At 11 o’clock at night, somewhere in Israel, a woman with a toothache picks up her phone. She isn’t calling anyone — nothing is open. She’s scrolling through Google Maps, tapping on dental clinics, looking for one where she can do something right now: book a slot, ask a price, anything. The first clinic that lets her act at 11pm gets her as a patient. The other nine get nothing, and never know she existed.

I build automation systems for small Israeli businesses, and clinics are where this pattern is most brutal. Not because clinic owners are behind the times — most of them run tight, modern practices — but because the appointment book is the entire business, and the appointment book is managed by humans who go home at six.

Two numbers explain almost everything about the economics of a clinic. The first is how many people try to reach you when nobody can answer. The second is how many people book an appointment and then simply don’t show up.

The 23 percent problem

Start with the second number, because it has decades of research behind it. A systematic review by Dantas and colleagues, published in Health Policy, synthesized more than a hundred studies of medical appointment attendance going back to 1980. Across specialties and countries, the average no-show rate lands around 23 percent. Nearly a quarter of booked appointments end with an empty chair.

The same review found something more useful than the headline number: the strongest predictors of a no-show are long lead time — the gap between booking and the appointment itself — and a history of previous no-shows. In other words, the patient who booked three........

© The Times of Israel (Blogs)