Ways to Reduce Your No-Shows

Patients in a waiting room

Every ophthalmology or optometry practice struggles with how to deal with patients who do not show up for appointments or cancel at the last minute. They can have a dramatic impact on your practice’s bottom line by lowering revenue and decreasing productivity. Have you ever calculated the annual lost revenue from no-shows? It can range from 10-15% of your total revenue.

Appointment Reminder System

Nearly every medical practice has some type of appointment reminder system, even if it is the old-fashioned method of having staff call the patient a day or two before the appointment. There is an advantage to personal contact when it is successful. The disadvantage is that staff may not reach the patient, and you won’t know if the message left on voicemail was received. If it is an unusually busy day, staff may not find the time to make reminder calls at all!

New technology can help improve your no-show rate. Some sophisticated scheduling systems contain automated appointment reminder systems, or you can purchase a separate system or service to make calls, send texts, or email your patients. Some software packages even give patients the ability to cancel and reschedule their own appointments on-line!

Develop a No-Show Policy

It is helpful to have clear written guidelines regarding no show appointments. They should be posted at the front desk. New patients should be given the practice’s no- show policy to sign with a copy kept in their medical record. A clear no-show policy helps the staff be consistent in managing difficult patients.

You won’t want to treat a long-time patient who forgot an appointment for the first time in the same way that you handle a chronic patient problem. Some practices charge patients a fee for not showing up; others do that after the third no-show.

Create Scripts for Your Staff to Handle Difficult Conversations

You won’t hear most of the conversations that staff have with patients, so it is difficult to know whether they are approaching patients with the professionalism and tact that you want. Creating sample scripts for a few scenarios will make their lives easier and ensure a professional approach to your patients.

Contact Your No-Shows Right Away

Assuming that you want your no-show patients to reschedule, it’s best to contact them right away. Staff should call patients that day, express concern that they missed their appointment, and state that they are calling to reschedule. If patients are embarrassed, they will feel more comfortable calling back for another appointment. This also addresses the problem of patients

who need to be seen regularly for clinical concerns. Document the call in the patient’s medical record. This is extremely important for patients with glaucoma, macular degeneration, emergent visits etc. The provider should also be notified and appraised of non-compliant patients.

Track Reasons for No Shows

Tracking the reasons that patients no-show or cancel at the last minute may give you valuable insight into how to reduce the problem. Develop a simple log sheet with the patient’s name, age, address, and reason (if you can determine it.) Reasons may include transportation issues, inability to leave work, childcare problems, illness, and forgetting the appointment- to name a few. Staff should work to schedule patients at a time when they are likely to make it to the appointment on time. For example, some patients rely on senior vans or public transportation. Don’t book patients for the earliest morning slots if the van service or bus always runs late at rush hour.

Know Your Patient’s Preferences

It’s essential to understand what type of communications your patients prefer. First, make sure that front desk staff are capturing up-to-date addresses, email addresses, landline, and cell phone numbers on every visit. This can be handled verbally or with a brief registration questionnaire.

There may be a way to capture other information in your registration and scheduling system. You need to honor the patient’s preferred communication. Staff should ask every patient if they prefer to receive postcards, phone calls, emails, or text messages.

Text messages are preferred by a significant majority of patients these days, and research shows that patients are more likely to read them within a few hours. It is essential to follow all HIPAA guidelines when communicating with the patient.

Consider Double Booking

Every practice has chronic no-show patients. You might want to double book the appointment slot if you think the patient is likely to miss the appointment. If he or she shows up, you may have to hustle more than usual that day. At least you will have prevented potential revenue loss.

Keep a Waiting List for Appointments

Waiting lists are great for patients who don’t want to wait weeks to see their doctor. You can use waiting lists to accommodate patients by filling canceled slots, especially if you have reasonable notice. There may be some patients who live nearby and have the flexibility to come to an appointment on very short notice. There is no harm in calling them to fill a last-minute cancellation.

Reduce Your Wait Times

Patients are less motivated to respect your time if they feel that you don’t respect theirs. Most people have busy lives, and they resent long wait times at the doctor’s office. Ophthalmology appointments for glaucoma or retina disease are already long, so waiting more than 10 minutes to get started adds to their long day.

Consider Offering Convenient Appointment Times for Working People

Many last-minute cancellations and no-shows occur because patients are unable to leave their job. Extending appointment times to early evening (7 PM) once a week will be very popular with some of your working patients. Another option to consider is opening a half day on Saturday once a month.

Engage Your Staff in This Project

How about engaging and rewarding your staff for reducing no-shows? They chat with the patients, and sometimes know who the chronic offenders are, and what the obstacles are. Staff will have a lot of insight and good ideas about how to improve the problem.

Hopefully, your appointment system can tell you the baseline number for no shows in a certain time period. Post a chart in the staff break room and show the progress towards the goal. Try offering a reward to everyone if the no-show rate can be reduced by 10 or 20% during the next quarter.

For a very small practice, you can provide a free lunch for everyone. Bonuses or cash gift cards are generally popular for this purpose and will be worth your investment. Hopefully, the changes you make will have a lasting impact.

To learn more about how MSO Eye Partners™ can help you reduce your no-show rate for your ophthalmology practice, contact us today.