If you run an appointment-based business, you want to book as many customers or patients as possible. You want to fill up all your available time slots and avoid having empty space or down time.

But it’s not always so simple.

The more you try to fill these slots, inevitably, the further in advance you will be booking appointments. Some people may be agreeing to a date and time that’s two,  three, or even six months in the future.

Even with the best of intentions, it can be nearly impossible for someone to know for certain that the appointment time will actually work with their schedule, not to mention the fact that the longer time between booking and arriving leaves ample opportunity for someone to forget or mis-remember their appointment.

So, it should come as no surprise that a number of studies have found a strong correlation between appointment lead times and attendance.

The trend is clear. Long lead times lead to more missed appointments.

How can you mitigate this effect and reduce the number of people who don’t show?

The most obvious solution is, of course, to reduce the lead times. Schedule appointments more closely to the present date to lower the opportunity for oversight, errors, or scheduling conflicts to interfere. But that’s not possible for every business.

In this article, we’ll look at a few ways that you can reduce lead time and some strategies for mitigating no-shows, even in the case when appointments are scheduled far in advance.

Ways to reduce lead time

As a matter of strategy, your business should try to minimize appointment lead time to the point that it makes sense for your business.

Studies have found that a lead time of greater than 30 days tends to dramatically increase the likelihood of a no-show. Appointments made within the 30-day window are half as likely to result in a no-show versus those with a lead time of 30 days or more.

Aim for schedule equalization

Any appointment-based business will struggle with maintaining a balanced schedule. Some days may be more popular than others, some days may be more prone to cancellation, and some days, there are extra meetings or outside obligations.

But one of the keys to reducing lead time is to maintain a consistent and predictable schedule of appointments and work. This will allow you to better control and predict the flow and avoid scheduling conflicts that often lead to long wait times or lost appointment space.

To do so, take careful note of the appointments that are booked, which ones arrive, which ones are no-shows, and what circumstances affected those outcomes. In doing this, you’ll be able to identify patterns that allow you to better control and balance your schedule. For instance, if you find that Mondays tend to have a cancellation rate higher than any other day, you may get into the habit of booking an extra appointment for that day to make up the difference and balance the schedule.

Offer online booking and appointment management

Same-day appointments have a no-show rate that is just one-half of the rate for appointments made three weeks in advance.

For many businesses, it is difficult or impossible to manage a schedule with such a short lead time. But online booking and appointment management offers a seamless way for businesses to keep on top of appointments while also providing a much higher level of flexibility for patients or clients.

In a world where we are used to instant delivery of movies, TV, music, food, and even consumer goods, it’s no surprise that people increasingly expect to be able to jump online and book an appointment for later today or just a few days from now.

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With technology like Apptoto’s online booking feature, it’s entirely possible that your business could put the process of managing appointments on autopilot, reduce lead time, and increase patient/client satisfaction.

Minimize repeat appointments and follow-ups

Depending on the type of business you run, it may be possible to create a “one-client flow,” which emphasizes the importance of streamlining each individual client’s experience. The aim is to provide as much service as possible within a single visit, rather than relying on multiple, shorter appointments.

In dentistry, for example, many practices are starting to align their entire operation in order to accommodate the initial diagnostics, cleaning, and exam, as well as providing necessary services (e.g., fillings, crowns, etc.), all within a single visit.

From a client perspective, this means they are able to schedule a single appointment and receive all the care they need without having to schedule a second appointment or come back at a later time.

Although this may require some additional flexibility in scheduling itself, it can reduce or completely eliminate the need for follow-up appointments that may lead to longer lead times between visits.

Rely on longer lead times? No problem. Just have safeguards in place

For some businesses, it may simply be impossible to reduce lead time down to the suggested 30 days or less. Even so, there are other proven strategies to reduce missed appointments.

In many cases, simply understanding the needs of your patients or clients and developing an effective communication strategy can dramatically undercut the instances of no-show appointments or even late arrivals.

Here are a few specific tactics you can try for long-lead times to safeguard against no-shows and improve appointment attendance.

Use automated reminders

Reminders work. But they’re usually time and labor intensive. Often, it requires a staff member to make dozens of calls per day to remind people about upcoming appointments or reschedule missed ones.

Using a tool like Apptoto, your business can put appointment reminders and confirmation messages on autopilot. Just configure a specific sequence of messages, select the channel of communication (call, email, or text), and let it run.

You’ll never have to worry about patients or clients not getting a reminder call.

Best of all, you can schedule the messages to go out in specific intervals, giving your clients and patients plenty of advance notice and consistent reminders as the date draws near.

Ask for confirmation

One of the most simple and effective ways to avoid no-shows and cancellations is to simply ask for patients or clients to confirm their appointment in advance.

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This is a huge boost in attendance for almost any business, with many appointments averaging 20-40 percent no-show rates.

As part of your reminder strategy, you can ask for an appointment confirmation as the appointment draws near.

If the appointment time no longer works, then you can allow patients to reschedule while you have enough time to still fill the time with another appointment. This will help you avoid gaps in your service schedule.

Provide more detail

One of the most overlooked aspects of no-show prevention is providing the client or patient with all the relevant information they need to feel confident about their appointment.

As a consumer, there is nothing worse than having an appointment and feeling unsure of where you’re going, what will be happening, if there’s a parking spot available, or who you need to speak to.

All these questions can turn into nervousness and anxiety. And that can turn any person into a no-show.

Do a full audit of all your communications. Identify areas where things may be unclear or which details are not included in your messages, reminders, or paperwork. Add them into your communication flow. Then, ask your current patients/clients what information they needed or wanted to know before attending their first appointments, and make sure it lines up with what’s in your communication.

You’ll likely be surprised to find that some of the details you thought were obvious or clearly stated may be overlooked or not made clear enough.


By taking control over lead time and implementing other strategies to help minimize no-shows and late arrivals, your business can eliminate many of the problems associated with booking and managing appointments.

Operations will run more efficiently, revenue will be predictable, and growth and long-term planning will be much simpler.

Get a firm grasp on your appointment schedule, and you’ll see major improvements all across the business.