Clients Missed Appointments?
Missed appointments seem to be becoming an increasing problem for businesses. We often hear about the cost to the NHS of missed appointments, and my GP surgery runs a monthly tally of the number of missed appointments and the cost to the surgery.
For small businesses and private healthcare providers the cost is a personal one; you just don’t get paid. It is difficult to know whether the number of missed appointments is increasing or whether there is a greater awareness. Because a missed appointment is lost income, it can’t be resold, so the only recourse is to claim that money back from the client. These articles are a discussion point on how you might keep failures to a minimum, and how to claim back the charge when a client misses an appointment.
So first of all is it worth it? Suppose you had one failure per week, you charge £30.00 per appointment and you are able to claim back 50% of the fee. Over a year (45 weeks) you would lose £675. It’s a lot so it does make a difference to try to deal with it.
- Minimise the failures.
First ensure that the client knows the date and time correctly of the appointment, and that they know there will be a cost if they fail to attend. When the appointment is booked , either over the phone or in clinic the receptionist should reiterate at the end of the booking eg “so your appointment is with John at 10.00 on Monday, 5th of November. If you need to cancel or move the appointment please give us at least 24 hours notice or there may be a charge.” In practice though we know that clients don’t always really listen to this, they hear what they want or expect to hear.
Should you send reminder calls, texts or emails?
If your clientele use mobile phones it is certainly worth sending a reminder text. Some diary packages will do this automatically and there is a minimal charge of about 10 pence per text. My local hospital send a text reminder 3 or 4 days before an appointment.
Telephoning is cheaper if you have someone available to make the call. My local private dental practice phone everyone the day before the appointment, in person. I asked them if they found it effective – they find it really makes a difference, and this agrees with the data available.
In my own practice I am now sending automated sms messages to clients which they will usually pick up on their home telephone number at a cost of 10 pence each. Most of my clients are elderly and don’t use a mobile routinely. I am letting them know that everyone is getting these calls, that missed appointments are problem generally, so it is not personal, and without exception they have been receptive to the idea. I don’t yet know whether it will make any difference.
Email reminders are cheaper, around 5 pence each. Obviously again, their usefulness depends on the clientele.
Data protection? A call to the Data Protection Service confirmed that there is no protection issue; you are contacting an existing client, you already have their contact number so unless they tell you they don’t want one you can send a reminder. You do not need to ask for their consent prior to sending a reminder.
- How effective are they?
A review in the Journal of Telemedicine and Telecare found that attendance improved by 39% with telephone reminders and 29% with automated reminders.
And a study by the department of primary care and social medicine at Imperial college London in 2008 found a reduction of 38% in the likelihood of patients not attending their appointments with the use of sms reminders for ophthalmology outpatients. In other words the failure rate improved by about one third.
Whether this is cost effective will depend on how big your failure rate is, but if you use the example above, it is effective.
For example 20 texts per day for 45 weeks of 5 days will cost £180 per year. The income gained by one third of patients turning up would be £225 per year.
However Britain has a fast aging population and those patients most likely to have an appointment with a medical practitioner of some kind are more likely to be older and less likely to have access to mobile phones and emails. They will also be less mobile and arguably more likely to forget their appointment.
The next article will be looking at what to do with late cancellations and charging policy. Comments on this or the difficult subject of charging would be welcome.
