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Annals of Family Medicine 2:541-545 (2004)
© 2004 Annals of Family Medicine, Inc.
doi: 10.1370/afm.123
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Why We Don’t Come: Patient Perceptions on No-Shows

Naomi L. Lacy, PhD1, Audrey Paulman, MD, MMM1, Matthew D. Reuter, BA2 and Bruce Lovejoy, MSN, APRN, FNP-C3

1 University of Nebraska Medical Center, Department of Family Medicine, Omaha, Neb
2 University of Nebraska Medical Center, College of Medicine, Omaha, Neb
3 University Medical Associates Family Practice Clinic at Baker Place, Omaha, Neb

CORRESPONDING AUTHOR: Naomi L. Lacy, PhD, UNMC Department of Family Medicine, 983075 Nebraska Medical Center, Omaha, NE 68198-3075, nlacy{at}unmc.edu

PURPOSE Patients who schedule clinic appointments and fail to keep them have a negative impact on the workflow of a clinic in many ways. This study was conducted to identify the reasons patients in an urban family practice setting give for not keeping scheduled appointments.

METHODS Semistructured interviews were conducted with 34 adult patients coming to the clinic for outpatient care. Interviews were audiotaped and transcribed verbatim. A multidisciplinary team used an immersion-crystallization organizing style to analyze the content of the qualitative interviews individually and in team meetings.

RESULTS Participants identified 3 types of issues related to missing appointments without notifying the clinic staff: emotions, perceived disrespect, and not understanding the scheduling system. Although they discussed logistical issues of appointment keeping, participants did not identify these issues as key reasons for nonattendance. Appointment making among these participants was driven by immediate symptoms and a desire for self-care. At the same time, many of these participants experienced anticipatory fear and anxiety about both procedures and bad news. Participants did not feel obligated to keep a scheduled appointment in part because they felt disrespected by the health care system. The effect of this feeling was compounded by participants’ lack of understanding of the scheduling system.

CONCLUSIONS The results of this study suggest that reducing no-show rates among patients who sometimes attend might be addressed by reviewing waiting times and participants’ perspectives of personal respect.

Key Words: Office visits, no-shows • patient satisfaction • patient compliance • attendance • family practice




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TRACK Comments:

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"Why We Don't Come" and "How can I treat you if I can't see you?"
Audrey Paulman
Annals of Family Medicine, 8 Dec 2004 [Full text]
It's all about delay
Michael L. Davies
Annals of Family Medicine, 10 Dec 2004 [Full text]
Delay
Audrey Paulman, MD, MMM
Annals of Family Medicine, 10 Dec 2004 [Full text]
Access
Michael L Davies
Annals of Family Medicine, 13 Dec 2004 [Full text]
Timeliness and respect
Elaine H. Menard
Annals of Family Medicine, 5 Jan 2005 [Full text]
Why They Don't Show Up
Anonymous Doe
Annals of Family Medicine, 29 Jan 2005 [Full text]
reverse no show
sharon l johnson
Annals of Family Medicine, 26 Jan 2005 [Full text]
Small sample size limits any major conclusions
Michael V. Kline
Annals of Family Medicine, 26 Jan 2005 [Full text]
Open Access Scheduling not equal to longer waiting room time
Nicholas J. Batley
Annals of Family Medicine, 28 Jan 2005 [Full text]
USA/Mexico border no-shows in pediatrics
Jamie F Jamison
Annals of Family Medicine, 2 Feb 2005 [Full text]
Another Reason: Shaming/Hexing
k.c. dillon
Annals of Family Medicine, 6 Mar 2005 [Full text]
The disrespect issue is deeper and more complex than doctors realize
C Reed
Annals of Family Medicine, 29 Apr 2005 [Full text]

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