In fiscal year 2009, many people took advantage of health care at Reynolds Army Community Hospital by not showing up to doctor's appointments and not calling ahead of time.

How many people'


These people cost the hospital $1.2 million.

"We have a schedule and the doctors are expecting the patients at 20-minute intervals," said Linda Buley, chief of managed care. "When somebody doesn't show up for an appointment, the doctor is setting there wasting his time. Then we have calls from other patients who can't get an appointment."

Because the physicians are less productive due to people not showing up, it gives the higher headquarters the impression that more doctors are not needed. More physicians on post would mean more appointments available.

The main problem is that patients choose to not show up.

"If you go to a doctor downtown and you don't show up, you still have to pay for that visit," said Buley. "We don't have that option here. We want to make sure the public knows it is hindering our productivity level and costing us money that we could use to buy more doctors."

"If I worked downtown, a 20-minute appointment with me would cost $94," said Dr. Bruce Lovins, chief of primary care. "Seventeen thousand no-shows multiplied by $94 is a lot of money. A lot of people in the military don't see the money connection. They see it as a bit like socialized medicine. Everybody gets it and they see it as free. So when they miss an appointment, there is not necessarily a realization that it actually costs the government and their tax dollars 94 bucks.

"What people don't seem to understand is that $1.2 million could have bought five or six more doctors. We hear complaints about people not being able to get in to see a doctor today and the next appointment was a week from now and I really needed to get seen. If folks would call in instead of just not showing up we might have been able to get you in that day. That is really the big piece of it. What we are really asking folks is to just tell us if you can't make the appointment. If you have a reason to not show up, that's fine, but just call and let us know. Even if it is 15 minutes ahead of time. We might be able to put someone in your appointment. The earlier you can tell us, the better. In a perfect world, and what they expect downtown, is 24 hours in advance."

"It is common courtesy and consideration for patients to call ahead of time," said Buley. "If you make a motel reservation, you don't just not show up. People need to take the responsibility to cancel their appointments."

"You need to take that responsibility to be nice to your neighbor," said Lovins. "Your neighbor could use that appointment. Because you didn't call in, your neighbor may not have been able to be seen. A no-show isn't a single missed appointment, but really it's two. It is a missed appointment for the person who didn't show up, but it is also a missed appointment for the person who needed to been seen, but couldn't get in."