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Stop Losing Money on No-shows


Most practices breathe a sigh of relief when a patient fails to show up for his appointment. But, those unfilled appointments add up quickly. Here's how to plug the holes in your schedule.

It’s unreal how often I hear someone in a medical office express relief when a patient doesn’t show up for her appointment. It’s like, hey, we are already busy and struggling to manage our day, so a missed appointment is no big deal.

Wrong! It’s a very big deal when patients miss appointments. It compromises their health and your bottom line. It may seem like missed appointments take some of the stress out of days that otherwise seem out of control, but in reality no-shows are a silent revenue thief that cost you plenty.

Consider a practice with an average of four missed appointments a day (which is fairly common); if the value of those appointments is estimated at $150 each, it’s costing you $144,000 a year in lost revenue. That’s based on a modest assumption of a schedule that covers five days a week, 48 weeks a year. Add another estimated $9,800 in labor costs to schedule, reschedule, and manage the paperwork involved with missed appointments and now the loss is over $150,000 for a single physician. Physicians simply can’t afford this kind of loss and shouldn’t ignore a problem of this magnitude.

Here are some simple steps to get a better grip on your schedule:

Appointment types. The first step to fixing the problem is to schedule more realistically. Start by examining the primary reasons for office visits and the types of patients seen in your practice, and then identify a realistic appointment duration for each type of visit. Doing this eliminates the typically allotted 15 minutes per patient, allocating the appropriate amount of time for each patient type. Many practices have adopted 10-minute appointment slots for added flexibility; this accommodates patients that need more than 15 minutes, but also recognizes that some appointments can be managed within 10 minutes.

New patients. Manage your schedule even more effectively by strategically spreading the new patient appointments out over the day, since they typically require more administrative and clinical time. Rather than scheduling three new patients in a row, sandwich three established patients between each new patient. Then honor the schedule by starting on time and limiting the double-booked patients to established patients who are scheduled next to a new patient. When the new patient is dealing with patient registration and preliminary nursing duties, the physician can be seeing the established patient. This makes sense and is a good use of everyone’s time.

Confirm appointments. Confirm appointments several days in advance. There are great automated systems to accomplish this so your staff doesn’t get bogged down making phone calls. Give your patients a clear message on respecting the commitment of their appointment with the words you chose. When scheduling appointments tell the patient “we are expecting you at 3 p.m.,” rather than “I’m squeezing you in,” which implies they’ll never be missed. The same is true when confirming appointments. “We are confirming (not reminding) your appointment. Dr. Wise will be expecting you at 3 p.m.” And never say “If you can’t make it, let us know.” This implies you are giving the patient permission to cancel.

In the end, keeping no-shows to a minimum is a matter of building a relationship that values time - yours, your patients’, and your staff’s. Everyone gains when the schedule is honored. It results in a better-managed day, improved compliance, better care, and increased revenue and customer service. So take control; make it a reality in your practice.

Judy Capko is a healthcare consultant and author of the popular books Secrets of the Best Run Practices and Take Back Time. Based in Thousand Oaks, Calif., she is a national speaker on healthcare topics. She can be reached at 805 499 9203 or judy@capko.com.

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