No AI-generated advice. No generic playbook. I've recouped thousands of dollars by learning this the hard way.
By Oscar Poon · September 20, 2026 · 6 minute read
An empty slot is a missed fee and a missed chance to fill it with someone else.
A few real numbers to set the scene before we get into the math:
23% to 33%
of outpatient appointments are missed
DialogHealth, 50+ Latest Patient No-Show Statistics You Need to Know ↗
30% to 50%
fewer no-shows when text reminders are used, versus a 5% to 10% response rate for email alone
Proactive Chart, Text Message & Email Appointment Reminders: Cut No-Shows by 40% ↗
74.7%
of Canadian seniors (65+) sent or received email in 2022
Statistics Canada, Canadian Seniors More Connected Than Ever ↗
Say a treatment is worth $80. A no-show means that $80 never gets earned, and unlike a cancellation with notice, nobody could grab that slot last minute either. You don't lose the fee twice, you lose the whole hour: one no-show a day isn't an $80 problem, it's an empty-chair-every-day problem. That's the math clinics forget to run.
74.7% of Canadian seniors (65+) use email today, which sounds reassuring, until you look at who tends to be in that remaining quarter. A Canadian study of immigrant older adults who don't speak English as a first language found that only about 1 in 10 had a computer at all, with nearly everyone relying on a smartphone instead. An email sits unread in an inbox nobody opens. A text at least lands on the device they're already holding.
Everyone's life is full: work, kids, groceries, a dozen other things pulling at their attention. An appointment booked three weeks ago is easy to forget, not out of disrespect, but because nobody has spare room in their head for one more thing to remember. A no-show is rarely defiance, it's usually just a busy life winning.
The fix starts with something as simple as a text a patient actually sees.
Asking a patient to reply and confirm before their treatment isn't just a reminder, it's a tiny promise. People are far more likely to show up for something they've just actively said yes to than something they silently received. The reminder itself also does something simple but important: it tells the patient this appointment matters enough to follow up on.
Text reminders alone cut no-shows by roughly 30% to 50%. Email struggles to even get noticed, with response rates in healthcare sitting around just 5% to 10%, which is a big part of why it doesn't move the needle the same way. No single channel catches everyone: email works for some patients, text works for far more, and a phone call closes the gap for the rest. Combining all three, automated where you can and personal where it counts, is what actually moves the no-show number instead of just feeling like you did something.
Using an $80 average treatment fee as an example (use your own number, the shape of the math doesn't change):
Your patients are busy too. A reminder that shows up on its own takes one thing off their plate. Good reminders don't just help your clinic, they take real stress off the people you're treating.
All of it automatic. No extra work for you.
How MyTCM's appointment reminders work, start to finish.
Turn on Text-to-confirm and a patient who doesn't reply gets flagged with an alert right on your calendar, so staff know exactly who to call. Running solo? You get notified the moment a patient hasn't confirmed, instead of finding out when they simply don't show up.
Take a clinic running 20 appointments a day, 5 days a week: that's roughly 400 appointments a month. Assume a text and an email go out at both the 7-day and 3-day mark, that's 4 messages per appointment, or around 1,600 messages a month.
That's right: MyTCM's $10 add-on covers up to 5 practitioners sending roughly 1,600 text and email reminders a month. We get wholesale pricing from our cloud communications provider. If you set all of this up yourself, here's what it would cost you:
Same volume, same job. MyTCM still costs a lot less to run.
Questions? Call 1-888-884-7726
Unlimited one-way text and email reminders are included free on every plan (Single License or Site License). Two-way text-to-confirm, where a patient replies Y to confirm or N to reschedule, is a flat $10/month add-on on either plan -- it needs a dedicated clinic phone number, set up for you after signup.
