As optometrists, one thing we all have in common, other than our ability to break dance, is that we all have no shows, what we list in my office as “NS.” 

And these NS patients seem to travel in packs, because one day half your schedule is obliterated by the initials NS. Throughout my career, I have found NS patients fascinating, just like kidney stones are fascinating. They are often patients who don’t even pay a dime, as their examinations are my tax dollars at work. A statistically significant number of them called me for the appointment. Why set up an appointment yourself and then just not come? 

We’ve tried everything: (a) sent them a bill, (b) sent them a bill with a personal note saying “this one time the accountant will NOT charge a fee because I know how busy life can be,” (c) told them we cannot reserve an appointment for them but would be happy to work them in the same day they call, (d) sent a handwritten apology that I was not in when they showed up for their appointment, and even (e) reappointed them for Friday (we are closed on Fridays). So far, nothing has helped, but I’ve only been working on solutions for 35 years. 

Many, many “experts” have ideas about this very issue, such as:

1. Pre-appoint. If I had a nickel for every practice management guru who says “pre-appointing reduces no shows,” I’d be chillin’ in the Caymans right now. I do pre-appoint, and all things considered, it does help keep you booked up sometimes. On the other hand, patients routinely forget the Wednesday appointment they made on Monday. Can they remember the one they made 13 months ago? Apparently not!

2. Mail a reminder. We do. The postal service has an amazing record of reliable delivery, except, of course, for my appointment reminders. No shows “never got one.” I’m thinking of writing the reminders on a $10 check so when they cash them I can prove they actually did receive them! 

3. Call and remind them. We call them the week before and the day before. Well, of course, that depends upon your definition of “we call them.” Back in the day, each family had one phone, and when you called a person answered, and you could actually reach them. Now, every person has a phone attached to his ear 24/7. We are the most connected generation in the history of the world, yet we can’t actually reach anyone. 

Those two words, no show, have taken on a life of their own. When I see them, or even NS, I become almost ill. More like homicidal. I want revenge... 

Don’t complain, No Show! You should have come to your appointment instead. And, if perchance you do happen to wander in for your appointment, you will ALWAYS be dilated—I think 50% atropine should do the trick. Don’t worry. It will wear off a couple weeks before you are due next year. 

Do I sound bitter? One man’s bitterness is another man’s honesty. We all have to live and die by our decisions and YOU missed the appointment, NS. Not me … unless it was one of those appointments we rescheduled to a Friday when we are closed, in which case, NYAH-NA-NA-NA-NYAH, I wasn’t there! 

Thank you all for allowing me to vent about no shows. Now I gotta go. I have a patient waiting. Wonder what he’d say if I no showed?