How Do Clinicians Respond to Patients Who Miss Appointments? [CME]
J Clin Psychiatry 1998;59:330-338
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Although patients miss up to 60% of
scheduled outpatient appointments, little is known about how
clinicians respond to "no-shows." In an effort to
determine how clinicians customarily handle missed appointments,
we surveyed mental health clinicians and internists at 2 academic
hospitals: a private psychiatric hospital and an urban general
Method: An anonymous questionnaire survey was
mailed to psychiatrists, psychologists, and social workers at
both hospitals and to internists at the general hospital.
Clinicians were surveyed about their usual response to
psychotherapy, psychopharmacology, and internal medicine patients
who miss appointments.
Results: Among the 356 responses (39.5%) to 902
mailed questionnaires, there was substantial variability in
clinicians' reported handling of "no-show" patients,
although psychiatrists tended to be initially less active in
pursuing patients than were nonphysician therapists and
internists. A number of clinical variables were associated with
clinicians' responses including the perceived risk of a bad
outcome, hospital site, support staff availability, and billing
Conclusion: The results suggest that clinicians'
responses to missed appointments are determined by a complex
mixture of influences rather than adherence to a readily
definable "standard of care."