Measuring No Shows in Physical Therapy Practice Management

I did a recent series of blogs on improving your no show rates based on interviews with Paul Christensen, DPT, OCS, ATC, FAAOMPT, who is on the Clinical Advisory Group for Clinicient.  Working on these blog articles reminded me of an important problem: there is not an accepted standard for counting no shows and cancellations.  To get meaningful metrics on failed appointments across different organizations, everyone must use the same standards and policies and have a common reporting infrastructure.  Let me explain.

Standards and Policies

Even within the same organization, I have seen failed appointments counted differently.  Well designed, totally integrated physical therapy EMR software can help with this, but the software can’t set and enforce your policies. For example:

  • Is an appointment that has been rescheduled a failed appointment? (It should be, in my opinion.)
  • What is your standard for a cancellation that has been made with adequate notice or inadequate notice?  (I have an opinion on this as well.)
  • Do you charge a fee for cancellations or no shows? (You should, and if you do, your front office needs to have a clear set of guidelines.)

Reporting Infrastructure

Even if there were more well designed physical therapy EMR systems and accepted standards, there is a lack of reporting across databases.  Since there has not been a better alternative, there have been attempts to get some idea about failed appointment rates by use of surveys. Although the survey data may be better than no data at all, I believe it is far from accurate because of a lack of accepted standards and self selection of survey participants.  I am guessing that most survey participants:

  • Already closely monitor no show rates
  • Have a no show rate that is better than their peers
  • Have a standard defining when an appointment is considered failed
  • Have a policy on what to do about failed appointments

At Clinicient, we have the ability to track metrics like this across organizations.  In future articles, we will share some of the metrics that we are able to monitor for PT, OT and Speech practices of all sizes and in different regions of the country.


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