Biz Tip 6:  Reduce Your No-Shows

Reduce Your No Show Rate for a More Successful Practice

As health care providers, we have only one product to sell, and that is our time. This time is used to pay our operating expenses and to earn our income. When an appointment is broken at the last minute or a client does not show up for their scheduled treatment time, then we are deprived of our only saleable product.

As with any service-based business that requires appointments to operate efficiently, most massage therapy clinics regularly deal with no-show clients who miss their scheduled times. No-shows have a negative impact on our daily schedules, and waste valuable time slots that could have been filled by other clients. The result is a loss of both time and money.

There are, however, actions that you can take to reduce the number of missed appointments and keep your operations running smoothly and productively.

  1. Appointment Reminders

Reminders of any kind can significantly minimize the number of no-shows. Depending upon the size of your practice, there are many ways to gently remind your clients of their scheduled appointment time. The traditional phone call works well, but can also require a significant amount of administrative time.

E-mail and text message reminders, take less time and are becoming the preferred choice. Automated e-mail and text messages are a feature found in some software applications, such as online appointment-scheduling software.

2. Missed-Appointment Charges

This is a common procedure among many massage practitioners. Not only does it allow the practice to recoup some of the lost charges from a missed appointment, it motivates many clients to either make their scheduled appointment time or at least call ahead to cancel or change it. Either way, it equates to fewer no-shows and a better-run practice.

3. Online Payments

Clients who pay for their massage sessions when they book are less likely to miss their appointments. That's why some practices give clients the option of paying for their sessions online. Some even require it when scheduling online. Besides reducing the no-show rate, online payments also streamline the accounting and payment-processing procedures.

4. Cancellation Policies

Before outlining some possible cancellation policies, let’s take a look at the concept of “expecting the best” and setting a positive relationship of trust and respect with your clients. This is a very thought provoking concept, provided by Stephen J Anderson of TOPS INSTITUTE (Total Patient Service).

1. Most “policies” are born out of frustration with poor customer behavior. Just take a look at the front office window of your typical physician. It is littered with the policies of the day like: “Payment is expected on day services are performed.” “You must fill out updated insurance information on EVERY visit.” “We no longer accept checks.” Etc., etc. Whatever the policy, the underlying message is usually, “Our customers think so little of us and treat us so badly, we have had to come up with a checklist of do’s and don’ts to survive.”

2. It is a funny thing about life. You most often get what you expect. If the message you send with all of your “policies” is that your patients’ behavior is pretty bad, you’ll most likely get more of it! Every policy sends a message of what “most patients do.” Since people tend to follow the crowd, every policy sends the message of what the crowd tends to do or wants to do.

3. You can’t focus on the opposite of an idea. If I’m told NOT to think of the Statue of Liberty, it would be impossible not to do it. The mere mention of the object immediately creates an image in your mind that you cannot erase unless you replace it with a different image or different idea. Translation: you can’t talk about NOT canceling without planting the seed of a cancellation.

Here’s the bottom line: Let’s say your “cancellation policy” is that patients must call your office 24 hours in advance to cancel or change an appointment or they will be charged a fee. Guess what? That is not a “cancellation policy” or prevention tactic. It is a cancellation invitation. Why? Because you just said to your patients, “When you make a commitment to an appointment, it is really not a commitment until the day of the appointment. So change it any time! Make us crazy so we have to constantly try to fill the appointment book at the last minute.”

So what’s the best “cancellation policy?" No cancellation policy at all! Crazy? Maybe. But before you dismiss the idea, consider the following:

What if you raised your expectations of what you expect from your patients by expecting the best. For example, instead of your appointment card having your “cancellation policy” it says instead:

“You have a confirmed reservation with (Name of your office.) (Name of patient), your reserved appointment is on: (Day), (Date), (Time). Please mark this important appointment on your calendar today. We look forward to seeing you at this time that has been reserved especially for you.”

What’s the underlying message here? “We are making a commitment to you, we know that you are making the commitment to us, and we know we can count on you.” That is a higher level of relationship than telling someone you are going to charge him or her when or if there is a no-show or cancellation. It places you in a higher-level category in their mind, separating you from any other massage therapy office they may have been to in the past.

Finally, what kind of relationship do you have or do you want to have with your patients? If your goal is to have a relationship of trust and respect, then create it. For example, if you set a lunch date with a trusted friend or mentor, you would never consider sending them an email or text that says: “I’m really busy so if you don’t show up, or change this at the last minute, I am sending you a bill for the lunch anyway!” You would never do that to someone you respect. You might consider the same for your patients. How much do you really respect them? If the answer is “not much,” your patients probably don’t respect you or your practice much either.

So as you reconsider your “cancellation policy,” have a conversation with the entire team about what you really believe about your patients and their behavior. What do you expect from them? What would happen if you raised your expectations? Would they respond accordingly.

Sample Appointment Cancellation Policies

  • Failure to keep your scheduled appointments at (name of clinic) hinders our ability to provide the best care to our patients. We ask that you show us consideration by calling at least 24 hours prior to your appointment if you are unable to attend.  This will allow us the opportunity to offer that appointment to another client. Repeated late cancellations or no-shows are disruptive to the optimal delivery of care to you and our other clients. Missed appointments prevent other clients from coming in at the same time and affect the consistency of your own rehabilitation program. Late cancellations due to illness or emergency are excluded from this policy. Failure to give the 24 hours notice necessary prior to cancellation, will result in a "No-Show Appointment Fee."  The No-Show Appointment Fee is ___________.


  • Our goal is to provide quality medical care in a timely manner. In order to do so, we have had to implement an appointment/cancellation policy. The policy enables us to better utilize available appointments for our clients in need of our care.


  • In order to be respectful of the medical needs of our clientele, please be courteous and call (clinic phone number) if you are unable to attend an appointment. This time will be reallocated to someone who is in need of treatment. If it is necessary to cancel your scheduled appointment, we require that you call by (10:00 a.m.) one (1) working day in advance. Appointments are in high demand, and your early cancellation will give another person the possibility to have access to timely medical care.


  • As a professional health care service, we have only one product to sell and that is our time. This time is used to pay our operating expenses and to earn our income. Once an appointment has been booked and the time is scheduled, we feel that it becomes the client’s responsibility, and should be a priority. When an appointment is broken at the last minute or a client does not show up for their scheduled treatment time, then we are deprived of our only saleable product. Therefore, we require a minimum of 24 hours notice to cancel or re-schedule an appointment time. This gives us a reasonable amount of time to re-book the time slot that you previously occupied.  Please help us to avoid billing for our lost time. Same day cancellations will be charged 50% of the scheduled service fee. If you do not call to cancel your appointment, or do not show up for your scheduled appointment, you will be charged full price for the scheduled service. Thank you for your cooperation and understanding. We dislike billing for lost time as much as our clients dislike paying for it.