The Physician Practic Pearls newsletter this week had a good article on handling cancellations and no-shows. A typical policy is to ask patients to call 24 hours in advance. Psychiatrists, for example, where a no-show means a lost hour of billing, often will charge patients for last minute cancellations and no-shows. In these cases, there is also the aspect of insuring patient compliance and buy-in to the treatment plan. The newsletter suggested several actions. First, is it easy for patients to reach a live person to cancel? That is the time to reschedule as well, while you have the person on the phone. If they are evasive or reluctant to reschedule, I suggest that you log it to follow up again in a week or so. This cancellation may be the prelude to losing the patient. A dedicated email address would be an asset – email is fast, convenient for everyone, and gets the job done. Do send a confirming note back when the message is picked up by staff. Analyzing your cancellations will tell you important information about your practice. One practice they describe found that two-thirds of the patients who cancelled never rescheduled. While the authors didn’t seem overly concerned if you have a full practice, these patients are leaving for a reason, and I’ll bet it’s something about the practice itself. Your active patients may be slow to leave, and may tolerate problems, but only to a point. Once they leave, they’re gone, and they will tell others. Another article on cancellation policies is courtesy of MediNotes, a developer of electronic health records for medical practices. The article, 7 Ways to Reduce No-Shows and Cancellations, outlines, well, 7 steps: 1. Communicate the importance of the appointment 2. Reconfirm the appointment verbally, eye to eye 3. Remind the patient about the appointment 4. Encourage compliance with the prescribed medicine or therapy 5. Track the reasons for no-shows and cancellations 6. Follow the 80/20 rule 7. Book appointments when it’s convenient for the patient It’s preferable to keep the patients and the appointments you have than trying to make up for patients who drift away. Give them reasons to turn to you for advice and to keep coming back.