Missed your appointment?
That’ll be $50, please.
No-shows and late arrivals for appointments are common and frustrating problems for many medical clinics, therapists, veterinarians, and other service providers. They cause gaps in scheduling, reduce revenue, and create general disarray. So it’s not surprising that many offices have started to take steps to combat these issues.
Increasingly, many offices are turning to no-show fees to curb instances of clients not arriving for their appointments or showing up late.
On the one hand, it makes sense: missed appointments alone cost the U.S. economy an estimated $150 billion annually. But that doesn’t mean punishing your clients for an occasional slip-up is the best way to solve the problem.
It’s a common solution — but it may not the best one.
Instead, we’ve found that many offices can achieve similar results by focusing on improved communication and strategic incentives, rather than punitive measures that can ultimately cause more problems than they solve.
No-show fees solve the wrong problem — and create a new one
In 2015, we conducted an informal survey of people who were late or didn’t show up for their appointments. We wanted to understand the root causes for these occurrences in order to learn what solutions might exist.
What we found is that most clients who were late or never showed up did so for one of three reasons:
- They had a legitimate conflict or last-minute development.
- They didn’t feel confident about the amount of information they had regarding their appointment.
- They simply forgot.
Each of these reasons seems perfectly logical and reasonable from a patient’s perspective, yet under most policies that institute a no-show fee, they would still be charged, even if the reason was entirely out of their control.
These practices may be increasingly popular among operators, but they are certainly not popular from the patient perspective. They often punish those who have legitimate reasons for missing their appointment and in almost all cases, create undue animosity between the client and the practice.
There is no doubt that this kind of tension can lead to strained relationships, loss of customers, or even worse attendance rates as clients are made to feel uncomfortable or at odds with their provider.
Even more importantly, charging a no-show fee puts financial pressure on the customer to arrive on time for their appointment, without at all addressing underlying issues in communication from the office staff.
In each case outlined above, there is a common theme related to how information is — or is not — relayed to the client. And this is more imperative than just appointment times, as it ultimately speaks to the strength of the relationship between the client and the provider, which is an essential piece of providing medical care.
It seems clear that in order to solve these issues, the practice must improve its communications and give patients a better way to communicate in return.
Solving the real problem
Looking back at the three cited reasons for missing appointments, it is obvious that better communication between a practice could bolster attendance and on-time rates for clients.
And in fact, in a further analysis we conducted in 2015, we found this to be true.
According to the data we collected, simply implementing an automated messaging and reminder system for appointments was able to reduce no-shows by nearly 50 percent across all providers.
This improvement seems to stem from the fact that two of the most common reasons for missing appointments — not having enough information and simply forgetting — can be largely mitigated through better communication. Messages from such a system can serve as both a simple reminder and critical information that a patient may be missing, like which door they should enter, where they should park, or where the office is located in relation to a well-known landmark.
Often, these small details can become a source of major anxiety for clients and prove to be a barrier to them attending their scheduled appointment.
In addition, having a convenient, two-way communication channel allows clients to either directly confirm their appointment or notify office staff quickly if they’re unable to make it during their scheduled time.
Increasing the effectiveness of reminders
While our study found dramatic improvements in attendance for businesses using reminder systems, we ultimately discovered that there are also many steps that can
improve outcomes further.
Based on our analysis of 178,000 individual reminders and messages sent to customers using Apptoto, we identified a number of best practices that were used to further reduce no-shows and improve appointment confirmations.
The data showed that:
- Appointment confirmations made via phone, email, or SMS were 90 percent reliable, meaning only 10 percent of confirmed appointments were ultimately rescheduled.
- SMS messaging is the best and most reliable channel for delivering such messages, with a 30 percent reply rate for appointment confirmations versus 23 percent for phone calls and 12 percent for emails.
- Reminders sent via SMS at 6 p.m. the day prior to the appointment worked best, with only 6.5 percent of all customers receiving messages at this time ultimately needing to reschedule.
- Personalized messages that reinforced the importance of the appointment and/or provided critical details related to the appointment (directions, parking, etc.) performed better than generic reminders.
- Small incentives or gifts for attendance or consistent reliability can be used to further encourage customers to make their scheduled time.
Of course, each office and their clientele are unique, so the ultimate best practices are the ones that work best for your team and your customers.
Taken together, it seems clear that a well-implemented appointment messaging system is able to achieve a similar — or possibly better — improvement in attendance when compared to no-show fee policies. And it doesn’t come with any of the negative consequences or stigma that come along with charging fines to clients who don’t show up.
This isn’t to say that a messaging system can solve all problems related to poor appointment attendance. In some cases, no-show fees may be a necessary solution.
But it probably shouldn’t be your first step.