Cancellations and no-shows

The nature of certain professions or specialties registered with the HPCSA may make it difficult for practitioners to sustain their practice if patients do not honour their appointments. As a result, some practitioners charge patients for failing to arrive for their appointments.

There has been some confusion on the ethical basis of this practice. There is currently no ethical rule prohibiting practitioners from charging patients for failing to honour their appointments. The practice of charging for a no-show is well articulated in Section 17 of the Consumer Protection Act which sates that; a consumer has the right to cancel any advance booking reservation or order for any goods or services to be supplied. It states that a supplier who makes a commitment or accepts a reservation to supply goods or services may impose a reasonable charge for cancellation of the order or reservation, and a charge is unreasonable if it exceeds a fair amount in the circumstances, taking into account:

  1.  The nature of the goods or services that were reserved or booked.
  2. The time the notice of cancellation was provided by the consumer/patient.
  3. The reasonable potential for the service provider, acting diligently, to find an alternative consumer between the time of receiving the cancellation notice and the time of the reservation that was cancelled.
  4. The general practice of the relevant industry.

This Consumer Protection Act further states that a supplier may not impose any cancellation fee in respect of a booking, reservation or order if the consumer is unable to honour the booking, reservation or order because of the death or hospitalisation of the person for whom or for whose benefit the booking, reservation or order was made. In view of this, the Medical and Dental Professions Board has reviewed its ethical ruling of October 2001 and ruled on this matter as follows:

A patient reserves the right to cancel a medical or dental appointment, and a medical or dental practitioner may not charge a consultation fee or a procedure fee for such a cancelled appointment unless:

  1. A cancellation was made less than 24 hours for a specialist appointment and less than two hours for a general practitioner appointment, before the appointment time.
  2. A practitioner can provide evidence of failure to find an alternative patient between the time of receiving the cancellation notice and the time of the cancelled appointment.
  3. The practitioner can provide sufficient proof that the patient was informed about the cancellation of appointments policy.
  4. The practitioner has first established the reasons for the patient’s failure to cancel or honour the appointment.

The HPCSA advises practitioners who have a cancellation or no-show policy to inform their patients at the time of booking that there will be charges incurred for failing to arrive for an appointment.