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About PMN
Practice Management News is a free newsletter for SpectraSoft customers and friends, offering insightful articles, handy user tips and troubleshooting advice to help you get more done with SpectraSoft software.
Case Study:
How one practice raised
compliance |
 |
When our no-show rate hit 18%, we knew we had to do something. At first we charged a fee for no shows and cancellations within 24 hours of the appointment. What I found was that it still didn't change the behavior.
Consistency Counts
|
Related WSJ: “Many missed appointments aren’t due to flaky patients.” |
In order to change a behavior the stimulus has to be consistent...and we weren't. We accepted some excuses for the no-show and not others. Human nature had us giving most people the benefit of the doubt.
In a large metropolitan area such as ours, I also found patients would contest the charge regardless of the reason they no-showed. If what they had to do was more important, they contested the fee. The result: we had a situation on our hands with an unhappy patient because of an appointment issue, which often affected treatment.
The Solution: Proactive Care and Follow-Up
After years of experiments that would have made Pavlov proud, our clinic appears to have had some success. In six months we have taken our no show rate down from 18% to 5%, following two basic tenets:
1. The quality of therapist treatment is always the most important
element that keeps patients coming back. If your clinic is understaffed
and overworked, it shows in patient care. Patients quickly pick up on when they
are rushed or don't get all the treatment they need or deserve. Then they start cancelling.
Hand pick your staff and make sure you aren't understaffed. I notice a significant trend of no shows when we are down a therapist. Therapists have an obligation to give the best care they can give -- give them the environment to do so.
2. Catch patient no-shows quickly. Our therapists are instructed to call patients if they see a no-show trend emerging -- and to get that patient off the schedule if it's obvious the patient isn't going to participate on a regular basis. Sometimes the no-shows result from a simple issue such as: not being able to afford a $40 co-pay 2 times a week...transportation...or they were uncomfortable with something that happened but never said a word. If all of these issues are addressed early, the therapist and patient can discuss viable alternatives.
Debunking the Myths
We often hear that the patients least likely to show for an appointment are often on government coverage, uninsured or self-pay. In certain situations, workers compensation patients can also show a tendency toward higher no-show rates.
However these are generalizations that need to be tested in your specific setting. Here at Georgia Hand, Shoulder & Elbow, workers comp cases seem to be the ones that show up regularly. We find that when a patient has a financial responsibility for their therapy, this appears to be a significant factor in no-shows and cancellations.
For example, I recently pulled 30 charts of patients that stopped treatment short or didn't complete the recommended course of therapy because of no
shows or cancellations: 29 of the 30 patients were private insurance and
one was Medicare; not one was workers comp. There was no bias when pulling
the charts: I simply ran a list of the last 30 patients that
exhibited multiple no shows in the last year.
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