Missed Appointments

O&P clinical care is a rewarding vocation. Most clinicians would agree that issues that impede the provision of O&P care, not the work itself, create the most frustration. Patients often bring challenging personal issues into encounters, and missed appointments are one of the most frequent causes of frustration. We may see these patient issues as unnecessary barriers to fulfilling our primary responsibilities. No-shows prevent us from performing most tasks essential for providing O&P care, create disruptions in our schedules, and take up appointment slots that could be used to provide care to other patients. Additionally, they can be interpreted as disrespectful and an indication of patients’ failure to accept responsibility for their own care.

In an interview published in the Winter 2021 issue of The Academy TODAY, Rebecca Herman, MSPO, CPO, a clinician with Shriners Hospitals for Children, described various aspects of this phenomenon. Figure 1 shows the reasons she described for missed appointments. According to Herman, research shows that “patients who are in the young-adult age category, lack personal transportation, have a low socioeconomic status, and are uninsured or insured by Medicaid are the most likely to chronically miss appointments.”¹ She points out that most Medicaid patients who can work do, and those who do not “cite having a disability, providing unpaid care for an ill family member, or being in school as reasons for not being employed.”¹ Most clinicians have predictable schedules that include paid time off for medical appointments and other reasons. Many entry-level jobs, the type that individuals with lower income are likely to have, do not include these advantages. Other factors that contribute to missed appointments are an inherent part of these patients’ life situations.