Your no-show rate is climbing, and it's not because patients forgot. They're scared of the bill.
An MGMA poll found 1 in 3 practices seeing more no-shows in 2026, and the drivers are financial, not behavioral... which means a fee on the first miss can cost you the patient you would have kept. Then a deep dive on the 10 minutes that buy back the rest of your day: the daily huddle, how to run one, and how to hand it off so you're not the one corralling everybody. Finally, a question from a practice owner watching volumes fall three quarters in a row, and what to do about it this month.
What you'll take away:
- Why a first-visit no-show fee can push away the patient you most want back
-How to move the cost conversation to before the visit instead of at checkout
- The 10-minute daily huddle: who's in the room, what you cover, and how to hand it off
- A one-month plan to get your team filling the schedule instead of waiting for the phone to ring
By the numbers (MGMA Stat, August 2026)
32% of practices report higher no-show rates in 2026... 58% about the same, 10% lower
Average Marketplace deductibles rose 37%, to $3,786
Marketplace enrollment fell by millions of patients between 2025 and 2026
42% of practices charge a no-show fee
Chapters
(00:00) What's in this episode
(02:00) No-shows are up, and forgetfulness isn't the reason
(13:30) Deep Dive: the 10-minute huddle
(28:00) Q&A: "our volumes are down three-quarters running"
Links
The article: "About 1 in 3 medical groups see higher no-shows in 2026 as patients face higher costs," MGMA Stat, August 2026 — https://www.mgma.com/mgma-stat/about-1-in-3-medical-groups-see-higher-no-shows-in-2026-as-patients-face-higher-costs
Have a question for a future episode? Comment on this episode at philboucher.substack.com
Sponsor: Novaferrum
The 2026 AAP Clinical Report has docs buzzing about testing CBCs & ferritins (appropriately so!) and explicitly flags palatability as a real barrier to adherence.
Several studies support that iron polysaccharide complexes may be better tolerated for some children.The relevant data point is the BESTIRON trial (Powers et al., JAMA 2017;317(22)), a randomized comparison of ferrous sulfate vs. polysaccharide iron complex (NovaFerrum) in kids with iron-deficiency anemia.
Both groups improved (hemoglobin 7.7 → 11.1 g/dL at goal), but adherence diverged: 94% of NovaFerrum doses were successfully taken vs. 82% for ferrous sulfate (P=.009), with significantly less reported difficulty administering the medication at weeks 6, 8, and 10.
If you get one chance to get it right (not trying 5 different forms of iron), NovaFerrum is a great option to keep in your back pocket, priced comparably to standard iron (about $0.22/serving).
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Weekly writing on private practice — philboucher.substack.com
Want to talk through your own practice? pbmd.co
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