I was raised in a family where a deal was a deal. If Dad said he’d pick us up from school at 4 p.m., he was there at 4 p.m. That commitment carried through to me in raising my family so that now when my daughter or granddaughter says she’ll pick me up at 6:40 to take me to an evening play, I trust I can lock my front door at 6:35 and their car lights will be beaming into my driveway.
So I find it hard to understand how patients who have been given a referral letter by their family doctor for an appointment to see a specialist or to undergo some medical test as an out-patient, fail to keep the appointment or to cancel it in advance so another patient can be booked to make use of the time.
Failure to cancel well ahead is even more distressing given the number of patients in need of urgent care and the shortage of medical facilities to diagnose or treat them.
A British study surveyed 103 no-show patients with a habit of missing appointments. They represented 12 percent of all patients. Their excuses ranged from forgetting to attend, forgetting to cancel, no reason, clerical errors, felt better, were fearful of being seen by junior doctor, inpatient in another hospital, on holiday.
Three had died.
Other valid reasons for missing an appointment would be a hurricane, flood, or a family funeral. But even a funeral would allow for cancellation 48 hours in advance.
A few were too apathetic to respond to the survey.
“Non-attendance at outpatient clinics is an economic drain on national health service resources,” concludes this 1997 British study reported in the June 2002 issue of Journal of the Royal Society of Medicine. Each missed appointment was estimated to cost £65 or just over $108 Canadian.
The second issue is manpower. A patient’s failure to attend, increases the time others must wait to see a hospital specialist. Non-attendance means under-utilization of equipment and manpower.
Lastly no-shows impact patient health. A delay in presentation and therefore diagnosis, or haphazard monitoring of chronic conditions, will predispose to avoidable ill health.
Recently CBC news reported in 2015-16 Newfoundland and Labrador tallied 176,000 patients (or 11 per cent) missing appointments for tests like orthopaedics, endoscopy and diagnostic imaging.
One might expect a similar rate of no-shows occurs in the rest of Canada, adding up to a major scheduling problem.
This is one reason doctors’ offices crowd their schedules and so many of us sit for an hour or more waiting to be seen.
Unless doctors overbook, they could find gaps in their day and less income in their bank accounts.
If everyone does show up, nurses are stressed trying to fit everyone in. Patients are whisked through with scant time to explain the purpose of their visit.
A sign on the wall reads “Only one complaint per visit.” Or words to that effect.
Not like the days when a family doctor took time to hear us out. I’m ever mindful of others in the waiting room checking the clock and slumping lower in their chairs.
Patients who fail to keep their appointments not only display bad manners but disregard for others.
If they were in agony waiting six months or up to two years for a hip replacement, they would be more inclined to check their event calendar regularly and make sure they were available, in town, not on some foreign vacation when their appointment came up.
Clinics are not checkouts. The next customer can’t step forward.
Claudette Sandecki sets her watch daily from her home in Thonrhill, B.C.