Salons, hotels, and no-shows: Is a therapist's time worth less than a haircut?

My hair stylist recently left one salon to work at another.  This morning, I googled the new salon, with the intention of finding a number to call and schedule my appointment.  When I saw that they had online appointment booking, I was elated. My heart soars whenever I see a link to “Book your appointment!”  How I dread scheduling an appointment that either requires a lot of back-and-forth calendar coordination or, even worse, an endless game of phone tag.


One thing that struck me was that this hair salon, like more and more service providers, required me to pay a deposit and prompted me to “accept” the terms of their cancelation policy.  It informed me, in no uncertain terms, that I would not be refunded the deposit amount if I failed to notify the salon of my intent to cancel at least 24 hours prior to my appointment time.  Now, I know a lot of us execute many our daily transactions online and are used to paying in advance for goods and services.  For example, I travel frequently for work and book my hotels room online.  Often, to receive the best possible room rate, I am required to pre-pay for the hotel room, in advance.  My payment will be forfeited if I fail to cancel within the 24h cancellation period.


 But, let’s think about the behavioral influence that collecting prepayment has.  Even at a subconscious level, it makes me more aware of the importance of keeping an appointment or hotel booking.  I immediately sync these prepaid transactions with my google calendar, and I often add a 48h calendar reminder for myself – to ensure that I cancel in time, if need be.


So, why is it that most therapy practices not offer online appointment booking, but even those that do offer it don’t require prepayment?  Assuming a HIPAA-compliant appointment booking option is utilized, requiring prepayment of some/all of the copay or cash fees would significantly reduce the number of no-shows – which for mental health providers can be as high as 43%. Over the course of a year, four no-shows per week can cost a practice up to $30,000!   This lost income is compounded by the time and money wasted on scheduling efforts – as traditional scheduling of just one appointment can involve several voicemails, emails, and/or phone conversations. 


When therapy clients are asked why they no-show for an appointment, the most common reasons cited are (1) work/family scheduling conflicts and (2) simply “forgetting” about the appointment.  Again, I can’t help but circle back to my hair appointment analogy.  I am much less likely to forget something that I’ve paid for.  I don’t mean to sound cynical . . .it’s just the god’s honest truth.  And, on the flip side, if I truly do need to cancel or reschedule an appointment, I am much more likely to handle it immediately and promptly, if the process can be done online (preferably on my iPhone) in less than 60 seconds!


So, in a world where haircuts and hotel rooms require prepayment and enforce a penalty for late cancellation, isn’t an hour of a licensed mental health provider’s time worth the same level of regard?  You can’t be responsible for your clients’ behavior, but you can put guardrails in place that protect you when their behavior has unfavorable financial and workflow effects on your practice.  A simple HIPAA-compliant mobile appointment scheduling tool with prepayment goes a long way in reducing those unwanted and costly gaps in your day.