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7 Steps to Reduce Patient No-Shows

Patient no-shows are aggrivating, but we have 7 ways to help reduce them.Perhaps one of the most frustrating things practitioners experience is patient no-shows. These can not only throw off your practice schedule, but they can break down motivation and efficiency. Steve Vargo, OD, MBA, is an Optometric Practice Management Consultant for IDOC, and he shared a few suggestions with Optometric Management reviewing how fellow eye care professionals can reduce these pesky patient encounters, or should I say, lack thereof.

Patient Recall System

The first and perhaps the most obvious suggestion is a recall system. This is the way you communicate with and remind patients about their upcoming appointments. The most effective approach is a multichannel system – utilizing communication pathways like email, phone, text, and even snail mail to reach patients. These tend to work best if patients are given the options and select which is the best for them. From there, you can test what times and frequencies work best for your patients and practice.

Your patient recall system works well with pre-appointments, but it’s best to consider these as “soft” reservations rather than “hard” bookings until the patient has confirmed. However, it’s important to give patients time to adjust plans or reschedule when you reach out with a reminder. Have staff stress to patients during the original appointment scheduling that they must confirm, or their time slot could be given away.

Overbooking/See More PatientsA line out the door is a good look for some businesses, but keeping your patients waiting can give your practice a bad reputation.

This technique is not for every practice, but it’s an important option to consider. The concept of this option is to book overcapacity in anticipation for no-shows. Now there’s a clear issue when the time comes that everyone shows up, and patients are the ones that must reschedule. This creates a poor experience for them and could begin to build a bad reputation for your practice.

Another similar option is adjusting the daily schedule to accommodate more patients. This means reducing a 30-minute exam time to 20 minutes, reducing the cost impact of a no-show. While this is a good option for some practices, consider the extreme need for efficiency in all aspects of the patient journey and the possible impact on patient experience.

Charge a No-Show Fee

Charging a fee seems like a good solution because it can help cover costs of the missing patient, but it’s more of a deterrent than a source of income. It’s intended to help reinforce patient accountability and culpability. With this option, it’s important that patients know upfront that a fee will be charged if they miss their appointment. Let them know as they schedule their appointment that they’ll be charged if they fail to cancel in a reasonable timeframe. Staff can even collect credit card information while scheduling the appointment to drive home the idea that a charge will be placed if they no-show.

Patient experience is one of the most important considerations with this option, as well. It’s important to be flexible with when to enforce and waive the fee. If a patient has a legitimate reason for missing without reasonable notice of cancellation, consider waiving the cost to build rapport and show empathy. However, use caution when determining whether to waive the fee. You don’t want to build a reputation of having an overly lenient policy.

Know Your Chronic Offenders

While patient experience is always a factor, you’re ultimately running a business. If a patient misses an appointment once, it’s unfortunate. If they miss it twice, it’s typically a pattern. When it comes to patients who continue to miss their exams, there are a few things you can do:Though it may be difficult, enforcing policy on repeat offenders can help your practice reduce its patient no-shows.

  • Increase policy enforcement – be firm but empathetic. They’re still people in a crazy, unpredictable world.
  • Charge a no-show fee – this could open their eyes and make them realize they are wasting someone’s time, and they must pay for that.
  • Overbook on days they’re scheduled – this takes careful planning and consideration of the impact on staff, patients, and practice if all patients show up.
  • Stop allowing them to schedule appointments – while walk-ins are still available, these patients may not be allowed to schedule appointments in advance to reduce the expectation.

Update the Language

Sometimes a simple update to the terminology and words used in conversation can help stress the importance of showing up for or at least canceling an examination. For example, changing the statement “Call if you can’t make it.” to a question like “Will you call if plans change?” requires an answer from the patients and puts the responsibility in their hands.

Another helpful conversation is to explain the “why” for the appointment. Many patients only return when it’s “necessary” like when they need new glasses or contacts, or they notice vision issues. Simply changing the statement from “We’ll see you next year!” to “I want to see you in 1 year because…” gives them a concrete reason to keep that appointment.

Auto Refill

Practitioners have enough trouble getting patients to stay compliant with their annual exams. This often makes having the compliance conversation surrounding nutraceuticals a daunting task. EyePromise® has a program that simplifies the patient recall system as well as helps drive patients back into the practice and keep their annual exams.

EyePromise Auto Refill is an automatic delivery for EyePromise nutraceuticals. In less than 3 minutes, staff members enroll and bill patients on a single, personalized webpage. After that, patients receive their first 3-month supply of their recommended EyePromise nutraceutical directly to the address of their choice.EyePromise Auto Refill takes the work of patient recall and continued education off you and your staff.

Beyond shipping, EyePromise handles patient education and compliance messaging through a product-specific educational email series. This helps reinforce the message delivered in practice and keeps eye health top-of-mind. About 10-11 months after enrollment, patients receive another email from EyePromise reminding and encouraging them to visit their eye doctor for their annual exam.


The data proves that the Auto Refill program helps increase patient compliance to 80% in the first year compared to in-office only, which is around 15%. That number drops to 60% and 50% in the next 2 years with Auto Refill and 10% and 5% without it.

Not sure Auto Refill is right for you? Schedule some time to talk to an EyePromise Regional Account Manager. They can tell you more about becoming a Prescriber and the Auto Refill program.