We are fortunate to reside in a country where healthcare is largely government funded. While there are obviously ways that it can be improved, the system does largely work and permits, for example, patients to freely schedule an appointment to see their physician in almost all situations, without needing to worry about the need for payment (or co-payment).

A significant challenge that arises in this situation is how to deal with appointment no-shows and late cancellations. Both situations are troublesome because the net effect is that another patient who could have likely used that appointment time-slot to see their physician could not. In the aggregate, for some clinics, up to 10 - 15% of all appointments are "wasted" in this way. This is bad for patient care and an incredibly inefficient use of health care resources.

To help patients cancel and reschedule appointments in a timely way, we try to make it easy to cancel and reschedule appointments online 24 hours a day, 7 days a week, from any device. We also take the additional technical steps of:

sending confirmation emails
sending automated reminders
including calendar events to add appointments to personal calendars

Unfortunately, while the above helps, the problem is not eliminated. We nevertheless hear from patients that they simply considered themselves "too busy" to cancel or reschedule their appointment, or that they forgot about the appointment.

From our own experience and in consultation with other clinics, the most effective solution by far is to institute a no-show & late cancellation fee. Unfortunately, since appointments are typically free, industry experience is that, for a small minority of patients, only if there's a clear fee for missing or late cancelling an appointment , do such patients diligently cancel or reschedule appointments in a timely way.

To be frank, charging a fee is not something that we like doing, but unfortunately, it's the only known effective solution to the problem above.

Lastly, since this issue comes up from time to time, we consider it important to speak to the fact that the underlying motivation of this policy is completely unrelated to increasing revenue. Indeed, our best case would be for this fee to never be charged. To this end we try to make absolutely clear the existence of this policy, since its whole purpose is to persuade patients to cancel or reschedule appointments in a timely manner:

This policy is clearly stated in all appointment confirmation emails
This policy is clearly stated in all appointment reminder emails
This policy is clearly stated on our website

Hopefully the above gives a bit of insight into the underlying purpose of this policy and why we, reluctantly, have to implement it.