One Way to Solve the No-Show Problem

We’ve all seen the dire predictions that the U.S. will have a doctor shortage of about 130,000 physicians by 2025. But is that really the case when you factor in under-capacity? Physician practices have considerably higher no-show rates than many other businesses, whether it’s airline travel or car repairs.

A recent MGMA study found that even well run practices have a daily average of 12 percent no-shows and last-minute cancellations. Some practices actually experience a whopping 50 percent rate.

The main culprit is lead-time. Statistics reveal that no-shows for same-day appointments are about half the no-show rate for appointments made three weeks in advance.

That’s why many practices are turning to cloud-based appointment and scheduling technology. When patients don’t show, they’re quickly replaced by others clamoring to be seen.

This flexibility is ideal for Millennial-age patients, who show far less loyalty to a single primary care physician than older patients. A recent study by Truven Health Analytics found that millennials are 24 percent less likely to have a regular PCP than are Boomer-age patients. For these younger healthcare consumers, convenience is king — and they’re perfectly comfortable scheduling a same-day appointment on their smartphones.

Boomers, on the other hand, are far more likely to take the traditional route: calling a medical practice to see about physician availability. This creates the long lead-times for appointments, which increases the likelihood of cancellations and no-shows.

Patients who use cloud-based scheduling tools are seen much faster and have higher show rates. Consider:

  • 20 percent of them get same-day or next-day appointments — and more than half receive appointments within a one-week window.
  • Patients prefer choosing their own appointment time, rather than working with someone over the phone and being given a time.
  • By receiving confirmation and reminder messages the way they want (text, voice or email), patients are up to 5 times more likely to show up for their scheduled appointment.

A new study from MD Live found that 82 percent of adults age 18 to 34 actually prefer a same-day smartphone consultation versus having to wait a week or more. Intel’s recent Healthcare Innovation Barometer revealed that 72 percent of all patients, regardless of age, were happy to “see” a doctor via Skype or mobile device for non-urgent cases. So the demand is there; it’s just a matter of efficiently connecting patients with doctors.

Our healthcare system usually looks for grandiose solutions (e.g., train thousands of new doctors) rather than focusing on the small steps needed to boost capacity. In a recent Health Affairs article, Scott Shipman, MD, director of primary care affairs at the Association of American Medical Colleges, wrote that “small efforts to empower non-physicians, reengineer workflows, exploit technology and update policies to eliminate wasted effort could yield the capacity for millions of additional patient visits per year in the United States.”

Calling a cab and getting a haircut have gotten easier thanks to online scheduling — and the same can be true for primary care medicine. A physician practice, like any other business, is more profitable when running at full capacity, minus the no-shows and abrupt cancellations.