Doctor Patient Relations

Reduce No-Shows by Stressing the Value of an Appointment

By Brian Chou, OD, FAAO

When looking for a restaurant in a new place, many of us judge how busy the restaurant is as an indicator of how good it is. For example, if there’s a line out the door with a 60-minute wait, you’d assume it’s good. However, if the restaurant is devoid of patrons, you might assume just the opposite.

The optometric practice is similar. The busy practice signals to prospective patients that the practice is doing something right. While a shopper may bargain on a pair of sunglasses if the dispensing floor is empty, the same shopper might feel embarrassed to do so around other customers. After all, the shopper has to fear that someone else might buy the same pair of sunglasses at full price before they do.

Consumers place greater value on goods and services that are scarce. If the earliest appointment for an eye exam is backlogged for weeks, the rate of patient-initiated rescheduling and cancelation goes down because they perceive greater value in their appointment and don’t want to give it up, sort of like the appointments were playoff tickets. Of course, if the wait is too long, the patient may just go elsewhere.

How can a business elevate value? One nightclub in downtown San Diego fakes its value to bystanders. Those walking by often see a long line of people trying to get in and people assume the club is very popular. In reality, the club incentivizes patrons from one of their lists to come for a free drink with no entry cover charge. The catch, which is not disclosed to those on the list, is that upon arriving, these patrons must wait in line outside for over an hour, unwittingly serving as visual bait to attract other club-goers passing by. This is a sneaky business tactic, and I don’t like it. I believe there is a better way to harness the psychology of scarcity and apply it to optometry.

To reinforce value in the appointment, scheduling staff should communicate and sub-communicate its value. For example, if Dr. Seymour has nothing booked on the day a patient wants to come in, one of the worst things a staff member can say is, “Oh, you can choose any time you’d like that day.” Those words will increase the rate of no-shows, last-minute cancelations and rescheduling. The better offer is for the staff to say, “I can schedule you for 10 am.”

For telephone reminders left on voice mail, wording is important. Take for example, if your staff says, “You have an appointment with Dr. Seymour tomorrow at 10 am. If you need to cancel, call us.” The mere acknowledgement of cancelation plants that in the mind of the patient, increasing the likelihood of it turning into a self-fulfilling prophecy. The better approach is to say, “You have a reserved appointment with Dr. Seymour tomorrow with check-in at 10 am. We look forward to seeing you!”

If the patient fails to show up for their scheduled appointment, the absence of any prompt follow-up by the staff communicates a blasé attitude and condones future tardiness and neglect by the patient and the patient’s family, too. A better approach is for staff to call the patient within five minutes past their scheduled check-in time, having the staff express concern with something like, “You had reserved time with the doctor at 10 am. Is everything OK?”

The team-coordinated approach–with scheduling, reminding and following-up on missed appointments–creates high value for the appointment, maximizing the likelihood that the patient makes their appointment on time.

Do you communicate the value of your appointments to reduce no-shows? If not, what approaches do you take to reduce no-shows?

Brian Chou, OD, FAAO, is a partner with EyeLux Optometry in San Diego, Calif. To contact him: chou@refractivesource.com.

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