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How Cancellations Affect Providers and Patients

This the first installment of Healthcare Matters, a periodic blog post by Pulitzer Prize-winning journalist Michael Waldholz to help you navigate the maze of financial and medical concerns that make staying healthy harder than it should be.


In the ever-more perplexing world of healthcare, I’ll bet something like this has happened to you.

Leaving my doctor’s office a few weeks back after a routine check up, the receptionist threw me a question I really couldn’t answer honestly: “What’s a good date six months from now to schedule your next appointment?” she asked. Six months from now! My physician—very good and therefore, I guess, very popular—is booked up until then. Dutifully, I checked my calendar and we picked a random time and day in May.  

Truthfully, it is as likely that I will cancel and reschedule as it is that I will keep the appointment, despite my best intentions.  “Who knows if I’ll be around by then,” I joked. She laughed. “Yeah, a lot of people say that.”

It made me wonder if this kind of confidence in my future whereabouts is becoming common in healthcare. So I did a little Googling. Turns out that cancelled appointments have become a significant and costly scourge for health care providers. Some surveys show that last minute cancellations or “no shows” typically occur three or four times a day. Although the large number surprised me, scheduling appointments months in advance, when most of us really don’t know what we will be going on in our lives, may explain why cancelling is so frequent.

My Google search indicates that cancellations aggravate the heck out of providers and their office managers. Several websites I uncovered were businesses that tout all sorts of scheduling techniques, as well as none-too-cheap software products, to help doctors reduce the problem. The sites all echo an industry claim that scheduling holes in a providers’ day can wrack up as much as $100,000 or more in lost annual revenue for a busy provider. Cancellations and no-shows nationwide can cost providers a whopping yearly $150 billion in missed income, the websites say.

Several surveys report that as many 20 to 25 percent of patients miss their appointments. Many cancel the same day, or simply don’t show up.

If true, this represents a major financial headache for providers. But, as I will explain in a bit, it also creates a largely unknow opportunity for us health care consumers.

The problem, it seems, has become so common that industry insiders have created a bit of jargon for it: Unscheduled Provider Capacity, or UPC.  “In today’s consumer-driven healthcare environment, managing your schedule to meet your patients’ needs should be your top priority,” one scheduling management company warns. In other words, we consumers want a greater say in how we handle our health care needs, and we want to make use of increasingly popular online technology to make that happen.

As a result, many providers are installing “robo-calling” software to remind patients, often more than once, of an upcoming appointment. Medical offices also are finally offering consumers the opportunity to “self-schedule,” and also cancel, appointments online. That’s a consumer-friendly solution the healthcare field has been much slower to adopt than the travel planning, retail purchasing or ride hailing industries.

One consumer website explains how consumers can exploit the so-called UPC. Patients can try snagging a last-minute visit by calling the provider’s office between 10 and 11 a.m. when cancellations start rolling in. Mondays and Fridays are best, a survey of office staffers suggests.

Another new way for consumers to take advantage of the UPC is right here at Slingshot Health. The platform offers patients the convenience of getting a same-day (or soon after) appointment by selecting the type of care or provider desired by location.

Providers, on the other hand, may accept bids based on their open time slots during the day, which are largely due to last minute cancellations. Patients are also asked to name the amount they want to pay for the visit. In this way Slingshot Health is the first of its kind, online health care marketplace for consumers and providers to buy and sell services. Doctors can alternatively counter the bid, adjusting the time and price for the appointment.

This is a win-win for patients and providers. It helps consumers keep the cost down for out-of-pocket expenses, and helps providers deal with the dreaded UPC. (For now, the online service is available only in Manhattan, and parts of New York’s Westchester County and New Jersey).


While we have a host of health-related subjects we plan to cover in the Healthcare Matters series, please feel free to send any questions you have for the author or our team to, and don’t forget to follow us on Facebook, Twitter, and Instagram.


About Slingshot Health

Slingshot Health is a health tech startup that brings top healthcare providers and patients together. Patients bid on the cost of services and healthcare providers accept bids based on availability. Slingshot Health is unique in that it is a mutual marketplace putting both patients and providers back in control. Visit us at