+Scott Watson

Friday, 14 August 2009

No Consequences? Why Should I Care?

Why is it that nearly 7 MILLION people chose not to keep the appointments they made with their medical doctor during 2007 and 2008? The decision to not turn up was at great cost to you and me, the taxpayer - £600 million per year. That's enough to run two mid-size hospitals.

But the patients who chose not to keep their appointments won't think about or even care about the statistics. Why should they? When we make an appointment with our GP or hospital, it's about us - not anybody else isn't it?

Why might you not show up for an appointment?

There are many reasons which may include:

-I forgot about it
-I felt better so didn't need the appointment anymore
-I was stuck in traffic
-My pals invited me to the pub/the match (and I forgot to be ill because I was having fun)
My young child/elderly mother needed me more than I needed the appointment

But whatever the excuse or reason for not showing up, why could it be that you don't take a few minutes to call and cancel or postpone your appointment? Well, it might slip your mind, but really isn't it more a case of placing so little value on the appointment itself, that it's not worth calling? After all, it won't be inconvenient for anyone so why bother?

How can the problem be effectively tackled?

We human beings generally need to understand the consequences of us either doing, or not doing something if any emotional response is to be generated. It's rather like your doctor saying 'Please give up smoking for the good of your health' versus 'If you continue smoking cigarettes, you are likely to suffer lung cancer and you won't be around to walk your daughter down the aisle when she gets married.' Both statements have an impact, both have consequences, but which do you feel would be more likely to get the patient to stop, think and then take some intelligent action? Possibly the second.


Some practical, but potentially non-pc ways of helping people to keep appointments.

When the patient calls to ask for an appointment, the receptionist agrees the date and time and asks a simple question. 'Will you please store this appointment in your mobile phone and/or calendar at home, just so you remember it?'

When the patient calls to ask for an appointment and the date and time are confirmed, the receptionist asks 'Are you ABSOLUTELY SURE that you will be able to keep this appointment? And then awaits a positive response and asks the patient to store it as above. This is about a gentle reminder and double checking the value they place on the appointment.

When a patient calls to ask for an appointment, the receptionist politely states 'Just to let you know, if you are unable to keep, or don't need to keep this appointment, we do require you to call us and let us know by (date/time) so that we can offer it to someone in need. Will you please do that for us?' This is about a gentle reminder and reciprocity.

When a patient calls to ask for an appointment, the receptionist politely states 'Just to make you aware, if you fail to keep this appointment without providing prior notice by telephone by (date/time), the next time you request an appointment with the doctor, other patients will be given priority over you.' This is about developing responsibility and a potentially sever consequence for not keeping their commitment.

Remember that people need to understand the consequences, both positive and negative of their action/inaction or compliance or failure with a standard/instruction or guideline.

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