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What Really Causes No-Shows? The Facts

At 10to8, we continuously strive to learn from how our scheduling platform is used. This way, we can build in features and nudges that will improve outcomes for our clients. We also use these insights to make recommendations in our regular white papers, helping managers of service-based businesses worldwide make day-to-day decisions based on data and benchmarks drawn from the large 10to8 user base.

Given how widespread and costly appointment no-shows are, we look today at what causes them. Based on interviews with 10to8 users as well as a survey of the research literature, we formed a few hypotheses as to what may be the most likely determinants of no-shows.

We chose a sample of businesses using the free 10to8 online booking system to manage all of their client appointments. The industries include healthcare, beauty, education, counseling, tradesmen, and professional services. We then performed statistical analysis using cutting-edge machine learning methods with a sample of 200,000 appointments, of which 4,801 resulted in no-shows.

With a sample of 200,000 appointments, of which 4,801 resulted in no-shows. Click To Tweet


Appointment no-shows FAQs

Customers frequently ask us about what really causes appointment no-shows. This is why we gathered this list of questions and answers to help business owners identify bottlenecks. There’s some low hanging fruit in here that you can easily fix and reduce the non-attendance rate of your bookings. Without further ado, let’s dive in…


Are first-time customers more likely to no-show?

You would expect customers who don’t have an ongoing relationship with you to be more forgetful of their appointment.

Answer: Not so. When all other variables are considered, there remains no statistically significant difference.


Are appointments booked further in advance more likely to result in no-shows?

A common practice in the industry is to book appointments only a few weeks ahead, due to the fear that clients are more likely to forget bookings further than a month in the future.

Answer: Yes. With each additional week booked further in advance, the appointment is 10% more likely to result in a no-show


Does sending SMS reminders reduce the no-show rate?

Sending reminders is rapidly becoming best practice, but this recommendation isn’t always based on thorough research. In particular, the impact of SMS reminders (as compared to email reminders or no reminders) hasn’t not been tested rigorously across multiple industries (i.e. most studies look only at medical contexts).

Answer: Yes. Across industries, sending an SMS reminder for an appointment reduces the no-show rate by up to 90%


Does letting clients book online reduce the no-show rate?

Clients relish (and even come to expect) the flexibility of booking appointments at their own convenience. As such, choosing the time and date of the appointment should be reflected in better attendance rates.

Answer: No. On the contrary, bookings made by the business (practitioner or receptionist) still result in 34% fewer no-shows than appointments booked online by the client. We will explore the reasons for this result in an upcoming article.


Does making clients pay in advance reduce the no-show rate?

A common tactic to prevent late cancellations or no-shows is to make clients pay in advance. Is this practice supported by the evidence?

Answer: No. There is no statistically significant difference in no-show rates between appointments paid in advance and those that are paid later.


What’s next?

We’re currently running multiple studies varying the content of SMS messages and measuring its impact on attendance rates across industries. Stay tuned to hear the results. In the meantime, sign up for a free 10to8 account now to ensure your next appointment will take place and your client will be delighted.


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Matthew Cleevely founded 10to8 with a few friends to help simplify managing bookings and make the world a little bit more organized. He helps out where needed across the business in strategy, accounting, finance, compliance, fundraising, and people.

Outside of 10to8 he works with a wide range of high growth businesses to help them achieve their goals. He's also got an MEng in Engineering from Oxford and MPhil in Economics from Cambridge.

Matthew Cleevely

Chief Executive Officer, 10to8 Appointment Scheduling Software

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