Here is a feature we considered and rejected. The idea taught us something about clinics, so it is worth writing down even though it will never be built.
The idea: when a patient does not show up for an appointment, automatically send them a discount. “We missed you! Here’s 20% off your next visit, book now.” Win them back before they drift to another clinic.
It sounds kind. It sounds smart. It even sounds like the sort of thing a retention-focused, patient-centric business should do. Every e-commerce app does a version of it. Abandon your cart, get a coupon.
Now think about it for ten seconds from inside the clinic.
You just paid people for not coming.
The patient who booked, arrived on time, waited politely, completed the treatment, and paid in full? She gets nothing. No message, no discount, no acknowledgement. She was reliable, and reliability is invisible.
The patient who vanished without a call, leaving a ninety-minute slot empty and a doctor idle? He gets 20% off. He gets a warm message. He gets rewarded, specifically and measurably, for the single most expensive thing a patient can do to a clinic.
Run that for six months and you have built a machine that trains no-shows. Not maliciously. Efficiently. The patient base learns, without anyone saying it out loud, that skipping is how you get a discount. The reliable patients learn that reliability earns nothing. Both lessons are correct, because you taught them.
Whatever you reward, you get more of
Products and clinics share exactly one rule, and it is the rule that killed this feature:
Whatever you reward, you get more of.
Not whatever you say you value. Not whatever is in your mission statement or on the laminated sheet behind reception. Whatever you actually reward, in practice, with your time, your attention, your flexibility, or your money. People are extremely good at noticing what gets rewarded and adjusting toward it, even when they could not tell you they were doing it.
This is why the feature was dangerous rather than just useless. A useless feature wastes money. A feature that rewards the wrong behaviour actively reshapes your patient base in the wrong direction, while looking like it is helping.
A loyalty programme for people who did not come is a loyalty programme for ghosts. You will get more ghosts.
What your clinic quietly rewards
So the useful exercise, and the reason this post exists, is to turn the same lens on your own clinic. Nobody sets out to reward bad behaviour. It happens because the reward is invisible from the inside, and the behaviour it produces gets blamed on “patients these days.”
Walk through a few.
Walk-ins get seen fast. A patient with no appointment turns up and, because the doctor is kind and the chair is momentarily free, gets seen in ten minutes. The 11 AM patient who booked a week ago and arrived on time waits behind him. What did the clinic just reward? Not booking. Expect more walk-ins.
Late payers get patience. “Balance next time” is accepted without comment, and next time it is accepted again. What was rewarded? Not paying. Expect more balances.
The patient who argues about the price gets a discount. The doctor, to end the awkwardness, knocks off five hundred. The patient who accepted the quote politely paid full price. What was rewarded? Arguing. Expect more arguments, and expect them from the same patient next time, because it worked.
The late patient gets squeezed in. Twenty-five minutes late, seen anyway, displacing the punctual patient. Rewarded: lateness. Expect it monthly.
The vanished patient gets the warmest follow-up. The doctor personally calls the man who ghosted mid-treatment, because losing him bothers her. The woman who completed her treatment gets a generic festival broadcast. Rewarded: vanishing.
None of these were decisions. Each one was a small kindness or a small avoidance of conflict, made in the moment, that added up to a policy nobody chose.
Reward the behaviour you want
The flip side is simpler than it sounds. Look at what you want more of, and make sure that is what gets the reward.
The patient who confirms by reply and arrives on time should have the smoothest, fastest experience in the building. Seen at her time, no waiting behind walk-ins. That is the reward, and it costs nothing.
The patient who pays per sitting should get the receipt, the thanks, and the next slot of her choice. The patient who completes a treatment plan should get the check-in message and, if you run any offers at all, she should be the one who hears about them first.
And the patient who no-shows should get exactly what a no-show deserves: a polite message asking whether he would like to rebook, and, if it happens again, a deposit requirement for his next slot. Not a punishment. Not a discount either. Just the clinic declining to reward the thing it does not want.
That is why we said no to the feature. Not because winning patients back is wrong, but because paying them for leaving is the wrong way to do it, and clinics have enough accidental incentives already without software adding one on purpose.
Reward the behaviour you want. Politely refuse the rest.
We’re building something for dental practices. The first 100 clinics on the list get it first, and cheaper. Join the early-access list →