No matter how carefully you schedule and how consistent your appointment reminder system is, you will have no-shows in your practice. Patients are human and sometimes they forget appointments, write them down on the wrong day, or have emergencies that prevent them from getting to the office when they’re scheduled to be there. An occasional no-show should be quickly “forgiven” and rescheduled, but patients who disrupt your day more than a couple of times by failing to appear or cancelling appointments at the eleventh hour need to be dealt with. Here is a recommended course of action.

Step 1: After a patient has been a no-show twice, have a conversation with them either by phone or in private at the office the next time they’re in for a visit. Make it clear that, while you value them as a patient, it puts a burden on the practice when they fail to keep appointments. Reiterate your practice policy of requiring a 24 or 48 hour notice to cancel or change appointments and ask for the patient’s agreement in following the policy in the future.

Step 2: If the first step does not result in the individual being more reliable (and assuming you want to keep the patient in your practice) it’s time to put something in writing. A brief letter from the office manager should once again explain the policy and ask for the patient’s cooperation. This step will get most people’s attention and let them know you’re serious about scheduling efficiency.

Step 3: If steps one and two don’t do the trick, then dismissing the patient from the practice may be your only option. If this becomes necessary, be very careful in how you proceed so that you are not accused of patient abandonment. Check with your county medical society, state medical board, and/or malpractice insurance carrier about the proper steps to follow when discharging a patient. This is a last resort, but sometimes it’s necessary for the overall health of your practice, not to mention the sanity of staff members who have to deal with chronic offenders.

For tips on reducing no-shows, check out this post from March, 2012.