November/December 2004 Annals of Family Medicine tip sheet

Interviews with patients revealed three reasons why 42 percent of appointments are no-shows: 1) patients feel anxiety or fear about the cause of the symptoms and anticipated diagnostic tests, 2) they feel disrespected by the health care system, and 3) they do not understand the scheduling system. In semistructured interviews with 34 adult patients, 22 participants (65 percent) mentioned emotional barriers to keeping appointments, including fear and anxiety about both procedures and bad news. Fifteen participants (44 percent) commented on issues of respect by the health care system, commenting that the health care staff did not respect patients, discounting their time, opinions and feelings. Forty-one percent of patients indicated they did not understand how a failed appointment affects the clinic and clinic staff. Patients seemed unaware of the financial impact of a failed appointment and believed a no-show may actually be a positive event for a busy clinic. The authors assert that the single issue of respect could underlie the association between waiting, satisfaction and non-attendance. They posit that the norm of reciprocity suggests that a patient who feels disrespected would feel no obligation to respect the system, and they suggest that health care providers could begin to address this issue of no-show rates by reviewing waiting times and patients' perspectives of personal respect.
Why We Don't Come: Patient Perceptions of No-Shows
By Naomi L. Lacy, Ph.D., et al


Are Frequent Callers to Family Physicians High Utilizers?
By David E. Hildebrandt, Ph.D., et al
Studying the charts of patients in a family medicine residency practice, researchers found that patients who make frequent after hours telephone calls to physicians' offices are generally high utilizers of health resources. Compared with other patients, they

Contact: Angela Lower
American Academy of Family Physicians

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