Appointment no-shows common across N.S. as family doctor registry continues to grow

Click to play video 'N.S. doctor clinic ‘fires’ patients for missing appointments' N.S. doctor clinic ‘fires’ patients for missing appointments
WATCH: There are more than 54,000 people on the wait list for a family doctor in Nova Scotia. And while they wait, some patients who do have a doctor are simply not showing up for appointments. One clinic has even taken to “firing” patients. Alicia Draus reports – Aug 31, 2018

As of Aug. 1, there were 54,915 Nova Scotians on the registry for a family doctor. But as the thousands wait, some who do have a physician are simply not showing up for appointments.

In August, 118 appointments were missed at the Duffus Health Centre. There were 132 missed appointments in July. It works out to about 41 and a half hours, or a full week’s of work for a single physician.

READ MORE: Number of Nova Scotians wait listed for family doctor tops 50,000

Dr. Andrea McDonald said five of those no shows were booked in for their first appointment.

“They were booked in off the 811 list and they didn’t show up for their very first appointment.”

She said it is unfair to other patients because it is a waste of resources.

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“That appointment goes unused. It means that someone else who’s maybe waiting for an appointment doesn’t get seen,” said McDonald.

The problem is not exclusive to the Duffus Health Centre, or even family physician appointments. Specialty appointments with lengthy wait lists are also being missed.

According to the Nova Scotia Health Authoirty, seven per cent of all appointments are missed due to patients not showing up, or not cancelling in time to book in another patient.

Susan Delaney, director for Diagnostic Imaging with the NSHA, said it’s something they have been working to tackle for years.

“On average, nine of 10 patients in the province wait about 220 days for an MR. It’s a long wait. So bottom line is if we knew patients weren’t coming, we could fit [other] patients in.”

READ MORE: Patients in Nova Scotia, New Brunswick face longest wait for medically necessary surgery

Delaney said they recently completed a study where they called the no-shows to find out why.

“Many of them are telling us they didn’t know they had an appointment.”

Previously the department would call the family doctor who would then inform the patient. After the study they tried different approaches, including sending out letters and having automatic call reminders.

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“It hasn’t made an appreciable difference in the no-shows,” said Delaney.

While the department is working to reduce the number of no-shows, Delaney said that sometimes a missed appointment can be a good thing.

“We have to respond to in hospital patients and to the emergency departments. In many cases we just fit those in between patients and can get behind,” said Delaney.

Dr. Tim Holland, president of Doctors Nova Scotia, said it is also important to note that the blame should not always be placed on patients.

“We have to recognize all the systemic barriers that lead to a missed appointment, be that challenges with child care, unreliable transportation, or simply our notification system,” said Holland.

Missed appointments were common at the newcomers clinic he works at. They made administrative changes to better alert patients of upcoming appointments, and educating them.

WATCH: ‘More work needs to be done’: Doctors on what needs to change in Nova Scotia

Click to play video '‘More work needs to be done’: Doctors on what needs to change in Nova Scotia' ‘More work needs to be done’: Doctors on what needs to change in Nova Scotia
‘More work needs to be done’: Doctors on what needs to change in Nova Scotia – Jun 26, 2018

“We were able to greatly reduce our missed appointment problem,” he said.

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The Duffus Health Centre has recently introduced a three-strike rule, where patients can be discharged if they have three no-shows.

“Those are people with no valid excuse,” McDonald explained.

“If for some reason you don’t need that appointment anymore, if you can’t make that appointment, if you’re busy at work, if you have a transportation issue and can’t get here, that does not preclude you from picking up the phone and calling and cancelling the appointment.”