Why Patients Don’t Show Up

Consider this scenario...

Your doctor’s office, dental practice, or other healthcare business is off to a good start to the day. The first few folks arrive on time and have a positive patient experience. Their appointments finish up in time for the healthcare providers to be ready for those next up on the calendar.

And then, in the space of an hour or two, first one and then two or more patients turn out to be no-shows. All of a sudden, the staff is losing momentum, uncertain each time whether to wait a bit longer for the patient or go ahead and turn to computer work or another task. Staff time is being used up calling or texting the no-shows, trying to figure out if they’re still coming or if they need to reschedule. Even once it’s clear they’re no-shows, there’s more work to do charging cancellation fees and, sometimes, trying to mend the relationship with an upset patient.

Lastly, perhaps one or two of the no-shows arrives half an hour late, and now a domino line of delayed appointments has started to fall.

Healthcare practices have this type of experience all the time—every week, if not every day. While the no-show rate in the healthcare industry varies by specialty and by practice, it hovers in the 5% to 10% range at a minimum, and in some cases tops 30%. Looking at the costs to your medical practice in terms of lost revenue and added stress, it makes sense to do whatever you can to minimize no-shows.

Thankfully, with an automated patient reminder system like Reminderly, that job is simple and affordable.

In this post, we’ll take a deep dive into why patients don’t show up in the first place, and we’ll look at why automated appointment reminders can take nearly all of the pain out of this aspect of practice management.

The two reasons why patients will always miss appointments

Although each instance of a missed appointment seems unique, when looking at the larger picture, it’s clear that no-shows are a statistical inevitability for medical practices. Indeed, missed appointments cost the healthcare industry at large some $150 billion per year!

Barring an effective intervention, we know for sure that at least 5% of your patients—and more likely 10%, 20%, or more—will miss their scheduled appointments. So, why is this the case?

The answers fall into two main categories, which we can call 1) human error and 2) human psychology. Let’s take a look at each of these.

Why patients become no-shows: human error

People are busy, and since most medical appointments aren’t part of our regular schedules, we’re prone to simply forget them. Maybe something comes up at your patient’s work, or their kid’s school calls, or the handyman at their house stays longer than they expected. Maybe they’ve recently had a disruptive life change like a divorce or death in the family, or a loss of their main form of transportation. Maybe they just didn’t sleep well last night. Any number of things can cause someone to lose sight of an upcoming appointment.

Another way human error comes into play is when someone remembers the fact of their upcoming appointment but gets the date or time wrong, and the first they’re aware of it is seeing a phone call from your office asking if they’re on their way. Good intentions, but a bad result for all involved.

Human error and telehealth appointments

What about telehealth? There is evidence—such as this case study, and this one—that telehealth appointments reduce the no-show rate. It may be that the online nature of these sessions is helps people to remember their appointments more easily. That said, patients do miss telemedicine visits for some of the same reasons they miss in-person visits, and additionally because of having technical issues accessing their appointments.

So, while telehealth appointments might have a slightly lower no-show rate, the basic issue remains for both telemedicine and in-person appointments: human error will result in people forgetting them some of the time.

The good news with the “human error” category is that by sending automated patient appointment reminders, you can virtually eliminate the missed appointments that stem from people simply forgetting them. By sending appointment confirmation prompts via automated text messages, emails, and/or phone calls, you’ll easily dispense with the large majority of those cases. Most times, when your patient gets their reminder message, they’ll quickly respond with their confirmation. And for those who need to cancel and reschedule, they’ll be happy to have received the notice in time to avoid the hassle and cancellation fees.

This kind of real-time communication with your patients improves patient engagement and patient satisfaction while also taking the load off your staff. Rather than needing to follow up and deal with tedious aspects of appointment booking, you can let a reminder service like Reminderly take care of the problem in advance.

Why patients become no-shows: human psychology

All appointment-based businesses deal with the “human error” reasons that people become no-shows. But healthcare practices also face a major second cause of missed appointments—when your patient’s psychology gives them reasons not to come.

Many patients, for instance, report anxiety about their medical appointments. If it’s their first time coming to your office, they might be nervous about how they’ll be treated. If it’s a younger person, they might be unsure what to expect and quick to flake out. If it’s an older person, they might feel worried about being misunderstood or hurried.

People of any age might be afraid of receiving a difficult diagnosis or of being scolded about some aspect of their behavior. They might feel a generalized anxiety stemming from confusion about their appointment type or the reason it’s necessary. Or they could be anxious about the pricing of the appointment or about potential knock-on costs from testing or medications.

Whatever the reason for their anxiety, it influences people to look for reasons to skip that next appointment.

Although it’s somewhat more complicated than with the “human error” reasons for missing appointments, the “human psychology” reasons are also effectively addressed with the use of appointment reminder software like Reminderly. Here are a few reasons why:

• With Reminderly’s two-way communication, those dealing with anxiety about the appointment are offered patient access. They can ask any questions and express any concerns they have in time for you to respond, still leaving time for them to cancel in advance if they decide to.
• Reminder messages offer your patients a self-service aspect to their experience with your practice, which can help boost their comfort level about engaging with you.
• Most basically, the reminder messages give your patients an easy way to opt out if they need to, while still giving you time to fill that slot with someone from your wait list.

The importance of a good patient reminder system

Taken together, human error and human psychology result in a certainty that some of your patients are going to miss their upcoming appointments. Rather than simply relying on a cancellation policy, you can be proactive about the reality of no-shows by implementing an effective automated appointment reminder system.

With adaptable options for text reminders, email reminders, and phone call notifications, Reminderly can customize a solution that meets your office’s needs and fits your clientele’s preferences for patient communication.

Receiving appointment reminders plays a role in patient satisfaction—surveys show that 85% of people want to get appointment reminders. Other data shows that even a single missed appointment has a negative effect on downstream care, with patients tending to delay or miss subsequent appointments. Missed appointments thus lower your practice’s patient retention rate, meaning you have to work harder to keep attracting new clients. So it makes great sense—both financially and in terms of patient retention—to incorporate automated appointment reminders into your practice management system.

In addition to automating your reminders, Reminderly supports your patient outreach. Since your database of patient phone numbers and emails is already stored there, you can use it to send sms or email updates to your whole patient list or to segments of it. For example, notifying them of a new doctor on staff, an upcoming change in location, or a special promotion.

Reminderly can also set up a short satisfaction survey to be sent to your patients after their appointment. We can then follow up with your most satisfied customers, sending them a link to your social media to leave a review: an excellent way to generate organic referrals and build brand credibility online.

The appointment reminder endgame: smooth workflow, happy patients

By taking the burden of reminder calls off your secretary, office manager, or the clinicians themselves, you immediately streamline your office workflow. At Reminderly, our clients typically see their no-show rate drop by 90% or more within a matter of weeks. But even for the small number of no-shows that remain, your staff will have clarity about the issue instead of facing constant uncertainty about whether patients are coming or not.

Reminderly integrates smoothly with your existing scheduling software, whether you use spreadsheets, google calendar, outlook, or other common programs. And since you can customize and save your communication templates, your staff’s efforts around patient reminders and patient outreach will only become easier over time. It’s possible to get that pesky no-show rate much closer to 0%, and benefit from Reminderly’s outreach functionality at the same time.

In the end, what you want is for your healthcare providers to be doing what they do best: providing healthcare, not dealing with tedious issues of patient communication. The appointment reminder endgame is to let your practitioners practice and give your patients a smooth communication experience, all for just dollars a day.