Talk to Patients

Patients miss appointments for a wide variety of reasons — some good, some not so good — and there are methods for addressing almost all of them. In order to address the specific reason a patient stands you up, you have to know what it is. You may be able to figure out what’s causing no-shows in your practice by taking a look at your neighborhood.

“Maybe there is heavy traffic in your area because of a roadwork project, or Friday afternoons are particularly bad because of a football culture in your town,” says Honaker, who practiced in Texas for many years and dealt with this problem first-hand. “Then you can tell your patients, for example, ‘If you get caught in that roadwork traffic and are running late, just give us a call.’” This signals to them that being on time is important, but you understand that issues come up, and perhaps will motivate them to try to be a little more courteous to you in turn. Of course, these approaches require personal relationships with your patients, which may, in the end, be the best way to get a handle on no-shows.

“If a patient is missing a lot of appointments or is chronically late,” says Honaker, “talk to them about it at the next visit. You can be really candid and say something like, ‘Hey, you put me in a bind last week when you didn’t show up.’ This takes both tact and good communication skills, but, if done right, can improve the doctor-patient relationship and solidify the bond. Oftentimes patients would love to arrive on-time for their appointments, but they have transportation problems. The family vehicle won’t start or the buses are running late or the bus schedule doesn’t match your office’s schedule. If you’re an urban practice, timing your appointment schedule according to local bus schedules can help. Rural practices might have to be a little more creative. “Do a cost analysis,” suggests Tina Colangelo, a New York-area consultant for healthcare services and physicians’ practices. “In some areas, it might actually be cost-effective to send Uber to pick up a patient.”

The millennial demographic poses unique challenges, and therefore you need novel solutions. Denise Pate, MD, an internal medicine physician, has found millennials tend to prefer online booking. However, their high cancellation rate can offset the convenience of online scheduling. One might think that voicemail reminders would be great for this high-tech, on-the-go generation, but Pate has had difficulty contacting this group. “When the office calls them, they may not have set up their voicemail or the mailbox is full. If you leave a message, they may not respond,” she says. When it comes to keeping appointments, millennials tend to be less reliable than older patients. “For this group, you have to have a same-day, next-day strategy,” says Elizabeth Woodcock, president of Woodcock and Associates. “Booking a month in advance just won’t get it.”

Of course, all of these techniques require knowing your patients and understanding their lives and situations. This may lead to a very obvious, but often overlooked, strategy. “One of the best things you can do,” says Colangelo, “is to ask your patients what kinds of scheduling, reminders, transportation solutions, and so on work best for them.”