How to reduce no show appointments? Top 10 ways

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How to reduce no-show appointments?

Half the battle is won if you are able to keep your schedule full at your practice. A full calendar lets you breathe a sigh of relief, it gives you an assurance that things are going relatively well for your business. 

However, the other half of this battle is ensuring that patients keep up with their appointments. What purpose does it serve to have a full calendar displayed on your computer screen if your office remains empty without any patients? 

If patients fail to turn up it means you’ve not only lost the revenue from that patient but also from a different patient who could have taken up the missed slot. This leads to the question, how can one reduce no-show appointments in their practice? 

Did you know?

According to a study published in the Journal of Medical Practice Management, the estimated cost of patient no-shows to healthcare practices in the United States is around $150 billion annually.

Another study published in the journal Health Policy and Technology estimated that the average cost per missed appointment in a primary care setting is approximately $200.

These statistics highlight the significant financial impact of patient no-shows on healthcare practices, resulting in lost revenue and increased costs.

How can you effectively navigate these situations? How can you minimize no-show appointments to avoid significant losses? 

Let’s look at how you can effectively solve and reduce no-shows at your practice by 90% 

Tried-and-Tested Strategies to Reduce No-Show Appointments: Top 11 Ways​

#1: Do a quality check to assess the quality of care you are providing

Patients are not always at fault when it comes to no-shows. It’s necessary to examine the quality of care you provide at the clinic. Is there something missing on your end? Is it prompting your patients to turn away from your clinic? These questions can only be answered if you take a thorough look into your day-to-day operations.

No amount of marketing efforts can do what quality care can do for your practice. It has absolutely no substitute. If you are able to provide positive health outcomes to your patients through quality care, your practice will become well-reputed. More and more patients will want to keep up with their appointments because they are assured of the quality of care your practice provides.

#2: Improve patient experience to reduce no shows

The patient experience encompasses everything starting from the time the patient schedules an appointment to when they walk out of the practice after the appointment. There are multiple stages in this journey where you can try and improve the patient experience. For example, you can make the  patient intake process more efficient such that it doesn’t take up a lot of the patient’s time. You can do that by allowing patients to fill out the patient intake form at their homes.

Your staff plays a very important role in how patients perceive your practice. It goes without saying that the staff needs to be friendly and welcoming. These few things contribute significantly to patient experience. Improving these experiences can help ensure that the patient doesn’t miss his/her appointments. 

One way to enhance the patient experience is by asking for feedback from patients once their appointment completes. This will provide valuable insights into the quality of your services. Identifying patterns in patient feedback serves as a cue to make improvements and explore ways to enhance the patient experience. 

#3: Offer flexibility in appointment scheduling

A good way to ensure no-shows is to offer flexible appointment scheduling. If the appointment falls easily into a patient’s schedule they will find it easier to keep up with it. To ensure flexibility with appointment scheduling, you can consider keeping more appointment slots open and ensuring your practice is fully staffed.

#4: Identify each patient’s preferred mode of communication

After patient schedules an appointment with your practice you can ask them which channels they prefer for further communication. For example, if an appointment has been scheduled by a patient via call, you can ask them at the end of the call how they would like to be contacted further on. This works as follows: 

Advantages of identifying your patient’s preferred mode of communication

  1. First, when the patient lays down his/her preferred mode of communication they are more likely to respond and thus be actively engaged in their healthcare activities.
  2. Second, with a better response from the patient, engagement will improve.  When patients are engaged in their healthcare, they are more likely to have a positive patient experience

    A study published in the Journal of General Internal Medicine found that
    higher levels of patient engagement were associated with better patient experience scores. The study analyzed data from a large national survey of adult patients in the United States and concluded that patient engagement, as measured by patients’ active involvement in their healthcare, was positively correlated with higher patient experience scores across various dimensions of care, including communication, provider-patient relationship, and shared decision-making.


  3. Asking for the patient’s preferred mode of communication will also help to account for those with special needs. Asking for their preferred mode of communication allows healthcare practices to accommodate these unique needs, ensuring effective communication and avoiding potential communication barriers.

So how does this help in reducing no-shows? When patients explicitly state their preferred communication method, it is because they rely on it the most. What they are indirectly conveying is that they will pay closer attention to your communication if it is delivered through their preferred medium. Therefore you can be sure that the patient will heed any appointment reminder communication you send.  

#5: Send appointment reminders to reduce no shows

Appointment reminders are the most effective way to ensure patients don’t forget about their upcoming appointments. In the previous steps, we discussed how allowing patients to choose their preferred mode of communication is important. By combining the preferred communication channel with appointment reminders, you can ensure that the patient reads the message and takes the necessary action.

Fact check: According to a study published in the Journal of Medical Internet Research in 2016, appointment reminders have been shown to significantly reduce no-show rates. The study found that appointment reminders, including phone calls, text messages, and emails, reduced no-show rates by an average of 31.8% across various healthcare settings, including primary care, specialty care, and outpatient clinics. This highlights the effectiveness of appointment reminders in improving appointment attendance and reducing patient no-shows, which can have a positive impact on healthcare practices’ operations, patient care, and revenue.

For example with Emitrr you can send text message appointment reminders by automating the entire process. You can personalize the message by addressing the patient with their name and  customize the reminder message according to the appointment day, time, provider etc.  Check out this video to learn how you can reduce no show appointment using automated text reminders with Emitrr

#6: Allow digital check-ins to reduce wait time

One of the reasons why people find doctor visits daunting is because it takes up a lot of their time. For example, filling up the intake form in itself can take up a significant chunk of the patient’s time, add to it the time it takes for your staff to process it and patients are looking at a long day at your practice. 

 digital check-in or touchless process can save precious time. Healthcare practitioners need to offer patients the chance to pre-register and communicate with the practice. These simple steps will ensure that when the patient visits all he/she has to worry about is the appointment itself. 

Some of the information that you can collect during digital check ins include:

– Personal and demographic information (Name, contact details, address, date of birth etc.)

– Medical history and current health information for patient intake fom 

– Consent and authorization forms

– Insurance information and payment information

– Patient preferences and surveys (preferences such as mode of communication)

– Vaccination status

#7: Offer easy rescheduling to reduce no shows

It’s important to remember that sometimes patients get caught up in emergencies or commitments that prevent them from attending the appointments. These situations are inescapable and you need to get ahead of them by allowing patients to reschedule their appointments.

You can simply pair a rescheduling option with appointment reminders. For example when you send an appointment reminder message that looks something like this:

“Hey, this is to remind you that you have an upcoming appointment at XYZ clinic on 10 May at 10:30 AM.”

You can just another line to this message that says:

“If you wish to reschedule the appointment use this link” 

This way you have not only ensured that the patient keeps up with their appointment, albeit at a different date and time but also free your calendar to accommodate other patient appointments.

#8: Data and analysis to understand the trend of no-shows

Is it possible that patients are more likely to miss an appointment on a particular month, or at a specific time of the day? Patient no-shows are usually dependent on  the healthcare setting, patient population, and local contextual factors. So it can very well be that your findings about patient no-shows are completely unique to your healthcare practice. 

To give you an example, A study published in the Journal of Medical Practice Management examined appointment no-show rates in a primary care clinic over a period of one year. The study found that the month with the highest no-show rate was December, which was attributed to factors such as holiday season, inclement weather, and increased patient demand for appointments due to the end of the calendar year.

Another study published in the Journal of General Internal Medicine examined no-show rates in a Veterans Affairs healthcare system over a period of one year. The study found that the month with the highest no-show rate was February, which was attributed to factors such as inclement weather, increased respiratory illnesses during winter, and higher rates of influenza.

So you can see that contextual factors play an important role in determining trends with respect to patient no-shows.

To understand the no-show pattern at your practice, it is essential to record all the instances of no-shows in your PMS (Practice Management System). With this data at your disposal, you can draw conclusions regarding why patients are missing their appointments and devise solutions to address the issue. 

#9: Improve patient relationships with Panel Management​

Panel Management refers to a proactive approach in managing and coordinating care for a specific group of patients within a healthcare organization. This group of patients is often referred to as the “panel”. Panel management aims to improve the quality of care provided to individuals within the panel while also enhancing the overall efficiency of healthcare delivery.

It involves communicating personalized treatment plans and addressing patient concerns, showing genuine care. By consistently engaging with patients, providing clear treatment plans, and being responsive to their questions, a positive patient experience is created. When patients feel valued and supported, they are more likely to keep their appointments, recognizing the effort put into their care. Embracing panel management can help minimize missed appointments and improve patient attendance rates.

#10: Use a patient engagement software like Emitrr to reduce no shows

Patient engagement software is a great tool to engage patients effectively. Engaging patients is done at different levels. It looks something like this :

Schedule→ Remind→ Digital check in→ Follow up→ Feedback→ Review Request 

Each stage of this process can be achieved with the help of a patient enagement software.  

For example, you can use Emitrr in the following ways: 

1. You can either use text, email, or calls to communicate with patients through their preferred mode with Emitrr. 

2. You can send text messages to schedule an appointment. 

3. You can automate the check in process by sending the patient intake form through their prefered channel.

4. Text or Email appointment reminders can also be automated easily with Emitrr. 

5. You can send appointment scheduling and rescheduling links, either through Email or Text through Emitrr

6. You can engage in 2-way HIPAA-compliant text communication with Patients for treatment follow ups, or sharing important information.

7. You can automate sending surveys to your existing patient database and also sync it with your PMS. 

8. You can automate review requests and collect more reviews for your practice. 

9. Panel management can also be done easily by using features such as dispositions. You can highlight panel management patients by creating a new disposition for them and then automating the process.  


Bonus points

#1: Curate a cancellation policy

Cancellation policies or fines can be effective in reducing patient no-show rates in certain cases. By implementing such policies, healthcare practices can create a financial incentive for patients to cancel appointments in advance if they are unable to attend, rather than simply not showing up. 

However, you might also want to consider leaving room for exceptional cases. Many times patients have very genuine reasons for their missed appointments. They could have been caught up in an emergency. Therefore it is advised to empathize with the patients and waive the cancellation policy for them. 

A cancellation policy can also be made effective after 1 or 2 consecutive missed appointments from the patient’s side. This will make sure that only those patients who have a habit of missing appointments are penalized for it. 

#2: Reward loyal patients

If you decide to impose fines on patients for missing appointments, it is also a good idea to reward those who regularly attend their appointments. This will not only help you build better relationships with the patients but also encourage them to consistently attend their appointments as scheduled. 

The rewards can be in the form of discounts on bills, or entry into a giveaway contest. 

One other method you can use to nurture your relationship with these patients can be sending them personalized thank you notes, birthday greetings, or holiday cards. You can get as creative as you want! Appreciation goes a long way and it will definitely help improve your no-show rates. 

#3: Offer transportation options

Sometimes the reason why patients end up missing their appointments is that they do not have a proper way to get to your practice.  What can you do to help your patients in these situations? 

If your practice falls on the way of public transport route or is near to a subway or bus station, you can send your patients’ schedules to such transportation options. You can simply add them to the appointment reminder texts that you send out to make it easier for patient communication. 

Another way in which you can help your patients with transportation is by partnering up with a rideshare service. It could work in the following way:

1. Identify patients in need: You could identify patients who may face transportation challenges, such as those who live far away from the clinic or hospital, lacking access to reliable transportation, or having physical limitations that make it difficult for them to travel to appointments.

2. Coordinate with rideshare serviceYou could then partner with a rideshare service, such as Uber or Lyft, to establish a process for coordinating and booking rides for eligible patients. This could involve setting up a designated account with the rideshare service, providing guidelines for using the service, and training staff on how to request and coordinate rides for patients.

3. Schedule and book rides When an eligible patient needs a ride to their appointment, the healthcare practice staff could help schedule and book a ride for the patient using the designated rideshare account. This could be done in advance or on the day of the appointment, depending on the needs and preferences of the patient and the availability of the rideshare service.

These are some of the steps you can follow to reduce no-show appointments. However, is there anything you can do after the no-show appointment? Here are three steps you can follow after a no-show appointment.

There has been a no-show, what to do next?

#1: Keep a waitlist ready 

Curating a list of patients for waitlist is a good idea to ensure that unfilled slots be filled up soon. By utilizing a waitlist, healthcare practices can fill appointment slots that would otherwise be left vacant due to no-shows, thereby minimizing the impact of no-shows on their schedules and operations. Here are some tips you can follow while curating and maintaining a waitlist: 

  • Take patient preference into accountYou may have some patients who wished to be called in earlier or within a specific time frame.  Due to appointments being booked in advance, they may not have had the opportunity to schedule an appointment on their preferred day. In such a case, you can create a priority scheme for these patients and add them accordingly to the waitlist. Another priority criterion can be patients with urgent medical needs or chronic conditions. 
  • Consent and eligibility: Patients should provide consent to be added to a waitlist, and practices may consider patient eligibility for the specific service or appointment being offered. This could include factors such as medical history, insurance coverage, or other eligibility requirements.
  • Send alerts to all patients on the waitlist: All the patients who have agreed to be on the waitlist should be informed of an opening to ensure that all patients have equal opportunity to secure available appointments.
  • Utilize technology: Implement a technological solution, such as an electronic health record (EHR) system or a patient scheduling software, to manage the waitlist efficiently. This can help automate the process and streamline communication with patients on the waitlist.
  • Promptly notify patients of available appointments: Notify patients on the waitlist as soon as possible when an appointment becomes available, and provide clear instructions on how to confirm or decline the appointment. Use multiple communication channels, such as phone calls, text messages, and emails, to ensure that patients are promptly notified.
  • Set reasonable timeframes: Set reasonable timeframes for patients on the waitlist to confirm or decline appointments. Avoid setting overly short or long timeframes that may inconvenience patients or result in missed opportunities.


If a no-show happens you can simply reach out to the patients in your waitlist to see if they want to use the vacant slot instead. 

#2: Don’t wait to reschedule – Use the “sorry we missed you” tactic 

If a patient informs you that they won’t be able to make it to their scheduled appointment, do not wait to re-schedule a new one. Simply acknowledging their cancellation without taking further action increases the likelihood that the patient won’t schedule an appointment later on. Instead, promptly request these patients to reschedule an appointment as soon as possible. 

For patients who did not inform prior and were a no-show to the scheduled appointment, you should reach out right away. Since they missed an appointment without prior information, they are more likely to schedule a new appointment easily. Implementing the ‘sorry we missed you’ sales tactic can be a good approach. Instead of adopting an accusatory tone, it is recommended to use a more empathetic tone that gently encourages them to reschedule their appointment.


Patient no-shows need to be handled proactively with a lot of care. If a patient who is typically punctual misses an appointment once, you can handle the no-show more leniently and perhaps even let it go. However, if you notice that certain patients consistently arrive late or miss appointments, it is crucial to take strict measures to prevent such occurrences. One effective approach to address this is by implementing a cancellation policy.

There are other steps too that can help you reduce no-shows. These include reminding patients of their upcoming appointments, offering easy rescheduling options, providing patients with transportation options, and many more methods that we discussed above. Implementing these steps in tandem will ensure that a) you are aware of the status of a patient appointment vis-a-vis whether the patients will turn up or not and b) decrease patient no-shows overall. A patient engagement software is an excellent tool that can help you reduce no-shows.

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