Decreasing the number of missed doctor's appointments may be a relatively simple fix, according to a new study from The University of Texas at Arlington.
Researchers found that when an outpatient clinic in the Rio Grande Valley called patients with an appointment reminder three or more days in advance—rather than just one day—it significantly reduced no-show rates.
Reducing no-shows benefits both patients—who receive an earlier diagnosis or treatment—and clinics, which avoid losing revenue from unfilled appointments.
"The policy had been to call the day before because people were worried that calling too early meant patients would forget," said Yaneth Flores, who coauthored the study while earning her Doctor of Nursing Practice degree at UT Arlington. "When we started giving people more notice, they were more prepared. They'd say, 'Oh, right, I still need to get my blood work,' or, 'I haven't picked up my referral.' We were honestly shocked to see that calling farther in advance improved the no-show rate."
The study, published in the Journal of Doctoral Nursing Practice, examined a clinic that serves approximately 1,600 patients a month and had a no-show rate of 29%, considerably higher than the national average of 18%. Researchers implemented the extended phone call reminders over a 12-day period, analyzing 653 patient visits. The no-show rate fell from 29% to 21%, saving the clinic $5,200 in otherwise lost revenue and providing patients with timely care in a region where rescheduling can take up to a month.
Dr. Flores said researchers called patients anywhere from two to five days in advance, with three days emerging as the "sweet spot." That window provided patients enough time to plan ahead, whether it meant getting lab work done or arranging transportation.
"It does seem simple, and this was only over 12 days, but if you spread it out over more time, you'd see even bigger effects," Flores said.
Flores coauthored the study with Rhonda Winegar, assistant professor of graduate nursing at UTA. Both are practicing nurse practitioners.
Dr. Winegar emphasized the significant cost of missed appointments—about $150 billion annually in lost revenue at clinics across the U.S. Missed appointments also exacerbate the physician shortage facing the country. When patients miss appointments, those slots go unfilled, leading to delays in care and poorer health outcomes, Winegar said.
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Reminder calls help encourage patients to complete tasks such as lab work or X-rays, helping them stay on track with routine care and reducing chances that missed appointments turn into emergency room visits.
"As simple as it sounds, calling a few days earlier really makes a difference and makes the appointment more productive," Winegar said.
Flores and Winegar hope their study illustrates the benefits of simple workflow changes—ones that are cost-free and require no new technology or software—and the impact they can have for patients and clinics.
About The University of Texas at Arlington (UTA)
The University of Texas at Arlington is a growing public research university in the heart of Dallas-Fort Worth. With a student body of over 42,700, UTA is the second-largest institution in the University of Texas System, offering more than 180 undergraduate and graduate degree programs. Recognized as a Carnegie R-1 university, UTA stands among the nation's top 5% of institutions for research activity. UTA and its 280,000 alumni generate an annual economic impact of $28.8 billion for the state. The University has received the Innovation and Economic Prosperity designation from the Association of Public and Land Grant Universities and has earned recognition for its focus on student access and success, considered key drivers to economic growth and social progress for North Texas and beyond.
