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Gain control of no-shows and protect your bottom line

Gain control of no-shows and protect your bottom line
22 April 2015

Patient no-shows are one of the most vexing issues in managing a medical practice. When a patient doesn’t cancel in advance with adequate notice or simply doesn’t show up for their appointment, the practice loses a block of billable time they could have used to see other patients.


According to the Medical Group Management Association, no-shows range from 5% to 7% in the typical practice. In order to determine the financial impact on your practice, multiply the amount of revenue your practice makes for the average appointment, by the number of patient appointments per week, by 6% (the average of 5 – 7%).  For example, if the average revenue per appointment is $150, and the practice sees 100 patients a week,  the weekly revenue would be $15000.  With a no show rate of 6% (the practice has approximately 6 no-shows per week), the resulting potential impact would be $900 per week.  Over the course of a year that would climb to be a substantial $46,800 of lost revenue per year. Using those numbers, each 1% of no-show is equal to $7,800.  Reducing the percentage of no-shows to 5% would reduce the lost revenue to $39,000 and yield $7,800 of additional revenue per year.  If the practice were really successful in reducing no-show and could get the percentage to 4%, it could increase revenue by $15,600.

By taking steps to reduce no-shows, you can increase revenue, reduce wasted staff time and improve patient wait times.


Here are some tools you can use to reduce your no-show percentage and regain lost revenue.

  • Call the patient a few days in advance. According to the American Medical Association, no-show rates are lowest when a live person does the calling, but having an employee may not be cost-effective for every practice. Automated systems are less effective at reducing no-shows, but still better than nothing.
  • Send reminders by mail. Sending a mailer or postcard is more expensive than electronic notifications, but may be the only way to reach older patients who do not have cell phones and do not check email frequently.
  • Reach out to patients electronically with text messages. Many patients carry cell phones, and almost all phones have the option of receiving text messages. In 2010, Kaiser Permanente implemented one-month pilot program using a text messaging reminder system that reduced no-shows by .73%. The program had a 95.65% success rate, with only 1.8% of recipients opting out of further messages.
  • Use email reminders. Many patients can receive emails on their smartphone, so don’t be afraid to send multiple email reminders, including right up to the day of the appointment. Your practice management program or EHR should be able to schedule and send an email confirmation automatically.
  • Find out how the patient travels to your office. If they are using public transportation, consider including a link to the local transit authority’s web site so they can check the transportation schedule.
  • Follow up after the appointment with one or more of the above techniques. If the patient showed up on time, send them a thank you message. If the patient was a no-show, send them a “We’re sorry we missed you” message and a reminder to reschedule. The longer you wait to reschedule the appointment, the less likely it will happen.


While some no-shows are inevitable, practice managers can do a lot more than just sit back and hope patients show up for their appointments. Outbound appointment reminders can reduce no-shows and protect the practices’ bottom line.