how to reduce no-shows

6 Best Strategies to Reduce No-Shows

Missed appointments are a bane of any industry.

Everybody misses their appointments once in a while. You oversleep, you take too long to get somewhere, you miss a turn — whatever the reason, you’re late for your appointment.

Unfortunately, your being late has repercussions not only for you but for other people and the business at large.

As with most things in life, but especially with no-shows, less is more.

In this article, we will discuss the best strategies to reduce no-shows in retail, primary care, and other industries.

No-shows: definition, statistics and negative consequences of missed appointments

First things first, let’s make one thing clear: no business can boast a 0% rate of no-shows — not consistently, anyway.

This is, sadly, especially true of hospitals. As of April 2021, the average patient no-show rate in the United State was 18%.

This number has, of course, been affected by the ongoing COVID-19 pandemic.

According to the recent Clinic to Cloud 2020 Survey: Building a Better Practice Beyond COVID-19, 71% of medical professionals have seen an increase in patient anxiety or distress, and 50% saw an increase in patient appointment confusion and no-shows since the pandemic began.

If you don’t know the no-show rate of your business, you can calculate it right away.

How to calculate your no-show rate

To calculate your business’ no-show rate, divide the number of no-shows by the total number of appointments.

No-show rate = Number of no-shows / Total number of appointments

Ex: If there were 100 appointments in a day, and 10 visitors did not show up, your no-show rate is 10 / 100 = 0.1, or 10%.

Calculating your no-show percentage gives you a nice starting point from which you can begin improving your business’ visitor show rates.

Why reduce no-shows: the problem with balking visitors

why reduce no-shows

The main negative consequences of no-shows are two-fold. These are:

  1. Direct financial costs — lost revenue and unrealized gains.

  2. Operational costs — through creating scheduling inaccuracies and forcing to rebook time slots.

No-shows are a costly phenomenon for hospitals.

Dr. Thornton, a breast cancer surgeon, says that no-shows are one of the most costly things that can happen to a primary care provider, and the increasing admin on the back of appointment no-shows is “simply unsustainable”.

I’m a cancer surgeon, so I’m responsible for all the no-shows. When a patient doesn’t show, I have to write a letter to the patient and their general practitioner, so it costs me time, plus it costs me money I haven’t earned.

For instance, a no-show rate of 12% can cost a vascular laboratory a gross loss of $89,107 annually. It also creates inefficiency in the scheduling system and increases the waiting time for outpatients.

It was also shown that reducing the no-show rate to 5% would result in increasing the revenue by $51,769.00.

These issues magnify when scaled up. 67,000 instances of no-show patients can set back the healthcare system around $7 million.

Suffice to say that at an average cost of $265 per missed appointment, every appointment counts.

How to reduce no-shows: 6 actionable strategies

There are certain causes for no-shows that you, as a service provider, have little to no control over:

  • Transportation-related issues
  • Scheduling conflicts
  • Weather condition
  • Personal/job-related drama that requires the visitor’s attention
  • Fear and anxiety (especially in primary care)

The factors affecting no-shows are many, but no matter the industry, you can use our actionable tips to reduce no-shows.

Send a warm-up message to the visitor

Lack of urgency leads to a lack of responsibility. Patients may not regard missing their appointment as crucial to their care and to healthcare providers.

To fix this, you should be open with your timetable. Share your agenda with the customer: what should they expect, what the agreed date is, the location, and maybe even something about you as a provider.

(Brevity is the soul of wit, but some people respond better to oversharing.)

In short, a customer needs to know why this appointment is important. As long as you can illustrate the importance, you can minimize the risks of cancellation.

Reduce the time between scheduling an appointment and the actual appointment

reduce appointment wait time

One of the more effective ways of reducing no-shows? Cut down the waiting times.

Whether it’s reducing no-show rates in primary care or in some other industry, your visitors want faster service.

The longer they have to wait in line, the bigger the likelihood of them leaving it mid-wait.

Try implementing a virtual queuing system that helps get rid of physical lines. Give customers the freedom to wander around and wait wherever they want.

It has been shown that time spent standing in queues feels like passing slower than it actually is. By focusing on the convenience of waiting, you can create a positive experience for your visitors and patients, which leads to a reduced no-show rate.

Allow for self-service scheduling

One research found that the no-show rate was lower for appointments that were scheduled using digital self-scheduling versus appointments that were scheduled using traditional office-assisted scheduling.

So that’s one of the ways to reduce no-shows — by implementing a self-service check-in.

This way, you can:

  1. Free up your labor resources by not requiring staff to manage lines by hand.
  2. Give your customers control over their sign-in process.

Self-service check-in kiosks are also a great way of collecting additional customer information that could be used to augment the service.

Set up automatic SMS reminders

sms messaging with customers

It has been shown that automatic notifications help reduce no-shows.

Dr. Chantel Thornton, whom we have quoted earlier, explains how the automation of appointment reminders and follow-up reminders has saved her both time and money:

“I send out automated reminders to patients to get their mammograms and ultrasounds done. I can send them addresses and referrals directly. I can remind them they have an appointment booked. It saves me masses of time and money.

If you want something more than an anecdote, there’s an entire study dedicated to this issue.

In their paper called aptly Telephone reminders reduce no-shows, Drabkin et al managed to reduce the no-shows from 20.99% to 7.07% with the application of phone reminders.

Two-way SMS communication in general is a good way of keeping your customers well-informed and notifying them of any changes or delays that happen.

Have flexible rescheduling, cancellation and rebooking policies

When customers or patients feel that it would be too much of a hassle to reschedule, they are likely not to contact you at all.

At best, you’ll miss out on this one interaction. At worst, they will take their business elsewhere.

Make your rescheduling policy more flexible to accommodate for mishaps that force people to come late.

Many airlines have adopted a new stance on fees since the coming of COVID-19. Instead of making passengers pay extra for rebooking or cancellation, they have applied a more measured approach and allowed people to plan their trip in peace.

Keep track of no-show appointment rates

No matter how hard you’re going to try to reduce no-shows, they are inevitable.

avengers thanos inevitable

Your main objective is not to let the no-show rates grow any bigger. That’s why it’s so important to track these numbers daily/weekly.

Again, the formula for a no-show rate is the number of no-shows divided by the total number of visitors for the same period.

You can consult the average no-show rates that are relevant to your industry to see if you’re doing okay.


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