American Osteopathic Association

Advancing the distinctive philosophy and practice of osteopathic medicine

How to Reduce Your 'No-Shows'

April 21, 2014:

When a patient misses a scheduled appointment, that lost income cannot be recaptured. It affects a physician’s bottom line.

When Do No-Shows Tend to Happen?

There are specific trends to look for related to no-shows in regard to when they occur and who the likely parties are. In studies conducted across all specialties, the first and last weeks of the month had a higher no-show rate than the middle two weeks. Some speculate that this could be due to patient cash flow issues related to when the household gets paid. Short funds at the end of the month make it difficult to pay co-pays or other out-of-pocket expenses.

Annual exams and non-urgent visits are most often the types of visits that result in no-shows. In an ob/gyn practice where well woman visits are scheduled six months out or more, this can be especially frustrating to the staff and physicians.

Which Patients Miss Appointments?

Patients younger than 35 years old have higher no-show rates than other age groups. Another no-show patient characteristic is a low socioeconomic status, perhaps compounded by transportation issues. Finally, patients who have an outstanding account balance with your practice have a higher likelihood of not keeping their appointments. However, for some patients, simple forgetfulness is the reason cited for missing appointments.

Strategies to Reduce No-Shows

A study conducted in 2007 at the Robert Wood Johnson University Medical Group indicated that approximately 23.1% of patients who received no reminder call missed their appointments. The number went down to 17.3% if patients were contacted by an automated appointment reminder system such as HouseCalls. But the no-show figure went down further to almost 13.6% if a staff member made the call.

A new trend in patient reminders is through email and text notifications. A study by the Internet Journal of Healthcare Administration found that email reminders provided a 36% decrease in “nonattendance rates.”​​​​​


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