A cancellation the day before a visit is not a lost hour. It is a phone call nobody made. The difference between the two is usually twenty minutes of your evening - and that is exactly why the hour tends to stay empty.
Why "message everyone" does not work
The first instinct is obvious: I have a list of ten people, I message all of them, someone takes it. That works once or twice, and then stops, and it is worth knowing why.
Nine people get a message that is not for them. One gets an hour; nine get the sense that a machine is writing to them. By the third time, they stop reading.
You need that same channel for something more important. You send appointment reminders by SMS. If your messages teach a patient that they usually are not the one meant, the reminder about a visit two weeks out goes unread too.
First come, first served - except nobody was told the rules. Two people reply "I'll take it," one gets the hour, the other gets nothing, often not even a reply. That is worse than not sending anything.
An order that works
A sensible way to handle a cancellation has three properties, and none of them is complicated.
One at a time, not all at once. You start with the one or two people who fit best. If they do not respond within a set time, you ask the next ones. The closer to the appointment, the wider the group - because with an hour opening up tomorrow, waiting costs more than the awkwardness of asking several people.
With a deadline to respond. An offer with no deadline blocks the hour on someone who has not read the text. With a deadline, it goes back into circulation on its own.
With an honest note when it is a race. If the offer goes to three people at once, the message should say so plainly - "first to confirm gets it" - and whoever taps too late should see at once that the hour is already taken, instead of waiting for a reply that never comes. Racing for an hour is fine, as long as everyone knows about it upfront.
Who to ask first
Signup order on the waiting list is the worst possible criterion, because it has nothing to do with whether that person can actually come.
Three things that actually matter:
- Whether the time slot even fits. If someone marked that they can only come after 4pm, offering them Tuesday morning costs a message and gets you nothing.
- Whether the visit fits in. An hour freed up after a thirty-minute visit will not fit a therapy session that runs an hour - with the break after it.
- How long they have been waiting. All else equal - whoever has waited longest.
The one thing people forget
The waiting list is your own patients. An hour that frees up at a time closed to new patients can still go to somebody on the list - the restriction is for strangers, not for the list, and a separate post explains why that matters.
What gets forgotten is somebody else: the person who added themselves to the list from the booking page. They are not your patient yet, and should not be offered anything until somebody at the practice has looked at their request. A list that treats them like everyone else can hand a freed hour to somebody you do not know before you find out they were waiting at all.
Is it worth it
The honest answer: it depends on your practice, and an average from somebody else's tells you nothing about it. It depends on how long the waiting list is, how quickly people answer, and what the freed hour was worth.
That is why it is worth having the scheduler count it: how many hours cancellations freed up, how many of those made it back onto the calendar, and what they were worth at the service's price. After two months you have an answer for your own practice, not an average from someone else's.
What this looks like in Appointomat
A canceled hour is held and offered by SMS first to the people on the list whom the time suits and whose visit fits - with a deadline, after which it goes back onto the calendar. When the question goes to several people at once, the text says "first to confirm gets it," and whoever taps after somebody else sees straight away that the time is taken. A request made from the booking page waits for your review before it is offered anything - that is the "Joining the waiting list from the booking page" setting under "Settings → Booking page". How many hours cancellations freed, how many came back and what they were worth is on the "Statistics" screen, month by month.
