Why Do Patients Not Show Up, and How Do You Stop Patient No-Shows?

Have you ever wondered why some patients do not show up for appointments or how to stop patient no-shows? It’s a common problem that administrators and clinicians who run private practices sometimes encounter. 

Understanding that patient no-shows aren’t just a scheduling inconvenience is crucial. These no-shows are a significant financial burden that can considerably reduce revenue, disrupt patient care, and create scheduling headaches. 

Despite the significant impact patient no-shows can have on a practice’s bottom line, this problem is understudied, leaving many healthcare providers guessing about potential solutions. 

Exploring why some patients do not show up for their appointments

Understanding why patients miss appointments is the first step toward finding a solution to minimize no-shows. Some common reasons why patients skip medical appointments include:

• Scheduling frustrations: Long wait times between booking and appointments can frustrate patients, sometimes leading them to lose interest in your services and seek care elsewhere despite having scheduled an appointment with you four months ago. Research shows that dissatisfaction with wait times is one of the most significant factors that lead to no-shows. 
• Life gets in the way: Many patients, particularly women with caregiving responsibilities, have hectic schedules, which make them more likely to miss appointments when conflicts arise. 
• Lack of trust: Some healthcare providers may inadvertently make patients feel like they're just another number, which can reduce their trust in the care they’ll receive. When patients aren’t convinced their physician is the best suited to perform the necessary treatments, showing up for an appointment becomes less of a priority. 

The impact of patient no-shows on private practices

Each missed appointment represents a lost opportunity to earn revenue and build long-term patient relationships. Frequent no-shows can also lower staff morale within your practice and disrupt the care flow. 

Patients missing appointments could also be a sign you’re not making your patients’ treatment journeys seamless. 

Ways to reduce patient no-shows

Now that we’ve gone over why some patients do not show up for their appointments, here are some practical ways to reduce your rate of patient no-shows:

1. Streamline scheduling and rescheduling

No one enjoys navigating through a maze to book or cancel appointments. Make the process as easy as possible by offering:

• Online scheduling: Create straightforward ways for patients to book or reschedule appointments online at any time. Many practices force patients to call in to reschedule appointments, increasing no-shows as many patients don’t want to be bothered with the hassle of having to call over and over or wait on hold for an hour to talk to someone.  
• Low-friction scheduling and rescheduling: Make scheduling appointments easy to build trust and then make rescheduling appointments as easy as booking one. Some sites have online scheduling abilities, but if patients want to reschedule or cancel, they’re directed to call instead of using the online option. When encountering friction, people are less likely to keep the appointment due to this barrier. They are more likely to get increasingly frustrated and feel they do not owe providers the respect and time involved in notifying them of schedule conflicts if providers make this process difficult and devalue the patients’ time by introducing time-consuming and unnecessary steps. Patients are more likely to remain engaged when they have the power to manage their schedules. 

2. Built trust with virtual visits

Patients value building connections with their healthcare providers, so offer initial virtual appointments to: 

• Help patients determine if you’re a good fit for them.
• Create a low-pressure environment to ask questions.
• Lay the foundation for a strong patient-provider relationship.

This approach is particularly beneficial for patients with busy schedules, bedridden patients, and anyone hesitant to commit to a first “meeting” with you. 

For example, spinal leak patients often spend years seeking effective, comprehensive treatments, so demonstrating your expertise through virtual visits is an excellent way to build trust. Some clinicians say that patients should just trust their credentials. However, healthcare education is highly variable, as is any provider’s past clinical experience. 

Clinicians need to understand that demonstration of abilities is a must. Sometimes, clinicians become offended at the idea of patients “interviewing” them. However, it’s important to remember that a patient-clinician relationship is professional, and patients are in their right–and should even be encouraged–to ask questions to determine a good fit and take a proactive role in their own care.

3. Use smart reminders

Sending reminders to patients about their upcoming appointments helps considerably to reduce no-shows. Simple ways to remind patients about their appointments include:

• Text and email alerts: Send reminders a week, day, and even a few hours before appointments. 
• Personalize messages: Personalize reminders by including names and details about patients’ upcoming appointments to make reminders less automated. 

4. Address barriers 

Understand and develop solutions to address obstacles preventing patients from coming to appointments. For example:

• Offer telehealth options to patients who don’t have reliable transportation. 
• Provide flexible appointment times for patients with busy schedules.
• Offer payment plans to patients dealing with financial difficulties. 

These small accommodations demonstrate to patients that you value their time.  

5. Discard high-friction policies

While policies like charging a deposit for appointments seem like a good idea to deter no-shows, they can sometimes backfire on private practices. Patients already wary of healthcare costs might interpret deposits as a red flag, suggesting the practice prioritizes profit over patient care. This can also lead to chargebacks, potentially harming the practice’s relationship with banks. Patients are more likely to dispute and win chargebacks for informal deposits compared to payments tied directly to a service.

While communicating and taking deposits can work well for some practices, they can also deter patients in others. An alternative approach is to offer a timely, accessible first virtual visit. This visit can act as a foundation to ensure value is delivered for the payment, build trust with patients, and help both parties determine compatibility and create a care plan.

We recommend avoiding high-friction policies and, instead, streamlining the customer journey at all points with approaches such as:

• Communicating clearly your cancellation and rescheduling policies.
• Emphasizing the benefits of showing up for appointments, like better health outcomes.
• Creating user-friendly online platforms for booking and rescheduling appointments.
• Taking payments for virtual initial visits as an anchor and demonstrating that excellent services are being delivered for the funds patients invest in their care.

Turning no-shows into yes-shows: Practical solutions that work

Addressing patient no-shows provides many benefits besides protecting your bottom line. It improves the patient experience by making it as convenient as possible for consumers to access the care they need. 

You can reduce no-shows and strengthen your relationships with patients by understanding the causes of missed appointments and implementing patient-focused strategies.  

Contact us if you’re ready to build a no-show prevention strategy tailored to your needs.