What radiology can learn from the service industry

Missed appointments continue to be a significant issue in radiology. In fact, according to one estimate, they can easily cost a mid-sized outpatient imaging center nearly $2 million annually. 

However, such occurrences are far from unique to the specialty; many service-oriented businesses have also fought their battles with no-shows, including the car rental industry, restaurants and airlines. The authors of a recent Journal of the American College of Radiology commentary urged imaging business leaders to emulate others’ success. 

“Because the healthcare industry is not the only one suffering from this problem, it is necessary to look at how other industries are handling this issue and adopt their best practices in developing this new system,” wrote lead author Jill Elizabeth Speece, director of business optimization for Atascadero, California-based Radiology Associates, and Kamran Eftekhari Shahroudi, PhD, of Woodward, Inc in Fort Collins, Colorado.

Here are a few of the authors’ suggestions, broken down by business line: 

  • Airlines: Flight carriers require customers to pay in advance and often review no-show trends to predict how many tickets they’ve overbooked. If too many passengers show up, airlines offer incentives to switch to another less-full flight. Radiologists may consider the double-booking strategy and provide perks for one of the individuals to switch appointments, if both arrive at the same time. 
  • Restaurants: The online booking system OpenTable will cancel diners’ accounts if they blow off four reservations. Other restaurants have publicly shamed patrons on social media. While neither of these make sense in a medical setting, imaging practices should similarly track each patients’ no-show frequency, and notify them of those tallies, the authors wrote. 
  • Car rentals: Companies often allow customers to pay at booking or when they pick up the vehicle. “Pay now” is usually cheaper, while “pay later” comes with caveats, such as cancellation fees for bailing at the last minute. Radiologists might consider offering pay-later options, for instance, if patients cancel because they cannot afford a costly out-of-pocket payment. 
  • Hotels: Lodging companies offer dynamic pricing to maximize revenue when demand is high, and discount them when business is slow. Imaging practices could emulate this by better managing wait times to reduce cancellations, notifying those who have checked in how long they can expect to wait, and updating them along the way.

While refusing essential services is not an option in medicine, there are plenty of other ways for radiology business leaders to address this problem in a less-punitive fashion, Speece and Shahroudi concluded. 

“It would be wrong to withhold a basic need from ‘bad patients.’ In health care, efforts to change the system are a better and more reliable option than trying to change patient behavior,” they wrote.