Iliff Family Practice

No-Show Policy
Richard Douglas Iliff, MD, FAAFP

It is one of the ironies of this age of constant communication that professionals are being strained by the problem of no-shows for appointments. I’ve gone 25 years without penalizing patients for failing to keep appointments, but I can’t ignore the issue any longer.

We try to call patients who have appointments for physicals, but more and more patients don’t answer their phones. We leave messages, but they don’t check their messages in a timely fashion. They carry electronic calendars, but they don’t pay attention to their calendars.

Personally, I think there is so much communication that people are getting overwhelmed. In order to regain control of their lives, they just ignore the bombardment of messages from all directions. This is a real cultural problem. But it’s not my problem.

My problem is that it costs me $315 per hour just for my office overhead. Nurses are expensive, as are medical supplies, office space, taxes, and equipment. So when a patient doesn’t cancel an appointment far enough in advance to allow us to re-book the time, it really puts a hole in our income.

(An old joke from MAD magazine in my youth involved an accountant who figured out just how much his time was worth. When he saw how much it cost him to go to the bathroom, he decided to stop. He died young, the story went, but he left a huge estate. I know how much MY bathroom stops cost, but I’m not giving them up, or my vacations. It’s not healthy.)

I forget appointments, too. It’s human. However, I’m also willing to pay my barber for what her time was worth when I do. She’s like me. If a client doesn’t show, she’s been robbed of the price of her time.
We’re very busy, and we keep up with our work so you can be seen the next day or next week, not four months down the road. We don’t double-book like the airlines do. If you are a no-show, somebody else would have been glad to take your spot. Therefore, from now on no-shows are going to have to share the pain. I’ll still lose money, but you will, too.

We’re going to keep trying to help you to remember your appointments. But if you forget, here’s the deal:

If you do not call the office (NOT the answering service) to cancel your appointment at least one business day beforehand, we will charge $100 for an abbreviated physical and $150 for a database physical, in addition to lab charges. [A group of children counts like a database]. This charge will NOT be paid by your insurance-- they are insuring your health, not your organizational abilities.

No-shows for non-physical appointments will be given one “oops”. After that, the charge will be $75. This charge will also apply if you leave without being seen less than one hour after your appointment time. Because we’re dealing with humans, and they are unpredictable, sometimes we may run that far behind.