One Missed Appointment is Actually Two Missed Appointments

January 17, 2019

 

The first missed appointment is the one the client actually misses, and the second is the one that they then re-schedule, thus taking away an appointment that another, possibly new, client could have had. Missed appointments can have a serious impact on your practice.

 

  • They reduce productivity

  • They decrease revenue

  • They increase waiting times

  • They deprive other patients of potential treatment

  • They decrease your treatment success for the patient.

 

We are all human and sometimes we just forget about an important appointment. If this happens once, we can forgive our client. But in practice one finds that there are certain clients who get into a habit of no-shows and cancellations. A no-show is what happens when a client does not let you know that they are not coming. These are worse than a cancellation because you usually wait 10 to 15 minutes, then try and call them and by the time you realize they are not coming, 20 to 30 minutes may have gone by and have been wasted.

 

A cancellation is certainly better; when a client informs you that they will not make the appointment, a few hours or the day before the appointment. Sometimes, however, they call just a few minutes beforehand, and that is almost as good as a no-show.

 

Why do People Cancel or Miss Appointments?

 

  • It could be an emergency. This happens and is out of the client’s control.

  • The appointment might be inconvenient for them because something better has come up.

  • They could have truly forgotten.

  • They might not be happy with the treatment and have decided that they don’t want to continue.

  • They owe you money and promised to pay at the next appointment.

 

In my previous blogs I have discussed how important our time is. Missed appointments can be a huge time waster in our practices. Over the years of running my practice, I have tried a few ways to minimize no-shows and cancellations. Some things worked and others didn’t at all. I tried to get heavy and make my clients pay a cancellation fee; this worked for some but was upsetting to others.

 

Strong Relationships

 

We often spend a lot of time with our clients and we build very strong, connected relationships with them. We go through the ups and the downs with them and because of this, our connections with them may pass the professional/client barrier and move towards more of a friendship. We support clients and they rely on us to advise them on their pets’ health care. This relationship is important because it builds trust and loyalty. Clients who enjoy this kind of relationship with you are less likely to not show up or to cancel at the last moment. They value your time and respect you.

 

However, you will not have this kind of relationship with all of your clients. There are others who will more readily cancel appointments.

 

What I have found works best is to keep building those relationships with my clients. If you want your clients to respect your time, you need to respect theirs. Make sure you are on time with your appointments. If someone is late, do not let their appointment creep into another client’s time. Rather cut the late person’s appointment short.

 

Also, do not overbook yourself. Allow enough time between appointments so that you can keep to your time schedule.

 

One of the mistakes I made when I first started my practice was being available all the time. I consulted five days a week between 8:00 am and 5:30 pm.

 

As my practice was just growing, a client could get an appointment any day they wanted.

 

After a while, I realized that this was to my detriment. The number of missed appointments and no-shows for the number of clients I was seeing was extraordinarily high. The reason was that clients knew they could easily get an appointment tomorrow or the next day. So if something else came up they would just move the appointment to another time that was more convenient for them. I had decreased the value of the appointment to them.

 

Allowing constant re-scheduling simply creates more no-shows and cancellations and is really not a good way to manage your time.

 

So I changed my consulting times. I consulted half days, alternating mornings and afternoons. My clients didn’t know this. I told them I was fully booked in the afternoon. I was, actually; I was catching up on my admin. When a client phoned for an appointment, I would ask them, “Morning or afternoon, early or late?” and give them two or three choices for the week.

 

This did two things; it made them realize that I was busy and it made them value their appointment, because they knew they might not be able to get another one at short notice.

 

Remind Clients of their Appointments

 

Reminding clients is a great way to prevent no-shows. There are a few ways to remind clients that they have an upcoming appointment.

 

In the early days I used client cards, but I found that clients lost them or forgot them and they didn’t seem to be very effective.

 

One can also email, SMS or phone them.

 

There are websites that offer SMS bundles. Google this for your country. Alternatively, you could use WhatsApp or SMS from your mobile phone. SMS has become a powerful marketing tool these days, because everyone uses Whats App and so when a person gets an SMS they usually read it.

 

The personal phone call is, however, always best. Apart from adding the personal touch, it allows you to find out how your patient is doing and what to expect at the appointment.

 

If you phone a client and they re-schedule, it will give you time to find another client to fill that slot. I would advise calling two days before the appointment and SMS the day before the appointment.

 

Always keep a list of clients who are happy to have short-notice appointments, whom you can call to fill those missed appointment slots.

 

How to Handle Clients who No-Show

 

After implementing the cancellation charge and realizing that this upset some of my clients, I decided to use the idea differently. I put up a sign saying “Cancellation fee for appointments not cancelled within 24 hours”, but to be honest, I hardly ever need to charge it. Clients are often grateful when they know they should have been charged for a no-show and you decide not to charge them!

 

I found the best approach was to speak to the client and explain to them the implications of not pitching up. When they realize that they possibly deprived a dachshund of therapy to enable it to walk again, the impact of their missing an appointment hits home. Once I started involving clients in the process, explaining the consequences of their no-shows, I found that clients started phoning beforehand, and no-shows became extremely rare.

 

When clients do phone to cancel, thank them and explain how grateful you are for letting you know, as you are now able to schedule another client for that spot.

 

In the end it is all about courtesy and relationships. Refrain from getting angry. Focus on the good relationships you want with your clients, and you will see the unwanted behaviour subsiding. Missed appointments are time and money wasters, but there are ways to handle the problem, as I have found to the advantage of my practice.

 

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Dr Megan Kelly
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