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 By Neil B. Gailmard, OD, MBA, FAAO, Editor June 22, 2011 - Tip #487 
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Reducing No Shows

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No shows are one thing that can really get under the skin of an eye care provider (ECP); and rightfully so.  Not showing up for an appointment and not bothering to call is a blatant disregard for the ECP's time.  Considerable office resources are reserved for an eye appointment and it is a shame to waste it.  But rather than getting angry over it and rather than threatening to send a bill for a no show fee, let's develop a strategy that will reduce no shows and still maintain great customer service.

I'm sure most practices make some effort to contact patients before their appointments to remind them.  Your method may use your own staff to place phone calls, or you can also hire a service that will use live people or very clever automated voice systems to make the calls.  There are other services that will confirm appointments by email or texting.  I like these systems because it provides a quick way for the patient to respond by clicking within the message which sends a confirmation email back to your staff.  But most practices still have some patients who have not opted in for email and texting, so phone calls are still needed.

Even with these efforts, if your no show rate is still higher than you would like, let's change the confirmation process.  Here are some points to consider:

  • Most offices call or email the day before the appointment to confirm.  Try doing it two days before so you still have time to fill any slots that become available.
  • The majority of phone calls go to voice mail, so those patients are really not confirmed.  The patient may not get the message and if he does, he does not have to commit to it.  If your no show rate is very high you could require the patient call your office back to confirm the appointment.  You could use this approach just for days that have a bigger show problem, like Saturdays.
  • Try to maintain a call list of patients who schedule an appointment but would like to come in sooner if a cancellation occurs.
  • If you end up with last minute openings on Saturdays or evenings, which have high patient demand, a staff member could call all the patients who are scheduled for that same day a week or two later and tell them a cancellation occurred and ask if they would like to come in sooner.

How much does a no show hurt?
It hurts quite a bit if you have long appointment slots that consist mostly of doctor time.  This is a good reason to move toward more delegation of clinical duties to staff members and converting to a faster pace.  A busy practice seeing patients every 15 minutes does not really feel a pinch with an occasional no show.  It is often a welcome catch-up event.  When that is the case, your staff can be very understanding when they contact the patient to let them know they missed the visit and to reschedule.  Your practice quickly gains a reputation of being very easy to work with and patients love you for it.  Tremendous patient loyalty occurs when your staff is nice to people who make a mistake.

I see nothing wrong with double booking a repeat no show offender, as long as your staff doesn't tell him he's double-booked.  Doing so would be an attempt to punish or teach a lesson, and I'm more interested in letting the patient win while preventing wasted office resources in the future.

Best wishes for continued success,

Read Past Tips Neil B. Gailmard, OD, MBA, FAAO
Editor, Optometric Management Tip of the Week

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Send questions and comments to neil@gailmard.com.

Dr. Gailmard offers consulting services to eye care professionals through Prima Eye Group; information is available at www.primaeyegroup.com.

Please Note: The views expressed in Management Tip of the Week do not necessarily reflect those of the sponsor.

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