Physicians Practice Pearls: Taking No for an Answer

June 1, 2006

Another selection from our popular weekly e-mail newsletter. This issue: dealing with cancellations.


Most medical practices perceive appointment cancellations as opportunities to fit in other patients, accepting them without question if they are made within the office’s required timeframe. Given their perceived negligible impact, staff typically pay little or no regard to tracking or monitoring patient cancellations.

Your practice should attend to them for several important reasons.

Cancellations that are not converted into rescheduled appointments have the same negative impact on your practice as no-shows. Simply because a patient cancels the afternoon prior to her appointment doesn’t always mean you have enough time to refill the slot.

To reduce the number of your practice’s cancellations, clearly define your cancellation timeframe to your patients and staff, and require that they enforce them. Request at least 24 hours’ notice for cancelled appointments. But before you inform patients of a revised cancellation policy, first evaluate how you currently instruct patients to cancel. Canceling an appointment is a frustrating process for most patients. If they must wade through your telephone system to reach an appointment scheduler, spending considerable time “on hold,” reevaluate your system. Provide patients a dedicated e-mail address, phone number, and/or direct access within your phone system to reach your scheduler to make cancellations easier.

Determine your cancellation conversion rate. It should be 100 percent; that is, you should convert all cancelled appointments to other waiting patients who will take the now-available slots. To effectively accomplish this, you will probably need to maintain a waiting list. Don’t break out the ledger cards; maintain your list on an Excel spreadsheet on your shared drive. Include patients’ full names, account numbers, phone numbers, date placed on the waiting list, and current next appointment. Highlight entries in yellow if you are successful in scheduling a patient in an earlier slot. And ensure you cancel the original appointment.

Finally, monitor your cancellations closely. Two practices with which I recently worked determined that a third of their patients who cancelled their appointments never rescheduled. If your practice is too busy to handle the patients it has, this may not be a problem for you. But if lost business affects your bottom line, tracking cancellations may behoove you. Follow up with patients who cancel but don’t reschedule within two business days. If patients don’t want to reschedule, ask why. Monitor the feedback you receive, as it may serve to help you enhance your patient services.

Don’t ignore your practice’s cancellations. Rather, take the opportunity to streamline cancelled appointments, maintain a process to offer them to patients who will show, and monitor the subsequent behavior of patients who cancel. Your practice and your patients will benefit from your efforts.

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 is a Certified Professional Coder. She can be reached at elizabeth@elizabethwoodcock.com or via editor@physicianspractice.com. Learn more about Elizabeth at www.elizabethwoodcock.com.

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