Recent figures indicated that no-shows or missed appointments cost the National Health Service £1bn in 2017. A figure that could fund a quarter of a million hip replacements. Self-employed practitioners and therapists feel the sting of missed appointments even more acutely as they still have to pay room rent and in some cases have to travel during peak times (another added expense) to make the appointment. Even more frustratingly, a practitioner may travel all the way to their practice for one client only to find out they have cancelled. There are of course circumstances where a patient has to cancel an appointment with little or no warning for illness or travel disruptions for example. However, there are many incidents where patients miss appointments which can be costly for self-employed practitioners.
Many practitioners exercise a 24 or 48 hour cancellation policy so that they can book another patient to cover their room rent. However, with new patients who do not arrive, it can be difficult to follow-up with them for missed appointments and a practitioner may feel uncomfortable charging an upfront fee. For patients, missing an appointment can also be quite a stressful experience, particularly if they were in need of a treatment. Also, for patients who are on a budget, they may feel reluctant to book another session if they are aware they have to pay double fees.
The most common reason for missing an appointment is simply forgetting. There is something slightly humorous about calling a no-show 10 minutes into their appointment time to see where they are and hearing a silence of 3-4 seconds, followed by a gasp as they realise that they should be in a session rather than sipping coffee on the other side of town. A patient, with all the good intentions in the world, may enter their appointment in their diary, on their phone’s calendar, pin the appointment card to the fridge but on the day forget to double-check their diary, phone and fridge and arrive at completely the wrong time.
Another common cause for missed appointments is miscommunication. This can happen with all forms of communication - face-to-face, on the phone, via email, etc. On a phone with bad reception, 10.15am becomes 10.50am and appointment requests or cancellations can often get lost in long email threads.
Incorrect data entry is also an annoying cause for missed appointments. Technology is a very valuable tool but sometimes it can be more of a hindrance. A few times patients have reported entering their appointment into their phone’s calendar, only for the phone to change the date or time of the appointment.
Human error also has a part to play in incorrect data entry, particularly with paper diaries - writing the wrong time or date is a very common thing. For example, the dates for February and March often fall on the same days of the week. Using a mental calendar you may say to yourself, the third Friday in February will be the 16th. From experience, I can tell you that if you are distracted, or if a diary is not properly labelled, it is very easy to inadvertently book an appointment for Friday 16th March instead of February!
Over the years I have developed a sixth sense for the different potential no-show clients and have found ways to minimise missed appointments accordingly. This might include the method with which the person books (by phone, email or online booking system), the type of reminders that are used and the lead time for reminders (people have often forgotten about an appointment less than 24 hours after being reminded).
Tips for practitioners
If you are experiencing high numbers of missed appointments, you may need to reconsider your booking methods: by phone or text, email, online booking systems, etc. You may also need to think about the information that is relayed to clients when they book including your cancellation policy. People are less likely to cancel at the last minute or forget an appointment when there is a financial penalty involved. (Don’t be shy about outlining your cancellation policy clearly but politely – your time is valuable).
You may need to experiment with various booking systems to see which works best for your business and your clientele (believe it or not, but not everyone uses their emails regularly!).
Depending on the method used to book the appointment, you may find it useful to send a follow-up confirmation text or email with the booking details. This way, if there was a mistake with the original booking, it is more likely to be picked up at this stage.
Most online booking systems make this process easier as they send an automatic reminder to clients at your specified lead time. Again, you may need to alter the method used depending on your clients.
No shows happen
As frustrating as it is, no-shows will happen despite all of your best efforts. Don't take it personally.
Tips for clients
Avoid the rush hour
Life is very busy and we sometimes have to multitask – I appreciate that. However, trying to book an appointment in the middle of the school run with hundreds of children screaming around you increases the likelihood that you are going to either mishear something or forget the appointment altogether.
See if you can imagine that phone call as the start of your treatment. Give yourself five minutes with as little noise and distraction as possible to make the phone call. Start to drop into a space of relaxation or spaciousness a day, a week or even a month before you have even stepped into the practitioner’s treatment room.
Don’t Book without your Diary
Avoid making an appointment without your diary to hand. Even if you do have a great memory, after a relaxing treatment our brains tend to turn to mush. Remembering your next appointment date or time or whether you have a conflicting appointment that day becomes quite difficult. Save yourself the stress and only book once you have a clear idea of your diary.
Set yourself reminders
Some of the simplest apps on mobile phones are the most useful. Using the calendar app on your phone, when you enter in your appointment, set yourself a reminder 48 hours (or however long you need) before your appointment. You can sync your calendar to most of your devices, so that there is less chance of you missing the appointment or more time to cancel if necessary without incurring a cancellation fee.