No Shows - Failure to Make Your Appointments
No-Shows are a double-edged sword in the medical world. An appointment was made and a slot was designated for your arrival. Other people who requested that same appointment time were turned down. You did not call to cancel your appointment; and you did not show up. The day after Easter I had three No Shows in a row; two for physical examinations. The double-edged part is that I also had time to write a Blog about it.Everyone makes mistakes. Everyone forgets appointments. Personally, I have developed this short-term memory issue over the last few years. (See "Rinse, Lather, and Repeat"). Sometimes, there are unusual circumstances that result in missed appointments, but most of the time, we simply forget. We are human.
We do have frequent-flyer No Shows in our practice. Each incident earns a red "No Show" stamp on their chart. Now that we are going to Electronic Medical Records, those No Shows are not as evident as before. We forgive the first one; send a nice letter when it happens a second time, a less-nice letter for the third time, and finally, after repeated No Shows, a letter of dismissal from our practice. This last letter is rarely sent. It is interesting that the same woman that repeatedly misses a doctor's appointment will never miss a hair appointment.Because I work in pediatrics, I can't really punish children because their parent may be an airhead. Parents and children do get over-extended and over-stressed, so I tend to cut them a lot of breaks. Because I have missed a dental appointment this year and a several meetings, I tend to be very forgiving.
I am one of the few medical providers in our practice that will see patients that are late (less of an infraction than not showing up at all) and see patients that are Walk-ins. Diseases rarely show up on any type of schedule that you can anticipate, so if a sick child is brought in, I see them, no matter how busy I am.
Looks like I just had two more No Shows. This is a new record; five out of 15 patients this morning chose, for whatever reason, not to call, cancel, or show up. The weather is nice; kids are off school today. Maybe traffic was bad getting out of Disneyland yesterday, I really can't say. In addition to having time to blog (quite unusual on normally busy Mondays), I cleaned off my desk and emptied a box of crap that I brought from home six years ago. I discovered that it was still crap (just older stuff now), so I threw it away. I now have a top on my file cabinet, creating more room to put more stuff.
I hear a child screaming, so I think a patient is finally arriving. Fifteen-month olds scream for any reason. They hate medical people. They hate scales. They hate thermometers. At least there is only one of them. One day, I had triplet 15-month olds for physical exams and immunizations. That experience worsened my tinnitus, for sure.
If you have been a No Show in the past, your doctor may forgive you; once or maybe twice. Next time, pick up that phone and call. You can even lie and make up some elaborate excuses. We still won't believe you but we do enjoy those stories.
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22 Comments:
I am a clinical psychologist and I, too, have a problem with no-shows. If you are a parent with a difficult child, please don't no-show for appointments, then expect to be seen right away when little Johnny is kicked out of school! One woman called yesterday and claimed it couldn't be counted as a no-show because she WAS calling - two hours after the missed appointment!
I told some (non-medical) friends of mine that I had a 4 appointment no show day, and they asked me how much I charged patients for not showing up!
Ha! When doctors stop making me wait for HOURS for my appointments, then I'll start feeling sorry for your no-shows. Really, if you want to inculcate a sense of timeliness in medicine, look to your own house before you start throwing stones.
I was once in therapy for a phobia and the psychologist failed to show up for two appointments!!!
He actually apologized and was surprised I never showed anger, etc. I realize people are human and sometimes forget even important things.
I remember being 15 minutes late for a doctors appointment and I was turned away. (I had a good reason too)
What about doctors who keep patients and clients waiting for hours??? Or those who cancel appointments at the last minute?
If doctors are allowed to charge for missed appointments, it is only fair and ethical to patients to charge doctors what they are worth for every one hour spent waiting.
As the office manager of my husband's practice, we had to institute a policy of paying if you didn't show. While people were initially upset, once we explained that their appointment was given to them to save the space for them and, if they couldn't make the appointment, we had others on a wait list that would appreciate the time slot they seemed to understand and it cut our no-shows by 75%. What patients need to understand is that when my husband is running late, it's not because he doesn't respect their time as much as his. It's almost always because a particular patient needs more time than has been allotted for their appointment. My husband is a very compassionate doctor, and does not rush his patients when they are with him. There are so many things that can happen that effect the schedule. I assure you, doctors don't like to run late anymore than their patients like them to. If we know he is running behind, we always offer to reschedule. Most of his patients know that if he is running late, there's a very good reason and are very kind about their waiting. They realize that they may be the one that someday needs 30+ minutes with him rather than 15.
Hello I am in the human resource's field so a person's behavior is a part of their personna. In medicine I assume the same. A no show is disrespectful if it occurs more than once. It nullifies or diminishes the importance of people. Of course there are sometimes valid reasons such as an emergency.
My physician and staff are excellent. I rarely wait and this is important, as I get the time needed with my family doctor without the feeling of being rushed. He is considerate and I appreciate that.
So respect your physician. One other point however:
We have a crisis in this country with the uninsured. No shows...how about that.....maybe because they cannot afford to show up anymore.....
I'm the patient who on too many occassions have sat for hours on end waiting for the physician. I was 10 minutes late due to traffic, the nurse tried to tell me I now had missed my appointment and would have to reschedule, then unfortunately for them, the doctor called in - he wasn't even in the office, he was tending to someone else at the hospital. Needless to say there was a discussion had and apologies made to me. This is not to say people shouldn't make every effort to be courteous and give a call, even if they're going to be late, but if you want to charge me for a no show or being late, then be prepared to get a bill in the mail when you keep me waiting for more than 15 minutes past my appointment time or if you're not in the office when I get there for my appointment. My time is just as valuable as yours and most of these offices have double booked the time slot. I've worked in several doctors offices. So again, I think there needs to be courtesy on both sides of the fence.
I work in a dental office and we do charge patients a reasonable fee for not showing up. Some patients pay and others get very angry and dont pay. My boss gets angry when patients dont show because he has to pay the other doctors or hygienists for doing "nothing" when the patient doesnt show. Of course if the patient calls with a good excuse we then waive the fee.
When doctors stop making their patients wait for hours after their appointment time to be seen, then I'll feel sorry for you doctors. Otherwise I have no sympathy whatsoever! I'm tired of bringing my kids in for their appointment and having to hold my sick child for 3 hours! If a doctor wants to ban me from their practices then that's fine by me!
i have a doc that covers major league baseball games , i rememberr to schedule when th e team is away. i do have a wait time to see the doc as i always make it for the last appt of the day, since i usually need more time with him .he does take time with his patients and is jvery good so i dont mind waiting. another thing they call to remind me of my appt the night before
Maybe if the nurses were to do a courtesy call a day before the appointment and stop chit chatting and laughing behind the glass windows then they would not have no shows!! That's why i changed doctors and they certainley do the courtesy call and i dont have to wait more than 10minutes.
Drs keep patients waited for hours at a time. And what comes around goes around. I do not feel sorry for any of them. Most of them think they are God. And they are not even close.
While, yes I do understand that a Dr's office, dentist office etc. is a business - so is the job that I must get to or leave early from to make that appointment. I could go on and on about how fast I drove (because of traffic etc. - I am also one of those people that leave work WAY to early just to make my appt. on time - "poor me". While my Dr. and his staff do act professionally - why is it that (and I do get an apology) MY time is not as valuable as theirs? While I understand that there are emergencies, there can NOT be emergencies on EVERY appointment that I have made. This is a family Dr. - in fact when there is an emergency they tell you to GO TO THE HOSPITAL if it is a real emergency because they dont do EMERGENCIES. Yes things happen daily to the Drs. schedule (as it does also in my line of work} etc. I am a production scheduler for a manufacturing company. A medium sized company with every customer thinking that they are the only one. They want their jobs yesterday. As a scheduler with more jobs daily, weekly, monthy, yearly than any Drs. office - yet as the Manager it is my job to keep everyone happy, including my employees. Dr's offices need to re-examine the way they schedule their patients time. I dont know the ins and outs of scheduling for a Dr./Dentist etc. all I know is that there are ways to keep the production flowing smoothly - even with my customers so called "hot job - I MUST get it NOW" or I will die! Yes that is what my customers act like - its a life or death situation! PLEASE for the sanity of all of your patients and your patients children, boss, husband, babysitter, nursery school etc. that are all but forgotten about in this scheduling nightmare - sit down with your employees and find out what the issues are and PLEASE try and come up with a better solution than making us wait an excessive amout of time for our appointment. It really would be so much healthier - mentally and physically for all of us.
I too, have waited hours in a dr. office for an appt. And I too, have been a (rare) no-show. It is usually due to memory. I now am disabled and can't drive...now it is really difficult to find a ride, then when I do have to schedule someone else's time then wait 3 hours for an appt., it is very hard to feel sorry for that Dr. So it is not always disrespect or ignorance that makes for no shows. I try to have my rides sceduled at least 3 days ahead, but there is always life! Too many things can happen in just 24 hours or less!
As a normal person, I can appreciate doctors being upset at no shows, but as a patient, I have to agree that doctors VERY OFTEN keep patients waiting ridiculous amounts of time. They often then rush, rush through the appointment without taking the time needed to really help the person.
I believe part of the problem is schedulers setting appointments for more than one person at a time. I'm sure there will be denials, but I've seen it with my own eyes.
U'se guys sure have got your nerve. I 82 years old and to my knowledge have never missed an appointment. Wish I could say that about Doctors, Lawyers and probably Indian chiefs. My policy is I'm early for every appointment, I wait 45 minutes to see the doctor. If by that time I have not seen him, I walk out. Understand, walk out. Once with my eyes dialated. Once on my neuro surgeon. I wouldn't mind if a doctor was late if the nurses informed me of that fact. But to sit in a doctors office for more than 45 minutes is asking too much.
Having raised four children over the last 27 years, I spent many hours waiting on doctors because they are "running behind" -- I have to ask myself how could they be running behind when I am the first appointment of the day. Hospital rounds has been the excuse. I don't think so - how about a 9 hole round of golf before work. As I have gotten older, I have decided that if I am kept waiting past my appointment time, I will remit my invoice to the doctor's office --- billing them for my time because it too is valuable especially when using personal time to cover missed time away from the office which eventually means less vacation for me in the end.
I can't help but agree with the last poster. Maybe we should bill the doctor for the many occasions when we have to wait excessively. When I am scheduled for an appointment at 1:00 p.m., I expect to be seen at 1:00 p.m. or at the very least within ten minutes. I have yet to arrive at a doctor's appointment where I did not have to wait longer than 15 minutes to be seen. So to hear a doctor gripe about missed appointments feels like sweet revenge to me...
i always call the dr.office for appointment and they always give the time as they like thats the thing first shld b changd in a dr's office..then the rest i feel..
My wife can spend up to two hours waiting to be seen by my kids' pediatrician. She was given a choice to see the other pediatrician in the same practice partners who keep a tight schedule - 15 minutes for every patient - no matter what. She would rather wait because when it is her turn, she is sure the doctor will not be looking at the clock.
I'm a teacher and every hour I have to sit in a doctor's office is an hour that other people's children do not receive adequate instruction. I used to schedule my appointments to be the first in the day thinking that the doctor wouldn't be running behind due to other patients. That ended this year though due to a special doctor of mine who can never be on time.... I'll never forget when he was 90 minutes late to work without so much as an acknowledgment or apology. I was his first appointment of the day and still had to take an additional hour and a half of leave time and leave 3 classes with a substitute.
I understand that people get busy, things happen, traffic jams occur etc... but the reality is that we all (both doctor's and patients) deserve respect and consideration. I don't care how valuable my doctor feels his time is, I am certain that my students' instructional time is at least equal in value. A simple I'm sorry I was late would have done loads to rectify the situation.
Well, if you are laughing at the doc's office bc you have had to "wait in the waiting room for hours" - let me just tell you why. because doctors sometimes double book their schedules because of no-shows. which also means that when everyone actually comes to their appointment, you're stuck in the waiting rooms. i guess you only have patients to blame. funny how everyone wants to get paid at their job, but don't mind stiffing others... (dumb when you actually think the person you are stiffing is someone who is there to help you) i say charge the immature people who don't come or give 48 hour notice.
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