended consequences. No-shows, cancellations, and bumps are more common when scheduling too far in advance:

  • No-shows - It’s not uncommon for patients to simply forget about appointments made long ago. Reminders help, but sometimes they can be too late to prevent a no-show. Suppose a patient whose appointment was scheduled a year in advance is in the middle of a Caribbean cruise when you leave a reminder message on her voice mail. To determine if you are scheduling your patients too far in advance, take a month’s worth of no-shows and determine when those appointments were originally made. If a significant portion of them were made six months to a year in advance, you’ve identified a problem that’s easy to fix.

  • Cancellations- Patients booked a year in advance will rarely know of potential meetings, vacations, or other obligations that will prevent them from keeping an appointment. It’s common for them to notice their appointment cards a month or two in advance and realize they won’t be able to make it. Cancellations are a significant improvement over no-shows, but they do require you to cancel one appointment and schedule another, doubling your work. Moreover, because some cancellations are made only days or even hours in advance, they often cannot be converted into new appointments. If your cancellation rate is high (10 percent or more), you may want to revisit your scheduling protocols.

  • Bumps- If your physicians schedule their vacations and continuing education trips at least one year in advance, it’s unlikely you’ll have to bump scheduled appointments. But that’s usually not the case. Many practices strive to obtain physician leave requests at least six weeks in advance. If you find you are rescheduling - or “bumping” - too many patients from their original appointment slots, it’s time to reconsider how your clinicians schedule their own time.

If your practice is affected by the challenges described above, reevaluate your typical “scheduling out” period. You may find that you run into no-shows, cancellations, and bumps if you schedule patients just more than three months out. Ultimately, determining your practice’s ideal scheduling out period depends most upon the specific patient population you serve.

Elizabeth Woodcock, MBA, CPC, is a professional speaker and consultant specializing in practice management. Elizabeth is a fellow in the American College of Medical Practice Executives and a certified professional coder. She can be reached at or via
Learn more about Elizabeth at

This article originally appeared in the October 2006 issue of Physicians Practice.

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