Unbooked at the desk, seventy percent never come back

I went through two years of appointment records at one clinic, looking at every new patient’s first nine weeks. About 1,500 first visits, each with a full nine weeks of history behind it, so nobody was cut off mid-story.

One split explained most of what followed.

Patients who left that first visit with the next one already booked came back. Fifteen percent of them never returned. Patients who left with nothing booked mostly did not come back. Seventy percent of them never returned. Same clinic, same providers, same year. The only difference I could see at the desk was whether the next appointment existed when they walked out.

The unbooked group was small, about one in six new patients, roughly eleven people a month. That is the number that made it interesting. Eleven names is a list a person can work. Sixty-five names, which is what “every new patient” comes to, is a list nobody works.

Two things I want to be careful about.

First, I cannot prove the booking causes the return. Someone who declines to book on the way out may already have decided not to come back, and the empty calendar is just where that decision shows up. What I can say is that it is the best same-day predictor I found, and it costs nothing to look at.

Second, I threw one number away. Early on I had a chart showing that patients with a cancellation averaged five visits and patients without one averaged one. It looked like cancellations were a good sign. They are not. Patients who never return also never cancel. That is survivorship, and I would rather say so here than let it sit in a slide.

There was a related list, too. Of the patients who did not return, about a third had booked and lost the appointment, and most of those were cancellations marked as “will reschedule” that never got rescheduled. About eight a month. Together with the eleven, that is under twenty conversations a month, and the records say almost all of the recoverable value is in them.

What I would check in your clinic: how many new patients left last month with nothing booked, and who is calling them this week.