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Why Are Appointments Booked Online Canceled Less?

Back in medical school, I always heard how hard it was for patients to get in to see a doctor in dermatology, my chosen field. It was a refrain I often found a little difficult to believe, considering how many newly minted dermatologists graduate each year, not to mention how this specialty usually can see more patients in a day than a family physician. Living in Houston, I had only to look on Zocdoc to see same-week appointment availabilities to fit almost every sub-speciality, time requirement and insurance plan.

Yet talking to patients, the problem seemed very real, and especially so when I left Houston to work in a rural setting. But what I also began to notice, having now joined the workforce, was how many appointments were canceled – and how many last-minute openings even my busiest colleagues seemed to have. Could it be that the lack of doctor availability isn’t just due to a physician shortage, but to the way patients schedule and attend their appointments?

Intrigued, University of Texas researcher Zuhair Siddiqui, MPH, and I decided to look more deeply into the phenomenon. Together, we set out to see what effect the act of booking online versus by voice actually had on appointment attendance. We launched a six-month study comparing what amounted to 130 appointments made online (using Zocdoc, in this case) and by voice.

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The findings were accepted and published in the peer-reviewed, MEDLINE-indexed electronic journal, Dermatology Online Journal. They showed that non-attendance (both cancellations and no-shows) was at 6.9 percent among patients who booked online. By contrast, non-attendance rates for dermatology appointments made by voice ranged from 17 to 31 percent.

Why were online appointments canceled less frequently? One explanation is that when patients have access to reviews, practice information, and all the available appointment times for all the doctors they’re considering at once – as they do when booking online – they can choose the best time and doctor for their specific needs immediately. This reduces some problematic behaviors common to dial-in scheduling, such as making a “back up” appointment at a time or with a practice the patients are not 100 percent happy with, only to cancel or ignore that appointment when a better fit is found on a subsequent call.

We also learned something fascinating while preparing for our study: The more rural the setting, the less likely its physicians were to use online booking. In other words, in the places where more patients are jostling for fewer doctors, cancellations and no-shows are at their highest. This suggests that online booking may be an asset even for doctors who should, based on physician-to-patient ratios, be very busy. And on the patient side, the continued migration toward online appointment-making may help alleviate the frustrations of feeling like a good doctor is hard to come by, especially when you want or need one the most.

Dr. Rashid M. Rashid is a Houston Dermatologist and Hair Transplant Surgeon specializing in hair restoration. He is one of a few hair specialists in the world with both an MD and a PhD as well as awards from the American Medical Association and ACGME. With over 75 peer-reviewed manuscripts, Dr. Rashid regularly also operates one of the few dual unit follicular extraction clinics. 

Comments (5)
  1. Carlos Moreyra

    In my experience as an orthopedic surgeon when I had an employed-practice, Zoc Doc appointments were cancelled far more than other ones.

  2. LPR

    My theory:
    Patients trust an online source vs the phone. If zocdoc says that dr is in-network he must definitely be in network. A lot of times oon docs try to get the pt in then they tell them in the office that they are oon & they may have to now pay x amount of dollars.

    2) what it really comes down to is pt reminders. Most practices have inadequate staff to call each pt to confirm / remind them of their upcoming appt. And doctors can’t really trust that the hourly staff is actually doing their job. zocdoc who emails & txts when you have that you have an appt. reminding the pt why they wanted to be seen in the first place. And pt tends not to cx bc they are constantly reminded of the reason . I need a job @ zocdoc. I’ve been saying this for yrs. there is so much they can learn from me lol

  3. E

    Aside from the online convenience, those offices that utilize online appointments also send electronic reminders and text messaging confirmation.

  4. V

    The only problem with the last recommendation is that more rural patients do not feel comfortable online. Today my patient told me he could not get his test results because his cardiologist has them online only and he has never turned a computer on. You are right about your other points. My schedule changes multiple times ina day with no shows and cancellations as well as same day appointments made late in the day when they finally “got up”.

  5. It ‘s really great to know.Thank you for sharing.

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