Primary-Care Clinic Overbooking and Its Impact on Patient No-shows

Following the successful stories in the airline industry, many primary-care clinics have adopted overbooking to deal with their prevalent patient no-show problem. However, there has been very limited research, to the best of our knowledge, that analyzes the impact of overbooking on the major causes/factors of patient no-show and its implications. While overbooking has little impact on many random factors that affect no-show, it does impact two important factors appointment delay (the time between a patient requesting an appointment and his actually seeing the doctor) and office delay (the amount of time patients wait in the office to see the doctor). In this paper, we develop a general framework to explore the impact of overbooking on these two important factors. While overbooking increases office delay (which negatively affects patient no-show rates), it appears to reduce appointment delay (which positively affects patient no-show rates). Our results show, considering both impacts, while overbooking increases clinic’s expected profit most of the time, patient no-show rates always increase after overbooking! Further, there exists a critical range of the patient panel size within which overbooking may also reduce the clinic’s expected profit. However, we propose two easy-to-implement strategies, overbooking with controlled appointment queue and selective dynamic overbooking. Both strategies can increase the clinic’s expected profit and improve no-show rates at the same time.