If scheduling appointments is what keeps a practice pumping, patient no-shows are the plaque that clogs the system. You could give the best care in the world but it doesn’t mean anything if you can’t get people in your doors.
There are many reasons why people don’t show up to appointments. So reducing no-shows is a balancing act. To do it right, you’ll have to continuously test different ways to see what resonates best with your patients.
But there are a few tricks of the trade to ensure appointment fulfillment...
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Keep a Telehealth Waitlist
If someone doesn’t show up to their appointment, your practice needs to fill the empty slot with someone on a waitlist. Believe it or not, this list further protects your practice’s revenue.
So how can you make such a list?
Stay in constant contact with your clients and ask them the days of the week and times they’re usually available. That way, you might be able to salvage a no-show. If someone doesn’t show up for their appointment, check that list and reach out to the patients and see if they’re available for a telehealth check-up.
Telehealth provides instant accessibility. In other words, it allows your clients to show up to the last-minute appointment without any added delays or stress. Not to mention it also boosts your practice’s overall patient experience due to its convenience.
Using your daily appointments and “on-call” telehealth schedule in tandem establishes a process that allows your team to fill in empty spots quickly upon no-shows. Not only that, but it also helps your patients keep their appointments even if they can’t show up in person.
Try to Reschedule Right Away
If you wait to reschedule someone who didn’t show up, there’s a good chance they will not call you to reschedule. This means that you probably just lost a patient.
The first step is to make sure that they didn’t just forget, lose track of time, or get stuck in traffic. If your patient hasn’t shown up, wait 10 to 15 minutes and call them.
The tone of this phone call is extremely important. Make sure you come across with a concerned tone. You don’t want to sound like you’re accusing them of failing to show up. If you do, then you may alienate them, causing them to go to a different practice.
Additionally, calling your no-show patients helps establish a connection. If they feel like you and your practice truly care about their well-being, they’re less likely to be a no-show again.
If you leave a voicemail and the patient calls you back after their appointment has ended, make sure to reschedule their appointment.
You should also make sure to ask why they missed their appointment so you can help them avoid a no-show in the future.
Implement Proactive Scheduling
This tip is for the smaller practices, the ones that can recognize the different faces that come through the door. Some practices can easily recognize the faces and names of the people who are always late by 15 or 30 minutes and who expect to still see their doctor.
If this sounds like a similar scenario to you, or if you can easily picture a patient that does this consistently, then you should implement proactive scheduling.
If someone is always 30 minutes late and they have an appointment at 11:00, be proactive!
Tell the patient that they have an appointment at 10:30. This means that your patient will arrive on time when they think they are running late as usual.
Additionally, you can create a 15minute buffer policy.
Put a policy in place that says patients need to check in 15 minutes before their appointment. This means that if someone is running 5 or 10 minutes late, they will still be able to start their appointment on time.
If you already have a policy like this in place, consider a more lenient time window.
Automate Appointment Reminding
Ask yourself this question. After someone schedules their appointment at your practice, do you ever remind them about it? Most practice owners would say yes. If you don’t, know that the majority of practices with no appointment reminding in place have an average patient no-show rate of over 10%.
But what’s more important is how this process occurs.
Your appointment reminding process may be manual. This is usually the more popular option for smaller, family-owned practices. But that opens up the door to mistakes.
For example, maybe it’s flu season and your office gets swamped. If this happens, your staff isn’t going to focus on reminding future patients about their appointments. They’re going to spend their time tending to the people in your waiting room.
By establishing an automated appointment reminding system you and your staff can set it and forget it. Better still would be if your system is AI-driven.
Once established, however, make sure your scheduling system prioritizes convenience. An automatic system may disregard dates and times your patients prefer.
If this happens, you could get in trouble. The University of Missouri found that convenience controls 33% of the probability that people show up for their appointment.
Use Multiple Methods But Don't Overdo It
Everyone has a preference on how they communicate. For instance, I bet you could list off a handful of people you know who don’t like texting right now. On your other hand, you could list people who live on their smartphones.
This goes to show you that people have different communication preferences. While trying to decrease patient no-shows, take this into account.
When someone schedules an appointment with you, ask them their preferred method of communication. They’ll be glad to tell you and much more receptive of appointment reminders catered to their preference.
If you send reminders without asking about preference, you’re losing money. A University of Kansas found that postcard appointment reminders had little effect on no-show rates. Although some patients may appreciate this medium, others don’t even check their mailboxes. Postage isn’t inexpensive.
By offering multiple methods, you’ll notice an immediate drop in patient no-shows. This is especially true if you tailor them to how people prefer to communicate. A study published way back in 2004 found that the no-show rate of those who received email reminders decreased by 35%. That study’s almost twenty years old and still holds relevance today.
However, you mustn’t overdo it with appointment reminders. If you send too many through multiple mediums, it gets overwhelming. Worse, it could come off as spammy. You need the perfect mix of reminders sent at the right frequency.
The "Sorry We Missed You" Sales Tactic
This strategy comes straight from a tactic used by many professional salespeople. After all, isn’t getting patients to come to their appointment similar to landing sales demos?
The last thing you want to do is guilt your clients who don’t show up. If you go the guilt-trip route, they’ll go out of their way to change their doctor.
However, you may have a bit more success by acknowledging the appointment attempt.
Send them this message through their preferred method of communication you found out when they first set the appointment.
Always be sure to give them a few different options so that you’re accommodating to their needs. These also make it easier for them to respond to since they won’t have to think of what to say back to you.
Salespeople use this tactic so often that I'm positive you've received an email that uses this strategy at some point. I’ll bet you have one in your inbox while you're reading this.
Draft and Enforce a Patient No-Show Policy
You more than likely know someone who’s never on time for anything. Even worse are those who always excuse themselves from plans. If people in your life continue those habits, you eventually stop inviting them. Eventually, they’ll reach out to you and ask you why you don’t invite them to events anymore. That’s a form of social penalty.
At some point, you’ll run into patients who act the same way. No matter what they schedule their appointment for, they never come. The most effective strategy to get them through your doors is by drafting a strict no-show policy and enforcing it.
It doesn’t have to be more than one page in length, as long as it gets the point across.
Let’s take a look at UNC Hospitals Neurology Clinic’s documented no-show policy.
The clinic groups and defines their no-show policy with same-day cancellations and late arrivals. At the top of the page, the clinic defines what they view as a no-show, “...any patient who fails to arrive for a scheduled appointment.”
After defining everything, they describe the actual policy.
Like most healthcare policies, it contains general yet specific enough information to understand what’s expected. The more specific language comes into play within their “Procedures” section.
What’s so great about how this clinic handles its no-show policy is its categorization. They have different rules for established and new patients. Categorizing their policies in this way makes it much easier to understand.
An established patient at the clinic has up to three excused no-show appointments before they’re subject to dismissal.
If a new UNC Hospitals Neurology Clinic patient doesn’t show up to their appointment, they require a new physician referral.
Neither established nor new patients at this clinic have much leniency with no-show appointments, there’s no wiggle room. That’s another testament to their policymaking.
Establishing a defined policy for no-shows will make your life much easier. It doesn’t have to be as detailed as UNC Hospitals Neurology Clinics. But it’s another great strategy to try and avoid them from happening.
Once you’ve drafted your policy, display it in your waiting room, on your website, and give it to those who miss their appointment. That way you place the responsibility to visit your practice back on them.
Don't Overbook, Keep a Slim Waiting Room
When you go to the amusement park, what’s the first thing you do before getting on to a ride? You check the waiting time. Most people don’t like waiting in a three-hour line for a thirty-second ride, it’s not a valuable use of their time.
Unfortunately, most people don’t view coming to the doctor on the same level of excitement as going to an amusement park. That’s what makes it so vital for you to ensure you’re not overbooking your waiting room.
Now, not even the most popular hospital systems have three-hour wait times. That’s not what’s most important about the analogy above. It’s that people often evaluate what’s valuable to their time.
This is especially true in healthcare. A qualitative study found that 44% of patients view long appointment wait times as a sign of disrespect.
You can’t blame them for holding those feelings, it coincides with societal norms. A study found that the majority of people get agitated when it takes 14 minutes or longer for food at a restaurant. Keeping up to date with the latest techniques to speed up your waiting room.
Offer Transportation Options
Maybe the problem isn’t your clients forgetting or not wanting to come to their appointment. Maybe they don’t have a way to get to you easily. After all, transportation isn’t always the easiest (do you know your public bus’ schedule?).
Similarly to displaying your no-show policy in your waiting room, send out public transportation schedules. Even those who don’t use public transportation may still keep them as a resource in case of an emergency.
Now, not everyone is comfortable with using public transportation. That’s why it’s not a bad idea to partner with a rideshare service. Back in 2018, Lyft partnered with Hennepin Health to offer ridesharing to their clients. After one year, the healthcare company’s no-show rate decreased by almost 10%.
Ridesharing companies recognize how they could help healthcare’s no-show crisis. Uber announced its healthcare-specific ridesharing service, Uber Health, in March of 2018. Since then, they’ve partnered with massive health companies to drive people to their appointments.
Some tech companies flip that process around and drive the doctor. In October 2019, Alignment Healthcare partnered with the Heal app to offer in-home primary care. This way makes no-shows near impossible to happen and avoids exposing illness in the waiting room.
Reward Those Who Show Up
Lastly, we need to recognize those who show-up. One of the best ways to encourage people to keep coming back starts by developing a strong relationship with them. It’s essential to instill the human element into your practice.
It starts with telling them how much you appreciate them showing up. But it doesn’t have to end there. Send your tried-and-true handwritten…
Thank you cards
Birthday cards
Holiday cards
Newsletters
These small touches go a long way. But establishing a relationship this way takes time.
What if they’re new?
A faster way to show appreciation is by discounting medical bills. It doesn’t have to be much, just enough that it’s noticeable.
If discounting medical bills isn’t an option, you could offer giveaways. Put the name of every patient that shows up into a drawing for a prize and run these monthly. This will motivate your clients even further. The prizes don’t have to be anything that hurts your bottom-line they could be gift cards, iPads, a laptop, etc.
Conclusion
I know what you’re thinking, “Getting new clients is hard enough. Now I have to worry about getting them to show up too?”
It may seem impossible to get your clients to show up to their appointments. But to many healthcare companies, these strategies aren’t groundbreaking. Rather, they’re commonplace.
Once you’ve mastered each, you’ll conquer patient no-shows. You can then focus on other important aspects of running your practice.
