We previously talked about how missed appointments cost the American healthcare system some $150 billion every year (1) and slowly but surely erode your practice’s stability. However, we promised you that there was hope on the horizon to fix this deadly menace to your practice and your patients — and here it is!

6 Tips to Help Prevent Missed Appointments

#1: Allow Patients to Self-Schedule (and Adjust) Appointments

Look: It’s time to stop wasting time — yours, or your patient’s.

Just let your patients schedule (and reschedule) their own appointments without the phone calls.

A 2019 patient survey from Accenture found that over three-quarters of your patients think the ability to book or change appointments by themselves online is important. Yet, only 2.4% of appointments are scheduled by the patient! (2)mIn fact, 68% of surveyed patients said they were more likely to choose a provider who let them schedule their own appointments — up from 58% the year before. (2)

Why would you make scheduling harder than it has to be?

Even if you don’t use AC Health and its (convenient, private, wonderful…!) ability to blast appointment openings to all clients and patient-set reminders, there has to be something you can do to let your patients make their appointments on their schedule, not yours.

C’mon. Cut the cord, people.

#2 Consider a Missed-Appointment Fee

Part of your intake with any new patient or client is to discuss expectations, to ensure that no one is surprised with what happens during the course of their treatment. One of those expectations can be a commitment from your patient to attend all of their appointments (or at least give you 24 hours’ notice), or else risk a cancellation fee. Such a fee would be a positive punishment to reinforce good behavior — i.e., attendance — of your patient, as well as a hedge against lost income from a missed appointment. (3)

It even offers a monetary “value” of your understanding and patience. You can allow a patient to reschedule an appointment at the last minute and generously waive the cancellation fee that you could have charged. Now, your empathy has a direct dollar value — one that your patients can’t help but notice.

Of course, be careful not to abuse such a policy as the provider. Too close adherence to this fee schedule, and you could risk bad reviews and negative word-of-mouth, even if it’s the patient’s “fault” they were charged the cancellation fee. Use your best judgement! But, it’s still a policy worth considering, especially for problem clients.

#3 Offer Prepaid Appointment Discounts or Packages

Psychologically, people tend to move to avoid a loss than to achieve a gain, especially if they’re not paying particular attention to the action itself.

That is, the less we’ve invested (time, emotion, money) in an activity, the more likely it is that we’ll do whatever it takes to avoid a loss. The more attention we pay to the activity, the more likely it is we’ll be equally motivated to achieve the gain as we do to avoid the loss. (4)

This relatively recent nuance of the “loss aversion” principle can be applied to your appointment incentives, too.

Basically, if a cancellation fee is the “stick” for missed patient appointments, then prepaid appointment discounts are your “carrot.”

For patients who are already on the cusp of dropping off — thus indicating a low investment of time and resources into their program with you — then the “stick” punishment is something they’re more likely to try and avoid.

That’s the traditional loss aversion part of the appointment equation.

On the other hand, for patients who may want to attend appointments but keep forgetting to for whatever reason — not paying close enough attention to the calendar, maybe, or not scheduling enough time for travel to and from your location — offering a discount for prepaid sessions provides an incentive for them to remember their appointments.

In other words, a prepaid bulk appointment discount rewards patients for their dedication to the program while simultaneously encouraging them to invest their money into their appointments.

This offer makes your patients psychologically more likely to prioritize and thus attend your sessions.

For providers, the prepaid option helps to smooth out revenue, much like the cancellation fee, even if a patient still manages to miss their appointment.

#4 Consider Double-Booking Historic No-Shows

Another risky-but-worth-considering practice? Double-booking your appointments. Obviously, if you have a new patient intake or a patient who’s wonderfully reliable, then you probably shouldn’t put two in the same slot. Still, if you have a patient who’s notorious for not showing up, then you may want to hedge your bets with another appointment scheduled at the same time. Chances are, at least one of them will show up, which decreases your chances of losing out income for the appointment slot.

Note that this technique is trickier for, say, a mobile therapist to implement, rather than a clinic owner. A waiting room at a static location with multiple providers can certainly make this suggestion more practical.

Be careful not to make people wait too long, though, if both patients do show up. Per one health platform’s research, long waits cause 30% of patients to abandon the appointment — the exact opposite of what you’re trying to accomplish! — and 20% of patients to change providers altogether. (5)

#5 Offer Group Appointments for Peer Support and Incentives

If you have enough patients who all suffer from the same condition, then consider offering group sessions, also known as “Shared Medical Appointments,” or SMAs.

SMAs gather together multiple patients or clients for a single group session, allowing for longer overall appointments than they might receive individually, as well as a camaraderie to develop between patients with similar conditions.

One health practice that has successfully used SMAs for over a decade, the Cleveland Clinic, says that their sessions can run 90 minutes with a shared health team, rather than the 15 – 30 minute appointment traditional for private appointments. (6)

And, their patients are “overwhelmingly satisfied” with their SMAs:

They enjoy the opportunity to relate to other people who are dealing with similar health issues, share stories and ideas, learn from one another and truly create a bond. […] Every patient has the opportunity to be a role model to someone else. For example, a 60-year-old asthma patient got back on the treadmill after being motivated by a 10-year-old who was successfully managing his asthma out on the basketball court every day.
The Cleveland Clinic observes that their SMAs are most effective for patients with “chronic conditions, such as asthma, diabetes, and hypertension.” (6)

Depending on your patient composition and your access to a larger location for group exercises — it could even be over Zoom! — SMAs may be a great way to:

  • Avoid the cost of missed appointments of individual sessions,
  • Offer clients peer-support through their treatment, and
  • Provide extra face time with you, their trusted provider.

(For an example of what an SMA may look like for a therapy or nutrition practice, check out this PT and nutritionist’s eight-week group patient program.)

#6 Set Automatic Appointment Reminders

Back in 2017, the Medical Group Management Association (MGMA) surveyed patients who said they’d missed at least one appointment in the last year. They discovered that the vast majority of patients simply forgot to cancel their appointment (53.4%). Other reasons included a mix-up on the time (28.6%) and a miscellaneous grab-bag of reasons including traffic, work, and scheduling conflicts. (7)

Extrapolating these results to your practice, it’s safe to say that well over half — maybe two-thirds — of your missed appointments could be avoided if you reminded your patients of their impending session.

You can do this in any number of ways, from an automated email to a personal outreach the night before via your AC Health app. Just create an appointment reminder template in the Messaging system, tweak the time, and boom — with a single tap, you’ve sent a gentle reminder to your patient about their appointment with you!

The personal touch will do wonders to increase patient compliance with their appointments, just like it does for their home exercises.

Which of these solutions could work for your clinic?


1. Grier, J. (2017, April 26). Missed appointments cost the U.S. healthcare system $150B each year. Healthcare Innovation. https://www.hcinnovationgroup.com/clinical-it/article/13008175/missed-appointments-cost-the-us-healthcare-system-150b-each-year.
2. Safavi, K., Webb, K., & Kallis, B. (2019). Accenture 2019 Digital Health Consumer Survey. Accenture Consulting. https://www.accenture.com/_acnmedia/PDF-94/Accenture-2019-Digital-Health-Consumer-Survey.pdf.
3. Pietrangelo, A. (2020, February 25). What Is Positive Punishment? Healthline. https://www.healthline.com/health/positive-punishment.
4. Yechiam, E. (2015, January). The psychology of gains and losses: More complicated than previously thought. American Psychological Association. https://www.apa.org/science/about/psa/2015/01/gains-losses.
5. The Real Cost of No-Shows for Your Healthcare Practice and How to Avoid Them. PatientPop. (2019, April 1). https://www.patientpop.com/blog/running-a-practice/real-cost-no-shows/.
6. Shared Medical Appointments. Cleveland Clinic. (n.d.). https://my.clevelandclinic.org/patients/information/shared-medical-appointments.
7. Harropp, C. (2017, October 3). Biggest challenges with appointments. MGMA: Medical Group Management Association. https://www.mgma.com/data/data-stories/practice-leaders-report-their-biggest-challenges-w.