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No-Shows and Chronic Health Issues: A Dangerous Connection

Posted on Nov 14, 2016 by Solutionreach



    The issues created by patients who no-show are well known to most practitioners. The schedule interruptions, the impact on revenue, and the wasted preparation are a significant source of frustration. Often, it’s easy to focus on the detrimental impact to your practice, but there is another side to the no-show equation: the patient.

    Patients who no-show for scheduled appointments suffer consequences as well. Those who may only need routine care could be ignoring the signs of a problem that could become worse over time. In every realm of healthcare, early intervention is always the best course of action. When patients miss check-ups or regular visits, the opportunity to discover potentially challenging illness is missed as well.

    Patients who suffer from chronic illnesses such as diabetes, heart disease, asthma, or COPD are prone to even greater consequences as a result of no-showing for an appointment. Patients who require consistent monitoring of their conditions have the greatest reason for keeping their appointment. Unfortunately, they are just as likely to miss appointments as other patients in your practice.

    The reasons chronically ill patients no-show are the same as other patients - transportation, fear, forgetfulness, finances, and last minute issues - but for patients with chronic conditions, these issues tend to be more exaggerated.  For example, many patients do not drive and must rely on friends or family for transportation to and from appointments. If someone isn’t available to take the patient to the appointment, or if a last minute complication arises, your patient is left stranded and unable to receive the necessary care.


    Patients who are newly diagnosed with a chronic condition may be overwhelmed with fear and confusion. These patients may be more prone to becoming a no-show if they don’t feel they’ve received adequate information about their condition or their treatment.

    Chronically ill patients also tend to be in a lower socio-economic class (although certainly not always). Their normal financial concerns can become exaggerated with the addition of a long-term condition. With this added financial responsibility, patients may feel that they are better off not coming to appointments that may require co-payments, testing, medication, or other expenses that will be difficult to manage.

    Some chronically-ill patients will delay care until their health reaches a critical point, requiring emergency treatment, paramedics, or other urgent intervention. Patients who no-show often fail to take this factor into consideration and don’t understand that the cost for emergency treatment and its related expenses far exceeds the costs of regular care.

    Addressing no-show issues with chronically ill patients takes a calm, caring attitude that is marked by understanding and compassion.  When you diagnose or begin working with a patient who has a chronic condition, provide enough information that you are certain he or she will understand. Rather than asking, “Do you understand,” have the patient explain to you what you’ve shared with them and then fill in any missing concepts. If the patient requires more information, provide a list of resources for them. Ask about their concerns so that you can work together to resolve them.


    Be sure to have an insurance or payment specialist on staff to work with patients to make their care costs more manageable. When patients know in advance what to expect, they can better manage their budget to accommodate the new expenses. Money is often a difficult subject to discuss with people, but it is a necessary discussion to have. Having someone on your staff who is well-versed in the insurance plans you accept and any financing options available will reduce a great deal of the financial stress your patient is probably feeling.

    Taking time to discuss your patient’s transportation issues will also be beneficial. Do they have someone who can drive them reliably to and from appointments? Do they use public transit? It’s much easier to schedule appointments around times that are convenient for chronically ill patients than it is to address issues related with that patient becoming a no-show. Be aware of any community resources that may be available to your patient and provide that information as well. Often the local government agencies which deal with services for the elderly or disabled have options for medical transportation.

    Patients who chronic conditions do not need to become no-shows in your practice. With a bit of understanding and some additional resources made available to them, you can help to ensure that they continue to receive the care they need and you can continue to run your practice smoothly.

    For more information on preventing no-shows in your practice, click here!

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