Patients missing appointments are a frustrating component of any clinician’s work week that can significantly hinder patient outcomes. In this O&P Check-in: an SPS Podcast interview, we had the pleasure of speaking with Northwestern Medicine Associate Professor John Brinkmann, MA, CPO/L, FAAOP(D) to understand why missed appointments occur and the strategies clinicians can use to address them.
The following includes an excerpt from our conversation. Click here to listen to the full interview.
The O&P Check-in: an SPS Podcast unpacks trends and stories from the tight-knit O&P community. From patient care, to technology, best practices, and regulations, this podcast features topics that help you stay current.
What have you found to be some of the most common causes of missed appointments?
In an interview published in the Winter 2021 issue of The Academy Today, Rebecca Herman, MSPO, CPO, explored a series of articles identifying the most common causes for missed appointments. The main reasons outlined were lack of transportation, work or other obligations, miscommunication, or not knowing the reason for the visit.
Illness or hospitalization is another factor. Often, patients are dealing with many other health conditions that will impact their ability to come to the office. They may also be taking medication that could make it difficult to remember their appointments.
Waiting too long for an appointment is another component that could make patients hesitant to come to the office at their scheduled time. Patients may rely on a family member to drive them, have limited time to take away from work, or have responsibilities at home that they need to handle. These factors could make waiting an hour or two at the clinic when they do arrive on-time a serious burden for the patient. Being sensitive to the patient’s time at the appointment will positively impact their future attendance.
Understanding the various reasons a patient misses an appointment is an important consideration that can lead to concrete actions and more positive clinician-patient interactions.
What steps can clinicians can take to help mitigate some of these issues?
When a clinician identifies why a patient missed their appointment, it opens the door to offering practical solutions and scheduling flexibility. When reviewing the appointment calendar, knowing a patient is chronically late is information that can be used constructively. Ask the patient, “Is it harder in the morning or afternoon to make an appointment?” The patient may have children they take to school in the morning and an afternoon appointment is more attainable. Identifying the cause and offering flexible solutions helps both parties win.
To address no-shows, text alerts or calling patients ahead of an appointment can be effective in some cases but may not help if deeper issues at play. For example, if the patient is unsure of the importance of an appointment or struggle with anxiety, a text may not convince them to come to the clinic. Talking to the patient in a supportive manner and with genuine curiosity to get to the root cause can help to break down these barriers to care.
Flexibility and getting to the root cause of a no-show are effective strategies, however, boundaries are still necessary to establish. In reality, clinicians can’t do their job well if they are accommodating those who are the least consistent with their care or appointment attendance. If a patient is significantly late to their appointment, accommodating the late patient isn’t realistic to the clinician or fair to other patients who came to their appointment on-time. In this scenario, the late patient should be rescheduled to another day. The matter is not about punishing the late patient, it is about protecting the clinician’s time so all patients can receive attentive care.
Missed appointments will never be 100% eliminated, but you can reduce them by approaching the issue with understanding to limit stress and find solutions that work for all parties.
To hear the full conversation and learn about other strategies to address missed appointments, click the following button:
