Missing Doctor’s Appointments and No Shows

Dave is angry. He forgets to keep a doctor’s appointment. He receives a bill for not showing up.

Susan is upset. She has to wait for an hour before her doctor sees her.

Doctors and their receptionists struggle all the time to book the right number of patients each day so everybody is seen on time. This helps patients, staff and doctors to get home to their families in time.

In reality, this never happens.

To physicians, the big problem is the “no shows”. Patients make appointments and some do not bother to show up. This happens inspite of being reminded by the physician’s office few days ahead of the scheduled time.

This costs the taxpayers dearly. In the United Kingdom, an estimated US$240 million worth of appointment time is lost each year because of the patients who fail to keep appointments with their GPs, according to a survey by the Doctor Patient Partnership (DPP).

In Alberta, the problem must be serious enough for the College of Physicians and Surgeons to provide directions on this subject. The College’s motto is “serving the public and guiding the medical profession”.

The College says: Although generally opposed, College recognizes that, under certain exceptions, physicians may bill patients for missed appointments.

Dr. Bill Taylor follows this policy. He is the only dermatologist in our region. His office gives out a pamphlet to the patients that says: If you miss an appointment without timely notification this becomes a “missed appointment”. This could result in you being billed for this and future missed appointments.

Dr. Stephen Cassar is the only plastic surgeon in our region. It takes a long time to get an appointment with him. Naturally, patients and physicians complain. We want instant service.

Last week, in sheer exasperation, he sent a letter to all the physicians indicating that in the last nine months he has had 80 “no shows”. This happens despite the fact that his office phones patients to remind them of their appointments.

This “no shows” do not include the ones who fail to attend due to inclement weather, family emergencies, or personal illness. Dr. Cassar says that if patients make their scheduled appointments as booked, then his waiting time would be cut be approximately 4-5 weeks!

An article in the Journal of the American Board of Family Practice says that missed appointments can affect patient health, disrupt schedules, and result in poor utilization of resources, and increased workload for staff and physicians.

Why do patients fail to keep clinic appointments? Asks a report in the International Journal of Clinical Practice. The answers are disappointingly predictable, says the BMJ. They forget the appointment, feel too ill to make it, or never receive details of it in the first pace.

Is there a solution to the problem? Like many things in life, it boils down to individual responsibility to use health services responsibly. Unfortunately, that message does not always get through to people who abuse the system.

The sad thing is, reasonable and responsible people pay the price for the delinquent ones.

DPP’s latest campaign – KEEP IT OR CANCEL IT!

This series of articles explore the health problems of Dave and his family. They are composite characters of a typical family with health problems.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

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