Reducing No-Shows / Reducing Missed Appointments


So, you are seeing too many no-shows or patients missing their scheduled appointments in your practice.   Here are some things to consider...

WHY - WHY - WHY...

Figure Out Why Patients are Missing their Appointments: Ask patients why they are missing appointments.  Don't stop at the first answer that you are given, but continue on to ask "Why?" several times until you hear what is the true or "root" cause of their failure to show up.  

Example: Why did you miss? "I forgot"... Why did you forget? "I did not receive a reminder."  Why did you not receive a reminder? "My cell phone number changed recently"  Ok, let's make sure your new cell phone is in our system!  Sometimes it take 3 or 4 "Whys" to get to the real reason...

Work to find out if there are some common reasons why patients are missing their appointments.  Then see if you can change something to address the reasons you uncover.


  1. If your staff is manually making calls, then consider starting to use an automated reminder system.  Automated systems can send phone calls, text messages or emails that will help remind 100% of your patients (keep in mind that if your staff is doing the reminder calls manually, a single missed reminder call can result in a no-show!)

  2. If you do have an automated system just sending phone calls, consider mixing it up a bit by sending a text message reminder instead of the phone call.

  3. If you are using an automated system, make sure you put a process in place to look at the results of the reminders.  You especially want to take a look at any statuses that show "BUSY OR NO ANSWER" or "INVALID PHONE" which would let you know that the patient never received the reminder and that your staff should follow up with the patient to verify the phone number at the next visit (or better yet, every visit).

  4. If you’re only sending a single reminder, try sending a second reminder.  Sometimes a call 2 days prior and a text 1 day prior works well.

  5. If you're only reminder is a 3-5 day ahead reminder, you might want to consider adding a 1 day ahead reminder so people don't forget. 

  6. Consider adding a "missed appointment" notice for the day after the patient misses their appointment with language like this:

    "Our records show you missed your appointment on <day> <date>.  Your healthcare is important to us. Please press 2 to talk to our staff to reschedule now or call us back at ___________. Thank you."

  7. You might want to consider adding some no-show fee language to your messages like this:

    "Please be aware that we have a $__ fee if you miss your appointment or don't give us at least 24 hours notice on a cancellation."

    Make sure the no-show policy is displayed in your office and on your new patient intake forms.

  8. THREE-STRIKES POLICY: You might also want to post that no-show policy at your front desk in bold letters in English and Spanish.You could further strengthen the policy with a "3-Strikes and You Are Out" policy -- if you miss more than 3 appointments in 12 months you will be discharged from the practice.
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