Commitment & Consistency Principles: Why Appointment Confirmations Work

When Homer’s Odysseus set sail for his homeland, he knew that he had one final challenge to overcome.

Between him and his home, he would encounter the call of the Sirens, known for luring sailors to shipwreck along the rocky shore. Odysseus knew that he had to take dramatic action to avoid the temptation and stay committed to his ultimate goal.

To commit himself entirely to the journey home, he did something dramatic.

He filled the ears of his crew with melted wax, so they would not hear the calls. Then, he went further by having his crew tie him to the mast of the ship so he couldn’t heed the calls and send the crew to their death on the rocks.


Today, we often hear allusions to the idea of the Siren’s song and the use of commitment and consistency as a way to combat a lack of willpower.

Although the stakes aren’t quite as high for your business  as in “The Odyssey,” it’s no less true that you want your customers and clients to follow through on their commitments. When they sign up for an appointment, it’s in both of your best interests for them to complete their voyage (okay, that’s probably bit too heavy-handed).

But running an appointment-based business does bring its own host of challenges and potential pitfalls.

Even if you do everything in your power to make sure clients and customers are prepared for their appointments and arrive on time, it can often seem like it’s out of your control whether they actually show up.

You set the appointment in advance (even just for next week). You try sending reminders. You might even leave voicemails, hoping that they will listen to the reminder message sometime before the day of their appointment.

But there are so many factors that come into play, it can seem like a losing battle.

Apptoto was created to help eliminate no-shows and late arrivals for appointment-based businesses. The way it works is based on sound science.

The seminal idea behind why Apptoto is so effective is rooted in decades of psychological research on how to persuade and influence people to take specific actions.

It may seem surprisingly simple, but so much of if  someone arrives to their appointment can hinge on just two factors: consistency and commitment.

Dr. Robert B. Cialdini is the author of the book, “Influence, The Psychology of Persuasion,” named these two components as one of the six principles that most affect human behavior.

In this case, persuading people to arrive for their appointment can be accomplished by understanding how these two important parts of human psychology drive many of the actions we take — including arriving on time.

The Power of Consistency

Consistency on its face can seem deceivingly simple. If we say one thing, we want our actions to reflect the same set of beliefs we espouse to believe.

If I say that I am the number-one Chicago Bears fan, then you can probably find me trash-talking the Green Bay Packers on most Sundays in the fall and winter. I do that because it’s consistent — part of my identity is shaped by the fact that I am loyal to one team and not the other.

But why do we, as humans, care so much about being consistent?

This is a much more nuanced and difficult question to answer. At a high level, we are repulsed by the feeling of being inconsistent. It seems disingenuous. It triggers cognitive dissonance in which the outward actions we are taking do not seem to align well with the internal view of ourselves. In turn, that causes us to question our own identity: am I really the number-one Bears fan if I don’t mercilessly taunt the Packers every game day?

“Once we have made a choice or taken a stand, we will encounter personal and interpersonal pressure to behave consistently with that commitment,” writes Dr. Cialdini in his book. “Those pressures will cause us to respond in ways that justify our earlier decision.”

How does this relate to Apptoto and appointment-based businesses?

If the desire to remain consistent drives our actions, then if we say that we will do something, we will often go to extraordinary lengths to make sure we keep our word.

So, if your customer or patient says that they will, indeed, arrive for their appointment, then they are much more likely to do so. This is a surprisingly powerful mechanism in our brain.

Just think of the times that you have promised a friend to do something or go somewhere. Once you’ve given your word — once you’ve actually committed — you’ll likely do just about anything to make sure your actions remain consistent with your promise.

But just setting an appointment is often not seen as “committing” to that appointment, per se (although for your business, you’d like for that to be the case).

That’s where appointment confirmations come into play.

Commitment Devices and Appointment Confirmations

Commitment devices are a way to get someone to commit some small amount of effort toward doing something, which dramatically increases their chance of doing some related (usually larger) action.

For instance, many companies know that if you sign up for a free trial of a product or service, you are much more likely to ultimately buy it. This is a commitment device. By committing in some small way — by exerting some level of effort — you have told yourself that it must be important and worth considering.

Simple actions that act as a commitment device have a surprisingly strong effect on our future words and actions.

We see this in all kinds of ways in our lives — using small commitments as ways to encourage ourselves or others to stay consistent.

Apptoto customers use appointment confirmations as a commitment device.

This effect stems from and is intertwined with the desire to remain consistent. That is to say, once we have taken some action to make a commitment, we feel compelled to act in a way that is consistent with that action.

Although reminders can help improve the number of people who arrive to their appointment by simply jogging their memory of the time or date they’re supposed to arrive, appointment confirmations act as a commitment device that psychologically triggers the need for that person to follow through and arrive as planned.


They are effective because they ask the client or customer to make a small but meaningful commitment — to confirm that they will be showing up to their appointment — in advance.

This minor action can dramatically improve the percentage of clients or patients who ultimately show up as expected.

In a study we conducted researching nearly 180,000 reminder messages sent by Apptoto customers, we found that of those who received a reminder message and confirmed their appointment, there was a 90% on-time arrival rate.

That meant only 10% of the total appointments in this cohort needed to be rescheduled, a huge improvement over rates at most appointment-based businesses.

So, while this minor message — and simple confirmation — may seem like a small action for clients and customers to take, it can have a huge impact. The psychology shows it’s true, and our customers have seen it in action.