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No Show: Understanding What Keeps Patients From a Medical Appointment

Patients, especially those suffering from chronic disease, may not always be able to keep a scheduled medical appointment. While poor health may be one of the biggest reasons for this, inability to get to the appointment and back home could be another. This in turn may be influenced by the patient’s geographic location, distance from the clinic/hospital, whether they own a vehicle, whether a family member or friend can drive them, insurance coverage of transportation service etc. Think about why you last missed a medical appointment – we’ll ask again at the end.

Geographic Location

Populations living in rural areas are challenged with having to travel long distances for healthcare access, especially for specialty care. Consider outpatient radiation treatment among breast cancer patients: patients in rural areas had to travel nearly three-times further (40.8 miles) than those residing in urban neighborhoods (15.4 miles). Considering that this treatment has a schedule of five days a week for up to five-seven weeks at a time, a patient living in a rural area would travel on average 2,000 miles more over the duration of treatment, according to the study author. 

Shortage of trained clinical staff in rural areas does not help: there are only 39.8 primary care doctors caring for a 100,000 people in rural areas, compared to 53.3 in urban areas. 

Access to a Vehicle

Patients are more likely to have missed a medical appointment or an outpatient procedure if they do not have easy access to a vehicle. According to the American Hospital Association, 3.6 million people in the U.S. miss a medical appointment because of transportation issues. Often, these patients are a person of color, non-English speakers, or of low income. Elderly patients who can no longer drive or have to depend on a family member to drive them to an appointment may also be no-shows. 

Clinics have partnered with transportation services and ridesharing platforms such as Uber or Lyft to provide patients with an option for non-emergency medical transport (NEMT), but that may not necessarily be a viable solution. When Patients Rising surveyed our audience, we found out that Uber and Lyft may not be a reliable NEMT service. 

Cost of Care

Healthcare costs continue to rise year after year. Throw in a pandemic, job losses, and inflation and that impacts how a person or family would prioritize spending. Of nearly 2,500 respondents surveyed in 2022, 46% said they had canceled a healthcare appointment in the previous year because the cost was too high. The younger generation (Generation Z and millennials) were more likely to cancel an appointment. 

Providing patients access to a financial navigator is definitely an option, and The Patient Helpline can help. 

Forgetting an Appointment 

This can happen, especially if the appointment was booked months in advance or if a patient has multiple appointments to keep track of! Reminder phone calls, text message, or an email would ensure that the patient shows up at their designated time. 

Why Have You Missed Appointments?

We would like to know what caused you to miss appointments. Come take this one-question survey. These results may end up in our next article!


Surabhi Dangi-Garimella, Ph.D. is a biologist who brings her skills and knowledge to the health care communications world. She provides writing and strategic support to non-profit groups via her consultancy, SDG AdvoHealth, LLC.

Surabhi Dangi Garamella

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