The occasional missed appointment happens at every medical practice and may even feel like a welcome break in an otherwise jam-packed schedule. But last-minute appointment cancellations and no-shows hurt your practice’s finances—they can even take a toll on your patients’ health. By some estimates, missed appointments and last-minute cancellations cost the U.S. healthcare system $150 billion per year. Another study found that, in family medicine practices, cancellations and no-shows represented nearly one-third of all scheduled appointments, with only about 60 percent of those appointments being filled subsequently by walk-ins.
The amount of staff time spent trying to fill last-minute cancellations adds to the high cost and interferes with other priorities, like greeting patients and managing check-in and check-out procedures efficiently. The bottom line? Cancellations hurt. Key to reducing them is understanding why patients cancel in the first place. If your practice isn’t doing what it can to remind and encourage patients to attend their appointments, you may be just as culpable for cancellations as patients themselves. At a time when medical liability experts say that missed appointments pose significant legal risks for physicians, reducing cancellations isn’t just good for business — it’s an ethical responsibility.
So, what’s keeping your patients from keeping their appointments?
Let’s face it: going to the doctor isn’t at the top of most people’s fun list. But for many patients, fear and dread of the doctor visit result in avoiding, delaying, or cancelling appointments altogether. It’s not hard to imagine the reasons. Doctors can bring bad news. They might tell patients something they don’t want to hear, or lecture patients for putting off treatment, not following medical advice, or engaging in unhealthy behavior. With procedures like colonoscopies, stress tests, and blood work, prepping for the procedure (fasting, for instance) or the procedure itself can be reason enough to call and cancel.
In the first quarter of 2015, only 11.9 percent of Americans were uninsured. But being insured is no guarantee of good care. A late-2014 Gallup poll found that as many as a third of people in the United States say they don’t get the medical care they need because of the cost. In fact, 22 percent of the 828 people surveyed put off treatment for a serious condition due to the expense, up from 12 percent in 2001 and 19 percent in 2013, Gallup found.
The Great Recession might be over, but plenty of patients struggle or aren’t able to pay for medical care. Rising out-of-pocket costs and employer deductibles, combined with stagnant U.S. wages, are common culprits. So when patients are strained financially, cancelling an appointment last-minute might look like the only option.
Hectic work and family schedules can make for a packed day. Studies show, in fact, that U.S. citizens not only work more hours per week than people in any other developed country, we’re also working more than ever in our own history. When the repercussions of taking time out of the work day to go to the doctor feel more serious than the health problem itself, it’s easy for patients to prioritize meetings and tasks over the doctor appointment they scheduled—especially if they aren’t acutely ill. Add anticipated wait times in your waiting and exam rooms, and the motivation to keep appointments can dwindle further down the list of priorities.
Offering early morning, evening, and weekend appointments, your practice can offset the cancellations you receive from harried patients who, despite best intentions, can’t feasibly get there during the workday.
Is your practice’s waiting list growing? Do your patients have to wait too long to get an appointment? If so, know that these factors affect your cancellation rate. Sick patients frustrated by having to wait a long time to get an appointment will cancel and go elsewhere if another doctor can see them sooner. Practice loyalty flies by the wayside, especially if someone isn’t feeling well and needs urgent care.
Last-minute cancellations come at a high cost to both your practice and your patients’ health. By figuring out what barriers your patients face — and working with them instead of against them — you can take the first steps in creating a system that works for your practice and patients alike.
Want more help reversing the revenue loss and other consequences of last-minute cancellations? Relatient’s comprehensive patient engagement platform offers medical practices mobile-first strategies like Patient Self-Scheduling and Automated Waitlist to extend a provider’s reach and give patients the self-service tools they want. Get in touch or sign up for a demo to learn more.