The Tech Doctor: No More No-Shows

October 1, 2007

How technology can help keep your waiting room full.


You know that each no-show patient per day creates a gap in your schedule, and you may be among those physicians who breathe a sigh of relief when a few extra minutes are freed up during a busy day. You have an unexpected break during which you can return phone messages, attack that pile of test results on your desk, or just take some time for yourself.

But you also know the impact that no-shows can have on your bottom line. Like some physicians, you may think that such patients are simply inconsiderate, but in today’s fast-paced world it’s easy for the most conscientious of patients to forget a trip to the doctor’s office scheduled long ago. So how can you help your patients keep their scheduled appointments and help your practice run more efficiently?

Technology to the rescue

Automated telephone reminder systems have been around for several years and have proven to be an easy-to-use, effective technology with a rapid return on investment. They require no special interface, which means no tacked-on fees after they’re purchased. In general, the bigger players in this field (MedVoice, PhoneTree, TeleVox, and JulySoft) operate by using an output file from your practice management system - your daily schedule report. If you’re still using pencils and an appointment book to schedule, you can opt to fax your handwritten schedule to a vendor, which will generate the calls. That’s right - no more excuses!

If your staff is personally making appointment reminder calls, you may find that this task typically gets pushed back until the end of the day, and it may not always get done. An automated reminder system can be programmed to call patients at whatever time of day you wish, freeing your staff to spend more time attending to the daily needs of patients and providers. Such automated systems also document the results of each reminder call, giving you extra liability protection within the patient-care arena. Most systems generate a report that tags each call with a date-time stamped result, informing you if the patient was reached, if the phone went unanswered, or if the message was picked up by voice mail.

If you work in a culturally diverse area, do you retain bilingual staff? You can program your reminder calls in many different languages, and you’ll find that this simple option is greatly appreciated by your patients. They will grow accustomed to receiving reminder calls and even rely on them to help them stay on schedule themselves.

Many practices believe that automated reminder calls are impersonal, and that requiring staff to make such calls adds a “personal touch.” But have you ever really listened to your staff make those calls? It’s not a particularly fulfilling or challenging task, so it often falls to the least experienced or newest staff member. Without proper phone etiquette training and an understanding of the marketing impact of even their tone of voice, your staff’s “personalized” reminder calls may in fact work against you. An automated reminder system can project a positive image of your practice by delivering a consistent, professional message to your patients.

And remember, you can customize the same software that generates reminder calls to communicate with your patients in their preferred medium, such as e-mail or text messaging.

And many such tools offer much more than simple reminder calls: They can recall your patients when it’s time to schedule a follow-up or an annual exam. They can alert patients to overdue balances or make them aware that their test results are in. They can even extend birthday greetings.

Internet-based versions of this technology require no special software or hardware, as is the case with appMINDER. With this product, you enter patient names, phone numbers, and appointment times, and they subsequently receive a phone call reminding them of their scheduled appointment.

So not only is the technology there, it’s easily accessible in many formats. Not sure which application would best fit your practice? Check out product Web sites for free trial periods and do some experimenting.

Self-scheduling via the Web

If you really want to go wild, allow your patients to schedule their own appointments that fit into their calendars - that will eliminate no-shows.

Think of all the Internet-based, self-service goods and services your patients are already accessing each day: They select their specific airline seats via the Internet. They purchase tickets and select seats for theater and concert performances. Why not let them select their preferred appointment dates and times for physician office visits? After all, the Internet never closes. If midnight is an easier hour for them to schedule an appointment, it’s no problem. No more waiting for the office to open the next day and then sitting on hold as your staff fields a deluge of calls.

With online scheduling applications, patients can enter the parameters of their appointment request - that is, they can indicate which provider they want to see, which office location they wish to visit, and which type of appointment they require. The system then presents them with available calendar dates from which they can choose open time slots. Patients see only those slots that are open and that match their criteria - just like selecting an airline seat online.


The word will quickly spread that yours is truly a patient-focused practice.

Rosemarie Nelson is a well-known healthcare technology guru and principal with the Medical Group Management Association’s Health Care Consulting Group. She can be reached at RosemarieNelson@alum.syracuse.edu or via editor@physicianspractice.com.

This article originally appeared in the October 2007 issue of Physicians Practice.