Appropriately handling a missed appointment is an important part of the responsible practice of medicine. Physicians are called upon to provide adequate information to reasonably inform their patients of their diagnoses, treatment plans as well as the risks and consequences of not continuing care or receiving follow-up testing and treatment. To safeguard the practice from claims of uninformed refusal of care and encourage continuity of care, it is important to keep the lines of communication open and to document appropriately when a patient fails to appear for an appointment.
Many practices use a telephone appointment reminder system to deter missed appointments before they occur. Dedicating one person on the staff to complete this task can reduce a number of missed appointments. Implementing a consistent practice of daily reminder calls places the office in good stead and encourages open lines of communication.
Consider posting the office policy on missed appointments in a prominent location. It may also be worthwhile to provide all patients a copy of such a policy, which may include a generic statement advising of the patient’s role in communicating clearly with the physician and following through with care recommendations.
When a patient misses a scheduled appointment, reasonable efforts should be made to contact the patient. What amounts to a reasonable effort may vary based upon the patient’s known healthcare conditions. Telephone calls to the patient should be documented in the medical record.
Additionally, a missed appointment letter should be sent each time the patient fails to appear for a scheduled visit. Many times a form letter can be appropriate for this purpose. A more detailed letter that includes an explanation of the patient’s diagnosis and treatment course, the risks of not adhering to treatment, and a recommended timeline to be seen by the physician is ideal and may be warranted depending on the circumstances. All letters should be written in clear, reader-friendly language that is in compliance with limited-English proficiency guidelines (i.e., a fourth grade reading level).
While follow-up on missed appointments can be a time consuming task, the work is important to the health of the patient and the practice. With appropriate protocols in place to contact and document the healthcare provider’s efforts, these good practices become routine.
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