Nudging Patient Choice: Reducing No-Shows Using Waits Framing Messaging

Abstract

Healthcare providers have long grappled with patients not showing up for their scheduled medical appointments; such no-shows lead to wasted resources and longer wait times for other patients. However, new operations research offers a promising solution to this problem. The study finds that using text message reminders that include an additional line of text indicating a potentially long wait for the next available appointment can significantly reduce no-shows by a factor of 28.6%. The intervention, called waits framing, was found to be more effective among patients who were more sensitive to wait times and when the information in the message was novel and credible. The study also uncovered the mechanism underlying the intervention. Specifically, the waits framing messages increased the perceived cost of missing an appointment, leading to a reduction in queue abandonment. This study provides insights into how behavioral science can improve service operations and help tackle challenges in healthcare delivery.