How to Avoid and Manage No-shows

By Chandresh Shah

Everyone talks about patient no-shows. Some practices take for charge and control, some, 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, financial issues, to 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 same day or one day in advance.
  2. Same day openings: Try to keep few appointments for 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 add manual reminders for some patients – chronic, high value etc. One size does not fit all.
  5. Keep waiting time to minimum.
  6. Thank patients who keep appointments and arrive on time.
  7. Provide printed copy for 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 same page.


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

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