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How to Reduce No-Show Appointments

June 12, 2024

A Venn diagram. On the left side, a blue circle with text: "Taking care of business". On the right side, a yellow circle with text: "Taking care of patients". The overlap in the middle is green with a dotted line that points to text that says "Reducing no-shows" in wavy green text against a white backdrop.

By Kayleigh Robinson

No-shows are a frustrating phenomenon that can disrupt the flow of your day and cut into your profit.

As a clinic owner or practitioner, it can feel like a situation outside of your control. Especially when you’re already in a juggling act — on one end you’re handling business needs, and on the other, you’re balancing caring for your patients. Switching between these two modes might feel stressful and perhaps at odds with each other.

Stephanie Honess, a physiotherapist and the owner of Waso Physiotherapy, has discovered that the two are not mutually exclusive. Here, she shares some of her best practices for reducing no-shows, ranging from technical tips to the hands-on work of building relationships.

Her biggest takeaway? Taking care of business shouldn’t come at the expense of caring for your patients.

Try a three-strikes rule for no-shows

Establishing a clear and fair cancellation policy is essential. Like the game of baseball, Stephanie adopted a “three strikes and you’re out” policy at her clinic.

In the post-pandemic world, patients should be encouraged to stay home when they’re feeling unwell. But in Stephanie’s experience, this led to a surge in late cancellations attributed to “quote-unquote sickness.”

The rise caused Stephanie to adopt some new policies. She and her team struggled to find the best solution to respect patients’ health while ensuring accountability in managing their appointments. But this challenge led them to their current baseball-inspired approach.

Stephanie Honess, a physiotherapist and the owner of [Waso Physiotherapy], smiles for the camera against a white backdrop. She has long dark hair, and a black top on with a silver heart pendant necklace. She crosses her arms. Stephanie Honess, physiotherapist and owner of Waso Physiotherapy

“We still don’t charge anyone if it’s sickness-related just because I still want to encourage people to stay home.”

Stephanie continues, “But our policy is a first-time grace period. The second time you get a 50% fee; the third time, you get charged the full fee. We’ve never had anybody go past the 50%. Usually, if people get charged once, they either don’t come back, or they just don’t do it again.”

Remember to include your policy in print, on your website, and through consents. Stephanie also recommends having your front desk staff communicate your policy in person to drive the point home.

Streamline appointments with online booking software

Your online booking system isn’t just there to book appointments. Here are some ways you could optimize your software to handle your business needs:

Don’t go chasing payments

Now that you’ve developed your no-show policy, use your platform to be transparent about your protocols and take action when necessary. Consider asking for a deposit or a credit card on file to secure appointments. By adding this step before patients hit that “book” button, you’re making sure they’re committed to their appointment.

Set up automated payments

Stephanie loves letting your tech do the talking: “I think technology helps a lot. Having email and text reminders for patients is very helpful.”

Appointment reminders are a tried-and-true way to reduce no-shows. Send one reminder before the cancellation window closes, and another on the day of the appointment.

Offering patients the opportunity to cancel or reschedule without penalty helps build relationships, so you don’t have to worry about burning any bridges with new or returning patients.

Take advantage of the waitlist

Appointment reminders aren’t the only thing you can automate! If you use a waitlist feature in your practice, consider automating those notifications so that patients can immediately scoop up the next available slot. Having a waitlist lowers the chance of your patients taking their business elsewhere if they can’t find their preferred time.

We see a desktop computer screen with Jane's EHR software open to a weekly schedule with various blocked times in various colors. Someone on the left points to the screen mid-conversation with someone on the right. We only see the silhouettes of these people from behind.

Find your ideal patient

It’s worrisome to think that your cancellation policy could turn people away, but remember: you want patients who align with your treatment approach, values, and goals. If people can’t respect your no-show policy, they’re not your ideal patient.

Your clinic will have less no-shows when you attract patients who actively participate in their recovery journey. “It comes back to that relationship building — coming up with a solid treatment plan and having a strong buy-in,” Stephanie says, highlighting the importance of genuine connection. “Those people value being there, and I think that’s the biggest thing — finding those people as your people.”

Chronic no-showers fill up times that could be taken up by other patients who need care. In addition to financial loss, it shows a lack of respect for the people who are left waiting. By creating a space that resonates with motivated people who value their health, you simultaneously create a culture of commitment and accountability.

Stay curious and compassionate

It’s natural to wonder about the well-being of patients who have dropped off. Stephanie acknowledges, “There’s always people that I think back and wonder how they’re doing. That’s just inevitable.”

But this doesn’t have to be the end of the road. Sending a kind and empathetic follow-up message, even when patients are no-shows, makes them feel like they’re a priority. It also allows them to express any concerns or reasons for missing their appointment.

Stephanie advises, “Touch base with them and make sure they’re doing okay. And then usually you’ll hear back, and they’ll just tell you either they’re doing great or they moved on to something else.” She recommends sending a secure email, as it allows patients to share their decisions or circumstances without being put on the spot.

Preventing no-shows in your practice takes some elbow grease. Make the process enjoyable by letting your tech handle the admin aspects, while you focus on what you love to do — providing care for your patients and getting to know them as people. Stephanie sums it up: “If you’re doing a good job getting people better, they prioritize wanting to come to see you.”

A graphic with six square sections, all in yellow and blue. At the top, the title reads: "Cancellation made simple" in blue against a white backdrop. The text underneath this title reads: "Use these methods shared by the Jane community as a jumping off point for developing your own policy." The first row of square sections starts on the left in blue with a clock icon. The text reads: "Offer free cancellation with a 48 to 24-hour window and charge the full fee if cancellations happen outside of this timeframe." The next square, in the middle, is yellow with a dollar sign icon. The text reads: "Choose a cancellation fee based on the cost of the service – about a third to half of the service cost." The final square in this row, on the right, is blue with a happy face icon. The text reads: "Waive the fee if it's a first-time cancellation and remind the patient about the policy for next time." The next row includes a yellow square on the left with a heart icon. The text reads: "Waive the fee based on compassionate grounds of illness, family, or medical emergency." The next square, in the middle, is blue with a credit card icon. The text reads: "Use the cancellation as an opportunity to collect payment information before the next booking." The final square in this row, on the right,is a yellow square with a page and pencil icon. The text reads: "Keep track of cancellations – three or more from the same patient and it's time to have a conversation.

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