Patients become no-shows for a variety of reasons, and the impact that has on your practice is well documented. It’s frustrating to prepare for a patient only to find yourself checking your watch and realizing you’ve been stood up. In previous blogs, we’ve looked into some of the reasons why patients no-show such as finances, fear, forgetfulness, transportation, and last minute issues. But there is another side to the no-show issue that is important to recognize: a no-show patient may be looking to receive their care from somewhere else.
The No-Show/Attrition Connection
Just as patients miss an appointment for different reasons, patients may seek care from another provider for many reasons as well. Sometimes attrition is a result of circumstances that couldn’t be helped, such as the patient moving to a new, less convenient area, or possibly the patient passing away. But there are issues that cause patients to seek new care providers which are impacted by you and your staff, and many of these can be hinted at by a patient who no-shows.
It’s a Matter of Time
No one likes to wait. Patients are no longer willing to sit in your lobby for 30 minutes or more after their appointment time as part of their visit to your office. If it seems that you don’t value your patient’s time, your patient surely won’t value yours and may begin looking for another provider where their time is more valued. The first sign of this may be a no-show or a last minute cancellation. Following up with the patient should make it clear if he or she missed the appointment due to time concerns.
When a patient acknowledges not showing because of the wait times experienced in your office, there are three important things you should do:
- Apologize for the wait and maybe offer a discount on the patient’s bill, or provide a gift card as a form of amends.
- Assure the patient that you will address the wait time issue with your staff to ensure that steps are taken to prevent future delays.
- Keep your word. Work with your staff to identify the reasons wait times are so long. Is there a lack of communication? Do insurance issues or payments take too long? Is the schedule overbooked?
Work with your staff to determine all the contributing factors to the wait time issue, then make the necessary changes. You may get this patient to come back for one more try, but if things haven’t improved, they will look elsewhere.
It’s a Matter of Money
Insurance and finances are not the most pleasant topics of conversation, but for the sake of your patients and your practice, they are conversations you need to have. Patients who are concerned about the cost of their treatment may no-show for an appointment. When you call the patient to follow up, it’s important to have information and options available. Is there a financing option you can offer patients? Do you or someone in your practice have a familiarity with the type of insurance this patient has? If you are referring the patient to a specialist, do you understand what the patient’s insurance will cover? Will the specialist work out payment plans if needed?
Financial issues are one of the most difficult to talk about, and patients may not want to initiate the conversation. However awkward it may seem, it’s less difficult to discuss money and insurance in advance than to lose a patient who either seeks care elsewhere, or who doesn’t seek needed care at all.
It’s a Matter of Understanding
Presenting complicated, detailed information to patients takes time. Patients who don’t understand what you’ve told them about procedures or disease can quickly become overwhelmed or afraid. This may cause them to no-show for an appointment because they don’t know what to expect. If their fear becomes significant, they may look elsewhere for care, or they may choose not to pursue care at all.
Before a patient leaves your office with instructions, it is incumbent on you not only to ensure you convey the information that patient needs, but to be certain the patient understands. Ask questions of the patient to be certain they have an acceptable level of comprehension. Ask the patient to explain the information to you to gauge their level of understanding. Investing a few extra minutes ascertaining your patient’s awareness of the information is an investment for both of you in the long-term relationship you hope to have.
It’s a Matter of Mobility
Transportation is a frustrating issue for all of us, but it’s especially frustrating when you don’t have access to reliable transportation. People who live in urban areas may not own a car due to the expense of parking or storing it. Many urban and suburban dwellers rely on public transit as their primary means of getting from place to place. Seniors or those with chronic health issues or disabilities will also turn to family members or friends to get them to and from appointments. Regardless of the circumstances, not having your own reliable transportation creates complications.
It’s tempting to determine that these patients are on their own for getting to or from an appointment. Transportation is seen as more of a personal issue which many providers don’t want to be involved in. But if a patient is unable to keep appointments due to transportation issues, it can quickly become a healthcare issue. Patients who are unable to get to regular appointments may be forced to wait until they have an emergency before receiving care, and for many of them, this may be too late. Patients who are elderly or have chronic health issues are particularly at risk.
While providers clearly cannot assume responsibility for every patient’s transportation, there are still steps they can take to improve the likelihood of a patient arriving to appointments. Ride sharing services such as Uber can offer patients door-to-door service for a nominal fee. Using a convenient app and integration through appointment reminders, Uber can contact patients who may need a ride to schedule the service. Not only does this decrease the risk of a no-show, but encourages patients to keep their regular appointments and safeguard their health.
It’s a Matter of Memory
Everyone forgets things now and again. In our busy world, it’s a common experience. But forgetting an appointment with a healthcare provider can have serious consequences. First, some practices charge a no-show fee, which can be both expensive and inconvenient. Second, missing scheduled appointments can interfere with ongoing care. This can impact the patient’s health and well being.
While many practices have a no-show policy which does not include a fee, they might limit the number of missed appointments a patient can have in a given time frame. Some patients may see these policies as punitive, which may make them less inclined to come back if they’ve missed an appointment for any reason. The important thing here is to consider your policies against the well being of your patients.
In conjunction with offering ride assistance, providing patients with appointment reminders can help to avoid or minimize the risk a patient will cease coming to your office at all. If something happens and a patient does miss an appointment, a missed appointment message can assure the patient your concern is for their health and can encourage them to contact you to reschedule the appointment.
It’s a Matter of Courtesy
Patients who become a no-show are not always going to become another casualty of attrition. Most of them want to come back and attend to their health. When you extend to them the courtesy of understanding and assistance, you encourage them to keep the dialog open. This builds improved rapport with your patients which in turn builds patient loyalty. With a few small options added to your practice, you can demonstrate to your patients that they matter to you.
To learn more about avoiding no-shows, check out our free guide, "No-shows no more.