Time and money: effects of no-shows at a family practice residency clinic

When patients fail to appear for scheduled appointments, the flow of patient care is interrupted, and clinic productivity declines. This study investigated the impact of failed appointments on a clinic by measuring time and money lost after taking into account same-day treatment patients (walk-ins).

Schedule information was retrieved for 4,055 visits over 20 business days. Data were collected on appointment status (show, no-show, cancel, walk-in), time allocated for the appointment, charges for visit, date and time of the visit, and other appointment information.

No-shows and cancellations represented 31.1% of scheduled appointments and 32.2% of scheduled time. Rates of failed appointments varied by type of provider, patient demographics, and patient status (new versus established). Walk-in patients replaced 61.0% of failed appointments but only 42.4% of the time blocked for those appointments. Walk-in visits generated 89.5% of the charges associated with scheduled visits. Over the course of a year, total revenue shortfalls could range from 3% to 14% of total clinic income.

Failed appointments pose financial as well as administrative problems for residency practices. Proactive reminder systems are needed to promote patient attendance.