You're ready for the exam, but where's the patient?

Some doctors bill patients who don't keep scheduled appointments. But others say that approach only alienates patients.

By Julie A. Jacob, AMNews staff. Oct. 21, 2002.

If there's anything more aggravating than the patient who doesn't follow directions, it's one who doesn't even show up for the appointment.

Patients who fail to show up for their appointments -- whether because they forget, have car trouble or can't get off from work -- cost a practice time and money, say physicians.

Marcy Zwelling, MD, an internist in solo practice in Los Alamitos, Calif., said that patient no-shows have become more of a problem in the past few years. It's become so much of a problem, in fact, that she now charges patients who fail to show up for their appointments without calling to cancel ahead of time.

Tim Gorski, MD, an ob-gyn in Arlington, Texas, estimates that about one out of three of his new patients misses appointments without bothering to call and cancel.

"If patients don't have a relationship with physicians, they don't mind not showing up," Dr. Gorski observed. "People hardly ever miss their haircuts ... they take that more seriously than seeing a doctor."

But there are ways to cut down on patient no-shows.

One effective way to get more of your patients to show up for their appointments is to have the office receptionist call the day before with a reminder, suggested Crystal Reeves, a principal with The Coker Group, a health care consulting firm based in Roswell, Ga.

"Some people simply forget about their appointments," said Reeves.

Michael Fleming, MD, who practices in a 10-physician primary care group in Shreveport, La., said his practice routinely calls patients to remind them of their appointments. [...]