confirming patients the day before or the day of the appointment often provides the keeper of schedule with

extra lead time on cancellations and does improve the chances that patients will show up. At least it reduces yhe incidence of patients who do not appear because they failed to check their calendars for date and time. The cost in this procedure is the time it takes the office personnel to call all the patients for the next day and the cost the telephone calls themselve. If such a procedure significantly improves the appearance rate of patients, the cost involved are comparatively minor.

Another tack is to indicate on the appoinment slip that a charge will be made if the patient does not supply adequate notice before he/she cancels the appoinment. Most health care providers who use the threat seldom carry it through. Patients are angered by this practice, particularly if they usually are present and on time for their appointments. To assess a no-shows fee may trigger some legal action and be more costly than it is worth in the long run. Patients who are chronic latecomers or no-shows can be given only half-hour appointments until they establish a more favorable pattern. This at least minimizes lost time.

To prevent the majority of broken appointments, who simple rules should be followed at the time appointment is made. The first rule is to be certain at the time the appointment is made that the patients wants the appointment at the time for which it is being made. A show of hesitancy about the time is the first sign that the patient will not be there when the appointment time arrives. An awarness of nonverbal and verbal responses to suggested dates and times will help avert many broken appointments. It is simply not possible to coerce a patient into agreeing to an appointment he/she cannot keep. The best method is to ask the patient what time is convenient within the office hours of the practice and schedule the appointment accordingly.

The second rule is to ensure that adequate time is allowed for laboratory work to be completed, with results back in the office before the appointment. And adequate time must be available and allowed for the performance of procedures planned for the visit.

There are few thhings more frustrating for a patient or a health care provider than to have to cancel an appointment at the last minute or to have to provide less than complete care because of a schedulling error. It is loss of income for the provider because of the wasted time. It may be a loss of income for the patient who had to leave a job. It certainly is an energy depleter for both because of the element of anticipation followed by the letdown.

a few other hints for appointment scheduling may prove helpful. the day, date, and time of the appointment should be said aloud to the patient and while writing it on the appointment card and in

the appointment book. saying it aloud minimizes writing errors and serves to solidify the correct tiime on the patient's memory. writing errors can be disastrous since the patients does not show when expected and does arrive at an unexpected time. appointments made by telephone should be followed by mailing a comfirming appointment card. the keeper of schedules may have less than ideal control over patients who forget appointments or over the weather and its surprises, but he/she does have control over the care with which appointment are made.