Modeling the effects of no-shows for a single-physician clinic considering patient choice

This paper tries to design a hybrid appointment system with no-shows of regular patients (who book in advance) considering patient choice to increase clinic revenue and patient satisfaction. For this purpose, a Markov Decision Process (MDP) model with no-shows of regular patients considering patient choice is formulated in this paper. The capacity management problem is to decide which appointment requests to accept to maximize the clinic revenue. We compared the results with the appointment system without considering no-shows, and analyze the effects of clinic revenue from the perspectives of day-length and average same-day demand with different no-show probability. Our results indicate that regular patients´ no-shows have a negative effect on clinic revenue. And the larger the no-show probability, the greater the negative effects of no-shows. Therefore, the clinic must carefully manage patients´ access to physicians´ slots to balance the needs of regular patients with no-shows and same-day patients (who require a same-day appointment).