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Dynamic Chiropractic – March 26, 2009, Vol. 27, Issue 07

No-Shows Are Like Mosquito Bites: Very Annoying!

By Michelle Geller-Vino, CA

"No-shows" have disrupted practices for decades, leading to loss of revenue, waste of valuable time and general frustration. Unfortunately, there will never be a surefire way to altogether "get rid" of patients who just don't show for their appointments. However, there are important steps and protocols that every practice can follow to help prevent and eliminate some of these no-shows from plaguing your office. Once you reduce the number of no-shows, you will notice the stress level in your office significantly decrease and your profit margin increase.

How many of your patients have a perfect attendance record? While some practices experience low rates of no-shows, others experience rates as high as 30 percent to 40 percent! It all begins with doctor/patient communication. As I always say, communication is the key to success. All doctors should insist on a report of findings and indeed give an excellent ROF. This is where the first real discussion takes place, and it is a time during which the doctor must shine. By providing patients with all pertinent information and showing them the value of being on time and sticking to a care plan, you will potentially avoid problems before they begin.

The second part of communication is between the front-desk staff and the patients. If patients are asked to write down their appointments on an appointment card, it gives them a sense of recognition of their next appointment by seeing the date and time in their own handwriting. The front-desk chiropractic assistant can also play a huge role in helping patients remember their appointments by simply saying something like: "Bye-bye, Mrs. Smith. We will see you next Tuesday at 3 p.m. sharp." By reiterating the scheduled appointment as a patient walks out, you have reinforced this date and the patient leaves knowing when they will be back again. Remember, the front-desk CA is the first and last person patients see. A friendly and outgoing CA will make a great first impression of your office, and of course, you don't get a second chance to make a first impression.

Another great idea is to assign a particular CA to provide all patients with a financial ROF. The team leader of the office would be an excellent candidate for this task. This is done after the doctor has completed their report of findings. The financial ROF entails sitting a patient down and not only going over the insurance information, but also specifically discussing the care plan designed for that individual patient. If proper explanations are given to patients about the importance of being there for all appointments, the number of missed appointments and no-shows should decline. Isn't it a fact that patients who comply with care get better faster and stay better longer? Make sure your patients know; tell them during the ROF and any health care class(es) your practice offers.

When dealing with no-shows, it is crucial for CAs to keep a log with the patient's name, phone number and date. It allows you to see on a daily basis who has missed their appointments. The log should have a column that shows when the patient has rescheduled their appointment. A telephone tracer log is a valuable tool for patient compliance. It will not only determine which patients have missed appointments, but also let you know which patients were no-shows. At a glance, you and the doctor can tell the reason for the patient's missed appointment. This is a great way to keep on top of the practice.

The staff must know the value of connecting with the patient and making sure all patients know and understand the value of their care plan and visitation schedule. Here are some important questions to ask yourself when dealing with patient appointments:

  • Was the appointment confirmed by a member of the team the day before?
  • Was the patient properly educated by the doctor when they first came into your office?
  • Does the team recognize when a patient may not be engaged in their care?
  • Is the team trained properly in dealing with patients?
  • Is the team friendly and courteous?
  • When a patient is late, are they contacted in a timely fashion and if so, what is said?

With regard to the last point above, I like to refer to this call as a "care call." Questions to ask during a care call include: "Is everything OK? "It isn't like you to miss your appointment. Did we make a mistake on your appointment time?" Always make sure the patient knows they missed the appointment and that you need to reschedule it, but do it while maintaining the caring relationship.

There are a variety of reasons why patients miss their appointments. No-shows and missed appointments will occur less if proper actions are taken and protocols are followed. Remember, if patients fully understand the importance of their problem, how long it is going to take to fix it and how much it is going to cost, they will tend to comply with care.


Click here for previous articles by Michelle Geller-Vino, CA.

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