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Breaking Down the Cost of Patient No-Shows

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Breaking Down the Cost of Patient No-Shows

Beyond the obvious scheduling problems that result when patients miss an arranged appointment, no-shows are a complex issue in the healthcare industry. No-shows cost the healthcare system billions of dollars each year. In addition to lost revenue, no-shows can have negative impacts on clinics, physicians, and patients. In order to reduce the number of no-shows at your facility, you may need to employ additional tools.

How no-shows affect clinics

Clinics suffer other financial burdens in addition to lost revenue. Even though the patient did not show up, the clinic must still pay staff members scheduled for check-ins, filing, follow-up scheduling, and additional administrative and care tasks. You may also experience wasted operational costs from having the room ready for a patient who did not show.

How no-shows affect physicians

Physician wages can also take a hit due to missed appointments. Most private and public practices have a fee for service pay structure, with patients or insurance companies paying after the appointment. Insurance companies will only pay their portion if the policyholder receives care, so physicians won’t profit if services weren’t provided (except in cases where a missed appointment fee or other penalty is applied).

No-shows also affect the physician-patient relationship in addition to lost revenue. The physician can’t update charts and other important health information when patients don’t attend. Outdated information may hinder the ability to provide effective care. Physicians miss out on getting to know the patient, which is essential to build a trustworthy physician-patient relationship in which patients feel comfortable disclosing and discussing personal health information.

How no-shows affect patients

No-shows can be costly for patients and have negative impacts on their health in addition to affecting the patient-physician relationship. Some clinics track and enforce penalties for no-shows. Some may enforce a no-show limit (for example, three or more). Others may charge a penalty fee or require you to pay for half of the service fee.

These penalties also can have negative effects on overall patient health. Some patients may discontinue care if forced to pay a penalty. Without regularly scheduling appointments, or by developing a no-show habit, patients miss out on care and underlying health issues are more likely to go undetected.

The reasons patients don’t show

To find a solution for patient no-shows, start by looking into the reasons why patients tend to miss appointments. Research shows young women are more likely to skip appointments. Another study conducted interviews and found the three main issues for patients missing appointments were not understanding the scheduling system, emotional barriers, and perceived disrespect.

Unfamiliarity with scheduling procedures leaves patients unaware of the negative impacts of no-shows on clinics. Most of the patients interviewed weren’t aware there were significant financial impacts for not showing up to an appointment. They assumed that doctors simply moved on to the next patient. Some participants in the study even believed a missed appointment would ease a doctor’s burden if they had a particularly busy schedule.

Emotional barriers that may prevent patients from showing up to appointments often center around a fear of medical procedures. Patients are more likely to skip procedures such as pelvic exams, blood tests, or shots. Some patients may skip an appointment to avoid hearing bad news from the doctor.

Some patients may start out attending appointments, but if they have a bad experience, they are less likely to return. Several study participants who reported missing appointments attributed no-shows to a perceived lack of respect or history of negative encounters. They felt doctors didn’t listen to their opinions, didn’t take their symptoms seriously, and perceived long waits as disrespectful of their time.

Finally, other commonly reported reasons for missed appointments include patients being unable to take time off work, symptoms resolving before the visit, or forgetting about the appointment.

Ways to minimize no-shows

Using cutting-edge tools and enacting streamlined administrative procedures can help reduce the number of no-shows at your clinic. Furthermore, ensuring patients are receiving quality care and positive interactions will encourage clients to follow up on their initial appointments.


For simple issues like forgotten appointments, use a patient engagement software system such as DoctorConnect. DoctorConnect is a full suite of automated communication software that includes appointment reminders and no-show management capabilities.

The appointment reminder feature includes two-way communication, sending a reminder and then prompting an easy auto-response for patients to confirm or cancel a standing appointment. The no-show management feature alerts patients who have missed an appointment and prompts them to reschedule.

Administrative procedures

Some administrative procedures can minimize no-shows as well. Your practice may consider rolling out no-show fees, which can discourage patients from skipping appointments and lead to fewer no-shows overall. Allowing patients to schedule their own appointments also makes it more likely they will show up because they have chosen a time that fits best into their schedule, eliminating issues such as work conflicts.

Maintain a positive patient-physician dynamic

Building quality patient-physician relationships can also improve no-show rates when combined with additional tools and administrative support. For starters, maintaining an efficient patient flow will help minimize wait times and demonstrate that your office values each patient’s personal time. Above all, be sure to address patient concerns and do your best to help clients overcome emotional barriers such as dental or medical anxiety.

What to do when a patient doesn’t show

Even with the best patient engagement practices, administrative procedures, and quality care, the occasional no-show cannot be avoided. When a patient doesn’t show, here are some things doctors can do with unplanned downtime:

  •    Give the time slot to a walk-in patient.
  •    If you wish, give the patient a personal call to find out why they didn’t show.
  •    Catch up on patient medical charts.
  •    Take the time to rest if you need a break.

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