Fewer no-shows: reminders, deposits and waiting lists.

What no-shows cost

All figures in euros. The logic works in any currency.

Doctor time, staff and rooms are paid for either way. A missed appointment is therefore almost entirely lost gross profit.

Reminders: what the evidence says

A Cochrane review of randomised trials found low- to moderate-quality evidence that text message reminders improve attendance at healthcare appointments compared with no reminders. They worked about as well as phone call reminders and cost less.

• Two reminders: one when booking, one 24 to 48 hours before.
• Ask for confirmation: “Reply YES to confirm or call us to rebook” – unconfirmed appointments get a call.
• Make rebooking easy: a link or number in every reminder. A rebooked appointment is better than a missed one.

Deposits and clear rules

• Cancellation policy: state it clearly when booking – for example free cancellation up to 48 hours before.
• Deposits: for long or high-value self-pay appointments, a deposit credited against the treatment gives patients a reason to turn up or cancel in time.
• Be consistent but fair: exceptions for genuine emergencies, but the same rules for everyone.

Waiting lists: refilling the gaps

1. Keep a list per treatment of patients who would like an earlier appointment.
2. Offer freed slots automatically by text message, first come, first served.
3. Track the refill rate: how many cancelled slots were rebooked.

No-show rate and refill rate belong in your monthly practice cockpit. For expensive equipment, every refilled slot also improves equipment utilisation.