My patient population is from a mostly indigent ? Medicaid population. No shows and DNKA?s are very common.
I have done everything I could think of to ?solve? the problem.
I have come to realize that for my practice, the no shows and DNKAs are just how it is going to be.
So, I have to redefine the problem.
What bothers me about the DNKA and no shows, is the negative impact on the patients health care, and the negative impact on the management of patient flow and my ability to be productive or not.
For the negative impact on health care, if the missed apt is important, then we will attempt to reach the patient [if we have a good phone number]
For the patient flow problems, what I do is :
When a patient cancels or no shows, I review each one and save it in the messages.
When I look in the messages, I form a gestalt opinion if the patient usually makes appointments, misses a little too much, or misses a lot.
I use the ?FLAG? system.
I have a ?5 minute apt? flag ? and in the apt category have a 5 minute slot with category of visit- poor comp
I also have a ?Walk In? flag For people who earn the Walkin flag [with the category- walkin only] they are only offered the apt first in the am [told the apt is at 9 am] or first in the pm- [told the apt is 1:30 pm]and are placed on the schedule to take up a spot 5 minutes before office hours start. So the schedule might have john with an apt for 8: 55 and the category will be walkin .
I find this way, patients are accommodated in the schedule, but if they miss, oh well, not too painful.
If they all come in [a rare event], then it might be a stressful day.
I do not check insurances until they arrive to the office .
