Strategies to Manage Missed Appointments in Private Physical Therapy: A National Cross-Sectional Study of Use and Perceived Effectiveness.

Abstract

Importance Missed appointments disrupt outpatient care and may be particularly consequential in private physical therapy, where continuity of care, appointment management, and fee-for-service remuneration are closely linked. Objective This study aimed to identify strategies used by private physical therapists to manage missed appointments and assess their perceived effectiveness. Design This study used a national cross-sectional online survey design. Setting The study was conducted in private outpatient physical therapist practice in France. Participants Participants were physical therapists working in private outpatient practice who completed an anonymous online questionnaire. Exposure The strategies examined included organizational, communication, and digital reminder strategies used to manage missed appointments. Main outcomes and measures Outcomes included the perceived effectiveness of strategies assessed using a 4-point Likert scale; responses to 3 predefined statements concerning relational and emotional effects; and exploratory association between digital reminder use and perceived overall effectiveness. Results A total of 1246 physical therapists participated. Online booking platform reminders were rated as effective or very effective by 78.9% of users (95% CI = 74.1%-83.2%), and SMS reminders by 77.7% (95% CI = 72.4%-82.9%). In-clinic posters received lower ratings (20.0%; 95% CI = 16.6%-23.4%). Digital reminder use was weakly associated with higher perceived overall effectiveness (Cramér V = 0.105). Respondents frequently agreed that missed appointments affected their relationship with the patient concerned (82.9%) and that they had experienced frustration or anger after a missed appointment (91.3%); 46.2% agreed that these feelings influenced their interactions with patients more generally. Exploratory content analysis of open-ended responses identified financial deterrents, organizational and reminder strategies, attendance rules, communication and patient education, and restriction or discontinuation of care after repeated absences. Conclusions Digital reminders were perceived as the most effective strategies for managing missed appointments, but objective attendance outcomes were not assessed. Relational and emotional findings should be interpreted cautiously because they were based on 3 directionally framed, nonvalidated statements. Relevance Future studies should evaluate strategies using objective attendance data and balanced measures.