Optometric Management Tip # 199   -   Wednesday, November 09, 2005

Patients who fail to show up for appointments are a reality in every eye care practice, but the amount of disruption it causes can vary widely. Here are some tips to reduce the frequency of no-shows and to minimize the inconvenience caused by them.

Confirmations No-show impact

Some doctors become very upset by no-shows, and some simply take it in stride. One of the biggest factors relating to this is the number of patients seen per day. Doctors who book appointments closer together donít feel a disruption in the schedule like doctors who spread the appointments out. This is a good reason to review your exam process and consider increasing your clinical delegation and decreasing the appointment time slot. A no-show in a schedule with 10 patients is a waste of your time; a no show in a 25-patient day is hardly noticed and might even be welcome. Many doctors think they simply donít have enough patients to warrant a busier schedule, but all they have to do is compress the patients they do have during any given week into fewer days.

Missed appointment charge?

The technique of charging the patient a fee for a missed appointment is occasionally used (we hear of this frequently with dentists), but I donít recommend it. Whether the fee is real or simply an empty threat used to discourage no-shows, I think itís very hard on the good will we want to establish. It may reduce no-shows, but it will also reduce the size of your practice. The position I take with a patient who misses an appointment is to be very understanding and supportive. Iíve missed appointments on occasion and that is how Iíd want to be treated. It happens.

The chronic repeat offender is the bigger concern, of course, but I instruct my staff to be very patient and tolerant with this group also. Itís part of the nature of working with the public. If pushed to our limit, we will simply double-book the chronic no-show patient (no need to inform the person about this Ė keep it invisible). With an efficient clinical process, itís not difficult to work in an extra exam if and when he shows up.

Best wishes for continued success,

Neil B. Gailmard, OD, MBA, FAAO
Chief Optometric Editor, Optometric Management