Perspectives > > Building the Patient-Centered Medical Home– Identifying patterns can enhance the health of all our clients
by Fred Pelzman, MD, Contributing Writer, MedPage Today January 13, 2025
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Fred Pelzman is an associate teacher of medication at Weill Cornell, and has actually been a practicing internist for almost 30 years. He is medical director of Weill Cornell Internal Medicine Associates.
“So, what should we do about 11 no-show visits?”
Just recently, an associate gave my attention a client who had actually made and canceled several visits in our practice– 11 over the 4-month period considering that they had actually been seen last, with a suggestion at that time for close follow-up to much better get manage on some medical conditions that had actually left hand.
It appears that almost each week they were phoning, setting up a consultation for a regular follow-up, and after that phoning and “rescheduling” on the early morning of the consultation. At other times, this “rescheduling” happened after the consultation time had actually currently reoccured.
We utilized to call this a damaged visit.
Obviously, if the client reaches the call center and states they want to reschedule the visit, the folks there dutifully do that, even if the consultation is currently technically over. They make no effort to recall into the client's current scheduling history to keep in mind that this has actually been a pattern, a continuous problem.
In truth, this is a waste of resources and a missed out on chance, not just for this client's health care, however for lots of others who are informed that there is no accessibility on the schedule.
I understand some folks who operate in practices where if you are a no-show for a preliminary see, you're instantly liquidated of the practice; for follow-up visits, a pattern of more than a couple of no-show consultations causes a caution letter, and after that being liquidated of the practice, not used any future visits.
The scheduling managers wish to have rigorous standards they can implement, a sort of “3 strikes and you're out” policy that can result in alerting letters, and if continuous, then termination from the practice. I've heard great deals of various arguments for the benefits and drawbacks of this, and there is never ever going to be a totally sure-fire method to handle this.
There definitely are lots of reasons that clients can not concern their consultations, typically beyond their control.
I as soon as became aware of a client who was fired from a psychiatry practice since they kept not standing for consultations. The factor the client required to see a psychiatrist was such serious agoraphobia that they kept missing out on chemotherapy treatments (as they were scared to leave their home to come in for care). Other times, the factors for missed out on consultations might be less severe.
Tools can aid with more efficient scheduling and enforcement.
