Three things cut no-shows the most: a text reminder 24 to 48 hours ahead with a link to cancel or reschedule, a waiting list for freed-up slots, and same-day confirmation of a new patient’s first appointment. To see how many patients you lose, have reception mark every unexplained no-show in the calendar for a month.
Many clinics try to make cancelling harder for patients. That backfires. A slot cancelled two days ahead can still be filled, but an empty chair at 9:00 cannot. If the missing patient came from an ad, you also pay twice. On the Be Fyzio project, each enquiry from advertising cost 203 CZK and the average service was worth 1,500 CZK. Example: if 2 in 10 of these new patients don’t turn up, the clinic pays 406 CZK for ads that ended in an empty slot and loses 3,000 CZK in revenue.
One month of the calendar shows what you lose
Without a number, you can’t tell whether no-shows are a minor nuisance or a hole in your revenue. Reception gives every appointment that didn’t happen one of three labels: “cancelled in advance”, “cancelled within 24 hours” or “no-show”. They also note whether it was a new or an existing patient.
Monthly loss = number of no-shows × average revenue per appointment + number of new-patient no-shows × cost of one enquiry.
Example: a clinic has 400 appointments a month and 5 in 100 booked patients don’t turn up, which makes 20 patients. At 1,500 CZK per appointment, that is 30,000 CZK. If 5 of them are new patients from ads and an enquiry costs 200 CZK, add another 1,000 CZK for advertising that produced nothing.
The second number shows why it pays to track marketing costs all the way to the patient who actually walks in. We explain the method in how to measure clinic marketing.
Reminders work when patients can cancel in one click
A text reminder is the cheapest step on the whole list. A Cochrane review found that 78.6% of patients attended when they received a text reminder, against 67.8% without one. Put another way: out of 100 booked patients, 68 turn up without a reminder and 79 with one. Text messages also worked about as well as a phone call from reception.
Time the reminder to the length of the treatment:
- 48 hours ahead for long treatments, so reception has time to fill a freed-up slot.
- 24 hours ahead for short check-ups and therapy sessions.
- An email with a calendar invitation straight after booking, if you have the patient’s email address. We cover email for existing patients in Existing patients and email.
A template you can copy:
[clinic name]: a reminder of your appointment on [day] at [time], [address]. If you can’t make it, reschedule or cancel here: [link], or call [phone number]. Thank you.
Leave the name of the treatment out of the message, because a family member often sees it on the lock screen too. Test the link as well: open it on a phone and try to cancel an appointment without logging in. If that takes more than a minute, the patient won’t bother finishing and will simply not turn up.
A waiting list fills the freed-up slot
A cancellation in advance is only good news if the clinic has someone to offer the slot to. A typical morning at reception: a patient cancels tomorrow’s appointment and reception leafs through the records looking for someone to call. By the time they get through to anyone, it’s noon.
A list of patients who want an earlier appointment is faster. Every time someone books, reception asks: “Shall I put you down in case something earlier comes up?” When a slot frees up, they text three people at once:
[clinic name]: a slot has come up on [day] at [time]. If you’d like it, reply YES by [time]. It goes to whoever replies first.
Check: at the end of the month, compare the number of cancelled slots with the number that were refilled. If more than half stay empty, the list is too short or the text goes out too late.
New patients need confirmation the same day
A new patient owes the clinic nothing yet, and booking with a competitor costs them little. So send a confirmation straight after booking: date, time, address, which entrance to use, where to park and what to bring. Reception confirms a phone enquiry from the website or an ad within an hour, while the patient still remembers you.
The more enquiries come in, the more of them can slip away at first contact. On the Doctor Dent project, enquiries grew from 302 to 498 in a year, an increase of 196. But each extra enquiry only matters if it turns into a patient in the chair. A free audit shows how patients find their way to booking on your website and how fast the site loads. We email the PDF within one working day.
This isn’t enough if a new patient waits 2 months for a first appointment. No text message will hold on to them for that long, because by then they have often found another clinic. Start by freeing up capacity for first examinations: at least a few slots a week, with a wait of no more than 7 days.
Deposits only make sense for long treatments not covered by insurance
Consider a deposit or cancellation fee only after reminders and the waiting list are in place, and only for treatments where one no-show blocks the doctor for an hour or more. These are typically implants or longer aesthetic procedures. For a first consultation, a deposit tends to get in the way: a new patient would rather book where nobody asks for one.
If you introduce a deposit, put the terms on the website next to the price list and in the confirmation text. Patients must see them before they commit to the appointment. Before reception starts taking deposits, have a lawyer review the wording and the whole process. We can’t vouch for the legal side, only for making sure the patient sees the terms in time.
Frequently asked questions
How much do automatic text reminders cost?
The price depends on the booking system and the number of messages. Example: 400 texts a month at 1.50 CZK each come to 600 CZK, less than a single no-show at 1,500 CZK. Check whether your booking system can send reminders automatically.
Is it worth double-booking a time slot?
For short check-ups it can fill an empty slot, provided you know how many patients usually miss that time. For long treatments you end up with a full waiting room and worse reviews. First, find out when patients miss appointments most often.
What should we do with a patient who has missed an appointment twice?
Reception confirms their next appointment by phone the day before and offers them a slot from the waiting list rather than a long reserved block. Write the rule down and apply it to everyone, so reception doesn’t decide on a whim.
Four steps you can take this week
- On Monday, ask reception to label appointments in the calendar as “cancelled in advance”, “cancelled within 24 hours” or “no-show”.
- On Tuesday, rewrite your reminder text using the template and try cancelling a test appointment on your phone.
- On Wednesday, set up a waiting list so reception can start adding patients who want an earlier slot.
- In a month’s time, on a Friday, put the numbers into the formula and decide whether you also need deposits.
