Mitigating The Disruption Of Patient Cancellations – Nicky Jardine

In an ideal world, doctors and patients would run on time and in perfect unison with the practice reception staff, with an orderly booking of appointments where cancellations were unheard of.

Even for the most organised doctors, staff or patients, there are factors outside their control that will make them late or cancel appointments.

Regardless of the cause, disruption to a booking schedule ultimately leads to consultations that are rushed or not utilised.

Minor delays as isolated incidences are manageable, yet excessive lateness or last-minute cancellations have consequences that impact everyone.

An accumulation of late appointment cancellations has a compound effect on doctor availability, particularly for those rural communities with limited coverage.

This cumulative effect of late cancellations on the ability of medical practices to serve patient needs provides a starting point when implementing cancellation policies.

Beyond The Financial Impact

Although it may not sit well with some, you can justify a late cancellation fee as:

• the administration must manage appointment changes
• the practice cannot fill appointment slots with such late notice
• clinicians spend time reading up on patient files before the cancellation
• both the business and practitioner are denied income
• patients, especially those whose needs are urgent, are denied that time slot

Highlighting the last point to patients may provide a positive incentive to call well ahead of time when cancelling an appointment.

Refining Policies and Procedures

Some organisation is required when trying to minimise cancellations within a practice:

• Set the standard at the front desk and with doctors by ensuring that, where possible, the practice is running on time.
• Immediately after a clinician cancels their session dedicate resources to ensure efficient rebooking of patients.
• Make it easy for patients to cancel their appointments independently, including through the online booking platform.
• Outline fees, DNA and cancellation policies on a dedicated page or section on the website and include the same information in online booking platforms and on-hold messages.
• Set a specific cut-off time, for example, at least two hours notice for change or cancellation of GP appointments and 24 hours notice for Allied Health appointments.
• Ensure all patients sign and agree to the cancellation and DNA policy of the practice when they book their initial appointment.
• Reiterate practice policies well before the booked appointment through letters, SMS reminders and verbal phone bookings.
• The policy should request that patients call to cancel an appointment and highlight that cancellations by email are unacceptable.

Layered Strategy For Patients

After ensuring the above is in place, a practice may implement a layered strategy to deal with cancellations and patients who are repeatedly late.

For example, the failure of a patient to attend a consultation may see:

• The first time they receive a letter/SMS outlining the cancellation policy.
• The second time incurs a cancellation/DNA fee.
• The third time the practice states that appointments are no longer available at the medical practice and offer a release of their medical records once signed consent is provided for their GP.

Considerations For Repeat Cancellations

Further to these measures, for those patients who are repeatedly late or cancel with less than two hours’ notice, the practice may also wish to:

• Record those patients who are late, cancel or do not attend on the practice software.
• Restrict available appointments to less popular times and only on their appointment day.
• Where penalties are applied, block bookings until payment for outstanding cancellation/DNA fees is confirmed.
• Send a notice that the practice requires pre-payment for future appointments.

Any argument is then qualified by producing their signed agreement of the practice policy, along with a record of cancellations and DNA.

Even if a patient does not appreciate the loss of income, the load on resources, the frustration of other patients and a rise in stress levels, a cancellation policy may, at the very least, educate them on the value of other people’s time.

With over 30 years of experience in the health industry, Nicky Jardine has a wealth of experience establishing systems and protocols to help your business function optimally, including creating and revamping practice policies.

Nicky has a range of professional industry contacts to fine-tune your requirements for optimising practice management towards a profitable and compliant medical business.

For more information, please email nicky@nickyjardine.com or call 1300 798 831.