7 Ways Doctor Offices Can Reduce Patient “No-Shows”

Vinay Nagaraj
Vinay Nagaraj

Guest Post by WAE Technology

Chances are your office is doing everything possible to reduce patient no-shows, but sometimes those prevalent ones stick out like a sore thumb.

Life Happens

However, unforeseen events, such as “life happens” take over the issue.  Sometimes you can’t help the situation.  For instance, a person got a flat tire, their child got badly hurt, or their loved one died.  Therefore, empathy is needed to understand what someone is going through.  Now lets just put all those unfortunate issues aside for now and focus on how we can make it better for both the patient and physician.
In my previous blog articles I’ve talked about several methods you can use right now to reduce patient no-shows, but I’m going to discuss the tools, management, and ways to reduce patient no-shows.

Management Scheduling

I noticed some doctor offices schedule their patients way in advance.  While doing research, a patient on Quora mentioned his doctor had scheduled his appointment 6 months out and expressed it was a bad idea.  A patient scheduled out way in advanced was more likely to forget or not attend their appointment at all.

How to fix management problem?

Put all your top “no-show” patients into a list and make them a top priority.  For example, use multiple tools to remind patients, such as email, online booking systems, text messages, and phone calls.  Sometimes people need more reminders, especially if their appointment is scheduled 1 month or more in advance.  Besides I even have a hard time remembering when to go to the dentist.  In fact, I forgot my dentist appointment three times because it was 6 months prior and the receptionist called me a week in advance.  Sorry, but I’m forgetful.

7 Ways doctor offices can reduce patient “no-shows”

What can management do?

  1. Implement a medical online booking system to reduce patient no-shows

For a better patient experience, let the patient book his appointment online.  This would save the staff and patient less time.  Thus, save money and resources.  For example, decreased overhead costs, decreased staff overtime, no paper print outs and reminder cards.  The physician deals with another patient instead and everyone is happier.
Allow the patient to book in a week advanced.  The less the waiting time the better because it decreases no show rates dramatically.  People tend to show up with less time periods in between.  For example, If I booked my appointment 1 or 2 days before or even the same day, I’m more likely to remember.
Another suggestion would be to call the person 1 day prior to confirm their appointment as a second reminder.  By reassuring the patient, it will reduce patient no-shows significantly.

CASE STUDY: Web-Based Medical Appointment Systems: A Systematic Review

Studies shows a significant reduction by web based and software appointment booking systems.
Data Sources from web based booking systems:
  • Siddiqui et al [] reported a no-show rate of 6.9% for dermatology appointments made with ZocDoc, significantly lower than the no-show rates of appointments made by traditional appointment making means (17-31%).
  • The UK national online electronic referral and booking service “Choose and Book” was reported to have a significantly better rate of attendance than traditional appointment methods (95% CI 4.3, 20.5%, P<.01)
  • Walters et al [] reported the Web-based communication tool “Patient Online” reduced patient no-shows by 42%. 
Medical online booking systems would be a fantastic option to add to your practice to reduce patient no-shows.

Related articles on medical online booking systems to reduce patient no-shows

Online Booking Systems Review: Demo and video

2. Tackle the Underlying Issue

Patrick Randolph of Queue Dr suggested to have the patient pick the time slot.  I believe this is a great idea.  If you give people options, I believe they will stick to it.  Remembering is hard, so why not let them choose.

If you ask them “what time will work for you morning or afternoon?”, they can tell you either option then give a time slot.  For example, if you let them choose 1 or 2 pm, they agree and then you schedule them in right there.  The patient writes down the time on their calendar and it makes a better impression in their memory.

According to Patrick Randolph Founder of Queue Dr, explains that giving patients the right to choose is powerful because it gives patients access to select their own time slots to fit their busy schedule.

3. Automated SMS and Email reminder service

Having an automated system for SMS and email is one the best ways you can implement in your business or medical practice.  You can have it all connected to increase the patient experience and ease the burden off your staff.  You can schedule notifications for SMS and email to each individual.  Remember the no-show priority list of those people, automation can be useful for these patients.

Keith Fletcher, a web based software solutions and applications for smart business, mentions if you keep all your appointments in an electronic calendar then you should consider a SMS and email reminder service.  He says, “most people are busy and will not bother to show up, but if you prompt them a few days before hand there’s a good chance they’ll show up or reschedule their appointment.

All is not lost and you still fill the time slot for a later time.  No money lost there.

As a matter a fact, Wae Tech Solutions has automated SMS and email reminder services to help medical clinics with scheduling.  Reduce patient no-shows significantly and watch your business grow.  It’s a great resource, so if you need any consultation I’ll be happy to assist you.

Twilio has made it possible to customize text notifications, reminder appointments, chat systems and voice notifications to implement into an application.  Developers such as myself can build web based or mobile applications to fit a health care system’s needs.  It’s an excellent cloud based communications system for all types of businesses.  To create an application, contact me anytime.

4. Partner Up with a Startup

I actually really love this idea because it allows a practice to leverage unique startup company inventions.  One startup has focused to reduce patient no-shows by helping health care providers to book rides for people to their appointments.  This idea has offered hospitals in the Philadelphia area an option to their patients that have trouble with transportation.

Why partner with a startup?

For example,  Ankit Mathur, the co-founder and chief technology officer of RoundTrip, a startup company that is trying to offer a solution to reduce transportation costs for people and reduce costs to the healthcare system is creating opportunity in the market place.  Mathur claims that people don’t have reliable transportation, so RoundTrip decided to partner with hospitals and clinics to eliminate that costly problem.

The startup has made strides and now is partnering with healthcare systems in 20 states including Mount Sinai Health System in New York, Cooper University Health System in New Jersey and MD Anderson Cancer Center in Texas. In the Richmond area, the company is participating in GRTC Transit System’s CARE On-Demand, a pilot program to transport disabled passengers.

5. Offer incentives


People love getting rewards for being a good customer.  This has worked for children when I was teaching 15 years ago.  I had an incentive program for well-behaved children in my classroom.  For example, Tommy is a good boy that never talked loudly, always raised his hand to answer and set a good example by teaching other kids to be quiet and listen.  Tommy gets to add some play money to his bank.  Tommy gets to lead the group for his good behavior.  Tommy gets a piece of candy.  Do you see the effects on reinforcing good behavior? Imagine the possibilities of reduce patient no-shows, this would be unbelievable.

What if this could work for adults?  Do you think an incentive program could be beneficial for your clinic?

Here’s what one expert says…

For example, this one clinic had patients play a game.  How did this go?

Well, the incentive program was successful.  Revenue increased to 30% in the clinic.  According to Aron Ezra, CEO of Offer Craft Published in the Strategic Health Care Marketing, mentioned games yielded double and triple digit increases in compliance with the health care desired action.  Patients enjoyed the game.  The outcomes were a short term behavioral change and a long-term behavioral change.

They borrowed the idea from behavioral economics to include incentives to patients.

Here’s how it worked

When patients came to pay their bill at the counter they spinned a wheel for a prize.  Some of the gifts included: $10 gift cards, $50 gift cards and a $150 gift card.  When they made their appointment for next time, they couldn’t receive their prize until they showed up for their following appointment.  This made patients want to claim their prize, therefore the medical clinic was able to reduce patient no-shows dramatically.

Even though they had to spend some money to attract these people, it paid off in the long run.  The money spent was just a small fraction and the clinic ended up increasing their revenue.  So I would agree that having incentives can reduce patient no-shows a lot.

Could this work for you? Why not try it out?

6. What about charging patients to reduce patient no-shows?

According to Brandon Bentacourt, a physician who wrote the article “Should patients be charged for no-shows?”, mentioned that charging patients a fee for a no-show would be a hassle.  He explained that collecting money from patients is already hard enough, so why make it more difficult.  Hunting down a parent for a service that he didn’t perform is already bad itself.

What is the intent of charging a patient?

Charging for a no-show serves two reasons.  Those two reasons include: to prevent them from being a no-show and to offset the cost of an appointment.  However, does this really deter a patient from not showing up?  Will this make up for the loss of revenue?

To charge or not charge?

Physicians grapple with the idea all the time.  An article entitled Should you charge your patients by Care Cloud, argued if your clinic had a co-payment of $25 and gets reimbursed $90 for each visit and there’s 2 no-shows per day, it costs the clinic an average of $64,800 per year in lost revenue.  Therefore, when there’s significant losses, charging a fee to reduce patient no-shows makes sense.

7. Have a good cancellation policy to reduce patient no-shows

According to Chantal Oicles, a marketing director at Reminder Services, mentions that without a good policy you have higher no-show rates, higher cancellation rate and gaps in your schedule.  Having a cancellation policy also works as a deterrant rather than a punishment.

What is the goal?

The goal is to give enough time for the person to cancel the appointment.  This will give the staff to search for another patient to replace the open slot.  A successful cancellation should be a contract so the patient agrees to cancel in the allotted time for example, you must cancel in 24 hours of your scheduled time.  Also, make it clear to the patient to avoid any confusion and give examples.  Mentioning 24 hours is not enough.  The policy also must be clear for staff members, so they have procedures to follow when someone cancels.

Stop telling patients to cancel

Another point Oicles makes is to stop telling patients to cancel their appointment.  It almost sounds like you’re telling them to cancel or making it too easy for them to cancel.  When you have a phone system telling you 1 to accept and 2 to cancel, it kind of makes it easy for people to delete their appointment.  Instead, you can have them press 1 to schedule an appointment with the receptionist or press 2 if you have any questions.


If you have any questions or concerns, please leave a comment below.  If you have other ideas to reduce patient no-shows definitely leave me a comment.  I’m always on the look out for suggestions.