Awkward. That's likely the word that comes to mind when you or members of your staff think about confronting patients who have a habit of arriving late -- or not at all. Discussing a patient's penchant for no-shows takes a bit of fancy footwork at the very least. Mishandle the situation and you may lose a loyal patient.

But, if you're tempted to look the other way, consider the economic impact. Missed appointments not only disrupt the flow of your office, they can affect your bottom line. Wasted time is lost revenue. And that's a luxury many practices cannot afford.

Missed Appointments: Who's at Risk?

Who is most likely to miss an appointment?

Factors associated with missed appointments include:

  • Length of time between scheduling and the appointment date;
  • Day and time of the week;
  • Doctor-patient relationship;
  • Severe weather conditions;
  • Whether or not payday has arrived;
  • Patient satisfaction; and
  • Urgency of the appointment.

One of your best lines of defense may be to not only establish and implement a general office policy for broken appointments, but to ensure your staff members are well versed in it. The same goes for your patients. They should be fully aware of your policy.

Many practices send patients out the door with an appointment card that's intended to be dual purpose -- reminding them of their next appointment as well as informing them of your office's policy. An example of common verbiage is: "If for any reason you cannot keep this appointment, please call our office at least 24 hours in advance. There will be a fee for missed appointments."

It's a great start, but it may not be enough. Consider making your patients much more active participants by either adding your practice's policy to your office's financial agreement form or, if you don't have such a form, creating one geared specifically to your missed appointment policy. Then, be sure that your patients not only read, but sign, the policy. You're likely to get better results if you can pull out a form which details your missed appointment policy -- acknowledged with the patient's signature.

But a written policy is only your first line of defense. Here are a half-dozen more tips to help encourage your patients to keep their appointments.

    1. Train your staff. All staff members – including your business team, nurses and assistants – need to work together to help make sure patients are aware of your office policy. Consider scripting and practicing a few standard replies in case staff members find themselves tongue-tied when they're in the moment.

    2. Educate your patients. There's a good chance the latecomer isn't even aware of the havoc a few minutes can wreak as your staff scurries to make up for lost time -- or the costs associated with a no-show. A simple reminder that missed appointments cost the practice money and consequently cause fees to be raised can be very effective.

    3. Confirm appointments. While it's true that answering machines and voicemail have eased the burden of appointment confirmations, it also may be time to consider a new twist on an old idea. Perhaps your patients would prefer (and respond better to) an email confirmation of their appointment, or would prefer that you use their cell or office phone number over their home phone. Consider surveying your patients to find out which method of delivery they would find most convenient and effective.

    4. Emphasize the potential consequences of a missed appointment. Be specific and forthcoming. Let your patient know, for example, that he or she may risk complications as a result of delayed treatment. Patients are much more likely to respond if they are aware of the possible negative impact a missed appointment could have on their health as well as their pocketbook.

    5. Offer incentives. Even the smallest rewards can reap big results. Incentives for keeping a series of appointments can range from a treasure chest of small toys from which young children can choose a prize to a free movie pass for the grown-ups.

    6. Visibly display your policy. Your missed appointment fee policy should not only be clearly stated in your office's welcome letter or brochure, but also on signs posted on the wall or desk near the reception and checkout areas as well as on your practice's website. You should also train your staff members to routinely remind patients of your office policy at the time the appointment is scheduled as well as when it's confirmed.

If you have a patient who, despite all of your efforts and warnings, continues to be a habitual offender, it's time to follow through by tacking your missed appointment fee onto his or her bill. Sure, you risk the possibility of upsetting -- or even losing -- a patient. But, if that patient's unwillingness to follow your office policy is costing your practice time and money, it may be a necessary step.

These are just some of the steps your practice can take. Most of the approaches can be implemented with minimal effort, yet provide significant protection against schedule interruption in the short term -- and the financial drain on your practice over the long haul.


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