How to Avoid and Manage No-shows

By Chandresh Shah

Everyone talks about patient no-shows. Some practices take charge and control, and some, do not so much. I’m dividing the nemesis of no-shows into parts. One, how to avoid them in the first place and also, how to manage them because inevitably you cannot ever eliminate them.

Good scheduling practices are financially more rewarding.

We have to start by analyzing, understanding, and empathizing with the reasons why there are no-shows to begin with. They can range from forgetfulness, and financial issues, to a lack of transportation.

Avoiding No-Shows

  1. Chronic Culprits: Patients miss appointments from time to time which is understandable but you need to identify chronic appointment ‘Missers’. Restrict them to the same day or one day in advance.
  2. Same-day openings: Try to keep a few appointments for the same day if your patient backlog permits.
  3. Double book: Double book chronic culprits so that you don’t end up with empty slots.
  4. Appointment reminders: Phone reminders and SMS are good but manual reminders for some patients – chronic, high value, etc. One size does not fit all.
  5. Keep waiting time to a minimum.
  6. Thank patients who keep appointments and arrive on time.
  7. Provide printed copies for the next appointments – even if you send emails and automated messages.
  8. Ask about transportation if you know some patients have issues.
  9. Staff education and prioritization. Create a policy to address scheduling needs and all staff must be on the same page.


  1. Keep wait list
  2. Follow-up no-show immediately – don’t wait.
  3. Manage ‘latecomers’. Counsel, and warn them as necessary. Enforce a small penalty after repeated warnings.
  4. Have a written policy that is clear, and implementable.
  5. Have a clear no-show fee. You can try the approach of taking it off on the next on-time appointment.

Let me know your thoughts and if you have something to share.

Author: Chandresh Shah

Chandresh Shah specializes in Healthcare IT and Medical Billing. He knows the market inside out; what works, what doesn’t. He advises and works with small business owners.