The survey says: Patient and provider perspectives on appointment scheduling in healthcare

Tebra recently conducted an online survey of 1,075 patients and 204 healthcare providers to assess patient and provider behaviors when it comes to rescheduling, cancellations, and no-shows. 

The patients we polled saw a mix of providers, including primary care physicians, dentists, medical specialists, and mental health providers. Of the providers surveyed, all personally see patients.

The biggest finding? Patient cancellations and no-shows are costing practices surveyed as much as $7,500 per month. That translates to a loss of approximately $375 per patient. Meanwhile, 59% of patients surveyed reported canceling or not showing up in the last 12 months.

The findings were compiled into a free report, "Tackling patient no-shows and cancellations — What patients and providers really think."

Patients had conflicts for a variety of reasons. The top 3 answers were work conflicts, not feeling well enough, and transportation issues. 

Understanding your patients' obstacles and challenges related to getting to appointments can help you optimize your schedules, boost revenue, and enhance the quality of care you provide.

In this article, we’ll dive into the data results on patient experiences and preferences and share what providers can do to improve appointment adherence and retention.

With the changing landscape of healthcare and care delivery, patients have more options than ever before — and more expectations. Here’s what the survey revealed about patient retention and attrition, along with actionable strategies to keep them. 

It goes without saying that patient retention is crucial for practice growth. Patients leave or switch to other providers for various reasons, but providers often don’t have a pulse on why. 

We found that 42% of patients surveyed said they would switch providers after being rescheduled just 2 times. But when we asked providers why they think patients leave their practice, 57% cited issues related to insurance followed by 34% flagging lack of access to timely appointments.

What’s more, generational data played a part. 30% of Gen Z patients (born 1997 to 2013) said they would switch providers if you canceled or rescheduled on them, followed by Millennials (born 1981 to 1996) at 27% and Gen X (born 1965 – 1980) at 22%.

Canceling and rescheduling a patient’s appointment while keeping them as a patient is a delicate balance. 76% of providers surveyed said the patient-physician relationship is very important to patient retention. Keep that in mind when you have to cancel or reschedule — your staff doesn’t need to reach out to the patient directly, but make sure they build and maintain a positive relationship with patients, too.

We asked providers what strategies they currently have in place to improve patient retention. Their number one answer? 78% said having a friendly, professional staff was their approach. 

Staff professionalism certainly matters to patients. But when they were asked what providers could do to stop them from canceling, rescheduling or not showing up, the results revealed something else. Their number one answer? 71% of patients said doctors should offer more-same-day or next-day appointments, followed by seeing patients on time and sending more appointment reminders. With this in mind, consider refining your no-show policies by adding same-day or next appointments. 

Drilling down into generational data again, we found that 74% of Gen Z and Millennials surveyed are more likely to attend appointments if offered same-day or next-day options, and 84% of those younger patients cancel or not show up due to work conflicts. Providers can cater to patient schedules and work commitments by introducing evening and weekend appointment slots.

Further, 64% of patients said they would be more likely to show up for an appointment if they were offered a discount for prepayment. Meanwhile, ​​94% of providers surveyed don’t offer them. While this approach could potentially reduce no-show rates and improve practices’ financial health, it’s important to keep in mind that prepayment discounts can be construed as "patient inducement" under AKS and CMPL, as well as various state laws and insurance company contracts — making it less practical.

We found that patient loyalty programs — programs to reward and incentivize patients for their continued commitment and loyalty to the practice — are not common among the healthcare practices surveyed. Almost all providers (96%) do not currently offer a patient loyalty program. 

Likewise, when we asked patients if they participate in loyalty programs, the majority (88%) said no. 

Instead, without a formal program in place, 50% of doctors said they reward all 3 of these patients behaviors:

In general, rewards for these behaviors might include economic benefits such as discounts and coupons for health-related products, services or local businesses, or “soft” benefits such as priority check-in or more flexibility in scheduling.

As we’ve seen, patients increasingly expect digital access tools and services from their healthcare providers. Practices that wish to remain competitive must provide experiences aligned with the consumer-grade digital interactions people are accustomed to today. 

79% of doctors we surveyed revealed they rely on digital appointment reminders to reduce no-shows and cancellations.

Digital reminders remain important — 40% of patients said that sending more reminders would stop them from canceling, rescheduling, or not showing up. But as noted above, they don’t find this option as appealing as more last-minute appointment slots or providers showing up on time to appointments. 

So while patients still want digital reminders — and more of them — they’re not the silver bullet. Patients have busy lives, with shifting and unpredictable commitments, making the availability of last-minute appointment slots a more valuable resource. 

We also polled patients about telehealth. 56% of patients said they would be willing to do a telehealth session if their provider is unavailable in person. Moreover, a large majority of patients (74%) said they would opt-in to a virtual waiting room in order to show up to the appointment on time. 

During a telehealth visit, a virtual waiting room allows patients to indicate they are ready for their appointment and/or for providers to indicate they are ready, while allowing staff to view and manage the experience. During an in-office visit, a virtual waiting room lets patients check-in for their appointment on their mobile device and bypass the traditional waiting room. 

The takeaway? A blend of digital interactions will continue to shape the patient-provider landscape — and have the potential to improve patient satisfaction and engagement.  

How are providers sharing resources with their patients? We found that 86% of providers offer patient education through brochures or printed materials, followed by posters or charts (39%), and models or props (32%).

In contrast, 68% of patients preferred health information in brochures or printed materials, followed by posters or charts (22%), and YouTube videos (19%). 

Providers did not cite YouTube videos as one of the Top 3 modes of delivering patient education — they may hesitate to use this medium because verifying the credibility and quality of the source behind a YouTube video is a challenge.

As before, brochures and printed materials remain staple. But as learning preferences shift towards digital engagement, providers can capitalize on this trend by offering a variety of education content — in different mediums and formats. This will give patients what they prefer and align with evolving digital trends in healthcare, while promoting proactive involvement in their own health. 

Whether you’re operating an established medical practice or just starting out, addressing the challenges of rescheduling, cancellations, and no-shows is crucial to a sustainable business model. In our survey, we uncovered several strategies and trends that can help practices navigate these issues more effectively. 

Patients surveyed want online scheduling options — full stop. 75% of them said that if they could reschedule their appointment online, without having to call the office_, they would be more likely to show up to their appointment. 

By implementing user-friendly online scheduling platforms, providers can give patients the control to make real-time changes and can improve appointment adherence. 

Not only does online scheduling offer the modern, digital experience patients have come to expect, it optimizes your practices’ resources — staff can spend less time on the phone, and focus their efforts and work on other revenue-generating tasks. 

Use your medical website to prompt for appointments and include a call-to-action (CTA) on multiple pages, so it’s easy for patients to book an appointment with your practice online. In addition, providers can allow patients to book from third-party sites such as Yelp and WebMD, place an online scheduling tool directly on social media profiles, and use Google to let patients book an appointment at your practice without having to visit your website. 

Inevitably, unexpected events occur for both providers and patients. 68% of doctors across specialties said they cancel on patients 1-10 times per month. By contrast, 59% of patients surveyed reported canceling or not showing up in the last 12 months.

Our survey found that both parties are fairly forgiving when it comes to having to cancel or reschedule — but only to a point. 

83% of patients said it was reasonable that doctors would sometimes have to cancel or reschedule. The top 3 acceptable reasons to patients were family emergency, sickness that is contagious, and personal emergencies. 

Likewise, doctors said that patients’ personal emergencies, family emergencies, and transportation issues were acceptable and understandable reasons to have to cancel or reschedule. 

The sticking point?  The data showed a 30% drop in compassion on the part of patients when it comes to providers seeing other patients during what was their scheduled appointment time. They might be forgiving of your family and personal emergencies, and when you’re sick with something contagious, but they draw the line at seeing another patient with more urgent needs.

The data also revealed differences in canceling and rescheduling behavior by generation. 

Gen Z had the highest appointment cancellation rate and the most notable percentage of missed appointments without first letting the practice know. By contrast, Baby Boomers reported almost always informing medical practices about cancellations.

Recognizing these dynamics can guide providers in managing cancellations effectively across various scenarios and generations.

53% of patients surveyed said they were Completely Likely, Somewhat Likely, or Somewhat Likely to switch providers for a “better no-show policy.”  

And fees charged for no-shows made a difference. 61% of doctors said they charge a $21-$40 fee if a patient cancels or no-shows. This is notable because the majority of patients (56%) said they are more likely to try a new provider with a no-fee cancellation policy.  

The takeaway? Patients not only want clear communication of appointment expectations and flexibility for rescheduling — they want little or no fee for missed appointments, too.  Consider recalibrating your fees for no-shows and cancellations. By doing so, you can strike a balance between holding patients accountable and showing empathy towards them. 

Based on these findings, there are a number of steps providers can take to address the issue of no-shows and cancellations: 

Today’s patients want healthcare experiences that can seamlessly integrate into their busy  lives. Booking a healthcare appointment should be as easy as other on-demand, digital experiences, from online banking to booking a table at a restaurant. And making a change to an appointment should be that easy, too.

Rescheduling, cancellations, and no-shows are bound to happen, but healthcare providers shouldn't simply accept them without action. Providers can heed patients' requests for more convenience, flexibility, and empathy to improve appointment management — to keep patients loyal and remain profitable in the long-term.