4 ways to end the no-show crisis

By Wendy S. Myers, CVJ, President, Communication Solutions for Veterinarians

No-show rates have reached crisis proportions. More than half of hospital managers are reporting higher no-shows, with most being new clients, according to a Veterinary Hospital Managers Association (VHMA) study.[1]

Besides the frustration of empty appointments, no-shows cost your hospital thousands. Before the pandemic, the average no-show rate was 11 percent.[2] Let’s say one full-time veterinarian sees 3,000 appointments per year and has an average doctor transaction (ADT) of $180. If one doctor has 330 no-shows per year (3,000 appointments x 11 percent), he risks losing $59,400 annually ($180 ADT x 330 appointments). If your hospital has three full-time veterinarians, no-shows cost you $178,200 annually.

Let me share four ways to end your no-show crisis:

STRATEGY 1) CONFIRM APPOINTMENTS EARLIER AND MULTIPLE TIMES.

Don’t wait until the day before appointments or procedures to remind clients. You will get deadbeat no-shows.

Send a series of four confirmations by text, app, or email:

• Confirmation 1: Immediately after appointment is booked
• Confirmation 2: 2 weeks before appointment
• Confirmation 3: 4 days before appointment
• Confirmation 4: 2 days before appointment

Texts trump email confirmations because texts have a 99 percent open rate and 95 percent of messages get read within 3 minutes of being sent.[3]

Healthcare emails have a significantly lower open rate of 33 percent.[4] Here are text templates for the series of four confirmations for new and existing clients. 

Send the first confirmation immediately after appointments are booked. This allows clients to add appointments to their smartphone calendars and to turn on travel time alerts, so they arrive on time for exams. 

Confirmation 1 text template for new client appointments: We’re excited to meet <pet name> at <time, date>. Complete new client form at <link> at least 24 hours before the exam, which is required to guarantee your appointment. Email medical records to records@yourveterinaryhospital.com. Bring a stool sample that is fresh within __ hours. Download our app <link> to pay after the exam. Get driving directions at <link>. Reply C to confirm or RS to reschedule.

Confirmation 1 text template for existing client appointments: <Pet name> has an appointment at <time, date>. Complete patient history form at <link> at least 24 hours before the exam, which is required to guarantee your appointment. Bring a stool sample that is fresh within __ hours. Download our app <link> to pay after the exam. Reply C to confirm or RS to reschedule. 

Your website should have new client and patient history forms based on the reason for the visit. Use different patient history forms for checkups, illnesses, progress exams, technician appointments, day admissions, and new puppy/kitten exams. Get examples of online forms from Lake Road Animal Hospital in Horseheads, NY at https://lakeroadanimalhospital.com.  

Clients will take 20 minutes to complete most pen-and-paper forms compared to less than 10 minutes for online forms.[5] Your hospital’s online forms will have required fields. Ask your website provider to design your online forms or use website form makers such as www.jotform.com and www.formstack.com. Clients will click a “submit” button after the form is complete. Data will be emailed to a specific email at your hospital such as records@yourveterinaryhospital.com. This allows you to quickly locate completed forms and add data to electronic medical records. 

The second confirmation is sent two weeks before exams. Many hospitals are booking three to six weeks out, so your second confirmation ensures clients are still committed to showing up as appointments near. 

Confirmation 2 text template for new client appointments: <Pet name> has a new patient exam at <time, date>. Please confirm this still works for you. Complete new client form at <link> at least 24 hours before the exam, which is required. Email adoption or medical records to records@yourveterinaryhospital.com. Reply C to confirm or RS to reschedule. 

Confirmation 2 text template for existing client appointments: <Pet name> has an appointment at <time, date>. Please confirm this appointment still works for you. Complete patient history form at <link> at least 24 hours before the exam, which is required. Reply C to confirm or RS to reschedule. 

The third confirmation is sent four days before the appointment. 

Confirmation 3 text template for new client appointments: This is a friendly reminder that <pet name> has a new patient exam at <time, date>. Remember to complete new client form at <link> at least 24 hours before the exam, which is required. Email adoption or medical records to records@yourveterinaryhospital.com. Reply C to confirm or RS to reschedule. 

Confirmation 3 text template for existing client appointments: This is a friendly reminder that <pet name> has an appointment at <time, date>. Remember to complete patient history form at <link> at least 24 hours before the exam, which is required. Reply C to confirm or RS to reschedule. 

The fourth and final confirmation is sent two days before the appointment. The message has urgency for the client to confirm and complete an online form. 

Confirmation 4 text template for new client appointments: We’re excited to meet <pet name> for a new patient exam at <time, date>. Complete new client form at <link> TODAY, which is required to keep your appointment. See you soon! 

Confirmation 4 text template for existing client appointments: We will see <pet name> for an appointment at <time, date>. Complete patient history form at <link>, which is due TODAY and is required to keep your appointment. See you soon!

STRATEGY 2) require clients to complete online forms to guarantee their appointments.

During scheduling calls, tell new clients that the form requests important contact and medical history information, which your medical staff will need. Text and email confirmations will include a link to this online form (see templates above), which must be submitted at least 24 hours before exams. Use a similar approach with existing clients, asking them to complete a patient history form based on the reason for the visit.

STRATEGY 3) CONTACT CLIENTS WHO HAVE NOT CONFIRMED OR COMPLETED FORMS 2 DAYS BEFORE THEIR APPOINTMENTS.

Tell first-time clients that you must receive their completed new client forms by the end of the day, or their appointments will be “released to another patient in need.” This phrase is better than the term “cancelled.” Remind existing clients to submit a patient history form to guarantee their appointments.

STRATEGY 4) CANCEL APPOINTMENTS IF CLIENTS HAVE NOT CONFIRMED AND/OR FORMS HAVE NOT BEEN SUBMITTED.

Call clients who haven’t confirmed and/or returned forms the day before exams. Say this: “We have reserved an appointment for <pet name> at <time, date>. We are experiencing increased appointment requests and have other patients on a waiting list. We need your confirmation and online form submitted by X p.m. today or <pet name>’s appointment will be released to another patient in need. Please text/email/call us with questions.” 

IMPORTANT: If you leave voicemails for clients, send texts or emails as backup communication in case clients don’t check their voicemail. Research shows 19 percent of millennials never check their voicemail.[6]

If clients don’t confirm and/or submit forms by the end of the business day, send texts or emails to inform them that their appointments have been cancelled. 

Text template for cancellations: We regret that we have not received your confirmation and/or online form, which is required to guarantee your pet’s exam. Your appointment on <time, date> has been released to another patient in need. To reschedule, click here <link> to book online or download our app <link>.

While you may be tempted to collect deposits for new client appointments, don’t. You’ll create the impression that your hospital is “all about the money,” start new relationships with sour experiences, and risk negative online reviews. You’ll also need to create a deposit policy to define whether deposits are refundable or non-refundable, which cancellation reasons will be accepted, and how far in advance appointments must be cancelled. The VHMA study found only 10 percent of hospitals collected deposits for new client appointments. 

When you implement my four strategies, you will get to zero no-shows. Ultimately, you will cancel appointments if clients don’t confirm or submit online forms. Be the boss of your schedule. This uncompromising approach lets you end empty appointments when other patients could have received needed medical care.

WANT TO LEARN MORE?

Enroll your team in the 1-hour course: When Clients Behave Badly: DO THIS.

References:

[1] Felsted K. Client No-Shows: Frequency, Deposits and Fees. Insiders Insights. Veterinary Hospital Managers Association. Available at: https://cdn.ymaws.com/members.vhma.org/resource/resmgr/insiders__insight_2020/VHMAInsidersInsightNovember2.pdf. Accessed Nov. 22, 2021.

[2] What Pesky No-Shows Actually Cost Your Veterinary Practice. Pet Desk. Available at: https://petdesk.com/blog/what-pesky-no-shows-actually-cost-your-veterinary-practice/. Accessed Nov. 17, 2021.

[3] Burke K. 107 texting statistics that answer all your questions. Text Request. Updated Jan. 24, 2019. Available at: www.textrequest.com/blog/texting-statistics-answer-questions/. Accessed May 19, 2020.

[4] Brudner E. Email Open Rates by Industry: See How You Stack Up. Published June 14, 2019. Available at: https://blog.hubspot.com/sales/average-email-open-rate-benchmark. Accessed Jan. 19, 2022.

[5] 6 myths about online patient forms debunked. PatientStudio. Available at: https://patientstudio.com/6-myths-about-online-patient-forms-debunked. Accessed Oct. 20, 2021.

[6] Svyrydenko A. Why Millennials Love Texting. TextMagic. Published May 9, 2019. Available at: https://www.textmagic.com/blog/why-millenials-love-texting-infographic/. Accessed Nov. 17, 2020.