No-Shows Means No Dough

Has your practice experienced the impact of no-shows, leading to empty slots in the appointment schedule, resulting in a decrease in productivity and a loss of income? You’re not alone. But it doesn’t have to be that way. Getting a handle on no-shows can have a positive impact on time management in your practice.

According to a MGMA survey, no-shows can vary from as low as 5% to as much as 50% in some high-volume practices. This can translate to hundreds of dollars lost each day and the loss of thousands of dollars on an annual basis. No-shows can also wreak havoc with your office staff scheduling, creating a ripple effect that may result in dissatisfaction in among next your previously satisfied patients. Proactive practices define the problem and then find a solution that cuts the no-show rate to a tolerable level.

Technology to the rescue
Sometimes patients simply forget that they have appointments. It is now standard practice for offices to call patients the day before their scheduled appointments to remind them of the day and time. In the past, my receptionist made the calls at the end of her day using old-fashioned land-line telephone calls. These calls were often made when the receptionist was tired, and as a result, the reminder calls dropped to the bottom of her to-do list. Another problem is that employees often must leave messages on answering machines. Since most patients work from 9-5, this makes it difficult for them to confirm the appointment.

A few years ago, I had an automated phone system installed, which can dial patients in the evening when they’re most likely to be home. These systems typically allow the patient to confirm or cancel the appointment with a push of a button. The program then generates a report for the receptionist to see in the morning. Any cancellations can easily be filled from the list of patient’s wanting an earlier appointment. This automated technology, TeleVox HouseCalls ( has reduced my no-show rate to less than 2 per week. The cost is approximately $100 per month per physician. This is easily worth the cost, as preventing just one no-show can equal the fee and make your practice more productive and more efficient.

A caveat: The automated phone system must interfaced with your practice management scheduling software. If it does not interfaced or bridge, riding a bridge can be costly. When you decide to implement an automated phone system, get a recommendation from the company that sold you your practice management software. Most practice management programs also can generate written reminders that use of snail mail. For your computer literate patients, consider e-mail reminders.

Neil Baum, MD

Neil Baum, MD, is Clinical Associate Professor of Urology, Tulane Medical School, New Orleans, LA, and author of Marketing Your Clinical Practice: Ethically, Effectively, and Economically, Jones Bartlett Publishers.