Everywhere around the world, medical practices are dealing with challenges such as canceled patient appointments and no-shows that result in lost time, reduced income, and even compromised patient care. As a doctor, you are well aware that there are hundreds and thousands of you competing for the same patient population. While education, expertise, professionalism, and the latest tools can help your practice stand out, ensuring that your practice remains competitive and profitable means recognizing and addressing the factors that seem to be draining your revenue. Among the most common factors resulting in a decline in profit include vacant appointment times and scheduling delays. According to the Medical Group Management Association, every day doctors lose around 12% of their available appointment time due to patients failing to show up or canceling their appointments. Given that the average doctor wait time is around 3 weeks, it's not a surprise that running a busy practice and dealing with last-minute cancellations can cause a heavy drop in revenue.
So, what is causing your patients to miss or cancel their appointments? Recent studies have found that no-shows and cancelled appointments can occur due to several reasons, one of the most common being the failure to remind patients of their appointments. “At the end of the day, each provider is expected to look back at their schedule and review patients who didn’t show up, and ensure that a safe follow-up occurs. Was this a scary follow-up, someone who had critically high blood pressure, worrisome imaging, worsening renal function, or an abnormal biopsy, for whom we made an urgent short-term follow-up appointment? Or was it simply a patient who had scheduled an annual physical, and then didn’t show up? We worry more about those sicker patients, but even the annual visits that no-show for their appointments come at a cost of health, and of health care. Perhaps they rescheduled to get their annual physical another day, but perhaps someone who really needed to be seen didn’t get to simply because of that placeholder, that appointment that was never used,” wrote Fred N. Pelzman, internal medicine specialist.
Nowadays thanks to the internet and recent technological advancements, you can utilize online tools to tackle such issues and help your practice run more efficiently. Here are some ideas you may want to consider:
- Implement automatic reminder calls, text messages or emails that will remind patients of their approaching appointments and allow them to cancel if necessary;
- Grow your practice’s visibility and prospective patient base through referrals and target marketing;
- Streamline appointment scheduling by emphasizing available appointment times and last-minute cancellations online for patients to see;
- Encourage patients who call to cancel their appointments to reschedule at the time of the call;
- Frequently contact patients who cancel or do not show up for their appointments;
- Allow patients to access your online services, such as online booking system;
Practices have even begun to respond to no-shows and cancelled appointments by incorporating several different strategies, from charging no-show fees to overbooking patient appointments. “It is possible that charging patients a fee for no-show appointments could reduce the rate at which they occur, and make patients less likely to schedule an appointment for which there is a chance they might not keep it. But it also puts restrictions on patients, and makes them feel they can’t make an appointment if there’s any chance they might not be able to keep it, and therefore get charged. Seems somehow to go against all we believe about our primary desire to get our patients in, to get them seen, to get them to health care,” wrote Fred N. Pelzman.
One strategy in particular, known as the appointment-schedule analysis, involves identifying your practice’s “fill rate” by analyzing appointment data (no-show and cancellation rates) and then integrating the end results. The goal of the concept is to help maximize the number of patients you see on a daily basis (fill rate), all the while improving your practice’s efficiency and maintaining quality of patient care. When determining your practice’s optimal fill rate, you must take into account the type of practice you have and the scheduling method that you use. For instance, if your practice relies mainly on same-day emergency visits, you require more flexibility in your schedule, meaning that a low fill rate may be best option for your situation. To determine your practice’s actual fill rate, you need to take the total number of appointments filled and divide it by the number of slots available. To do so, you must assess your practice’s appointment schedule on a daily and monthly basis. A higher fill rate may indicate more staff-related stress and overbooking, while a lower fit rate may indicate more no-shows or cancelled patient appointments.
Once you have calculated your practice’s actual fill rate, you can compare it to your desired rate. This will allow you to gain some insight as to what action you should take or changes you should make, if necessary, to increase your practice’s efficiency. A higher fill rate may cause you to consider expanding your practice, while a lower fill rate may cause you to consider reducing extra capacity. In any case, the appointment-schedule data will show you how your practice can benefit from reviewing appointment slots and making necessary changes regarding supply and demand. It is an opportunity that will allow you to be able to grow your practice, either internally, externally, or both.
Apart from analyzing your appointment schedule, there are several other ways in which you can help your practice operate with a higher level of efficiency and maintain a steady workflow. Take an active approach by:
- Implementing electronic health records (EHRs) to help streamline your practice’s strategic process;
- Training your fellow colleagues to code accurately in order to increase revenue;
- Setting up social media accounts to increase your online presence and engage with current and prospective patients;
- Increasing training of front-desk staff members who are the first to greet patients;
- Keeping a record of inventory and avoiding overstocking;
- Talking to vendors and renegotiating contacts;
- Implementing a prescription policy and a cancellation policy;
You may have the best intentions to manage your schedule by trying to squeeze in a few extra patients or making more time for those patients who have scheduled their appointments weeks in advance; however, this can result in increased wait times, frustrations, and inefficiency. If the scheduling system does not work, it can affect both you and your patients. Therefore, when it comes to resolving the challenges associated with scheduling, this requires getting to the root of the problem. It may sound easy but the reality is far from it. It takes time, dedication, and team effort to create ideal solutions that can eliminate patient frustrations, increase your practice’s efficiency and profitability, as well as help you manage your days just a little bit better.
By analyzing your patient appointments, you can increase your practice’s revenue and improve operations. Consequently, this can result in improved patient service, satisfaction, and care. “Patient satisfaction is vital in order to build and maintain a successful practice. You can be the most talented robotic surgeon and have a reputation for doing a radical prostatectomy in less than one hour with perfect continence, cancer control, and erectile preservation, but if your patients are not satisfied with your care before and after their surgery you may find large gaps and openings in your schedule and a decrease in the number of surgical procedures you perform,” wrote Neil Baum, urologist. By implementing strategies to help tackle vacant appointment times and scheduling delays, you will be able to see changes in no-show and cancellation rates. They might not happen overnight, but they will definitely impact the future growth of your practice and its reputation over time. The key is to be flexible and encourage much-needed changes that will better serve all of your patients and help your practice flourish.
- There could be a number of reasons for a patient no-show, but all of them result in a drop in revenue.
- You can use the appointment-schedule analysis to determine how best to maximize the number of patients you see each day.
- Implementing EHRs can streamline your practice's strategic process.