Circumventing Late Fee Anger


Doctor's offices usually charge a fee if you don't show up for your appointment. There are a handful of people in this world that respond to these fees by saying "I should not have been late. I apologize. It was my fault. How much do I owe?" Most other people make excuses and try to get out of the extra fees. "Traffic was bad. My kid was sick. I got stuck in a meeting. I just forgot." These are the things they say, and they expect them to work. I used to give these excuses too. I expected service providers of all kinds to be flexible to my needs… until I ran a business that relied heavily on scheduling.

It is very difficult to schedule labor when your customers show up at random, so like most businesses, we instituted policies to deal with absences. I came to view the situation in a very different light.

There was too much traffic? You should have left earlier.

Stuck in a meeting? So was I, but I ended it to meet you like we agreed.

I never felt good about imposing the penalties, and it was a rare customer who agreed to pay them without an argument.

A few weeks ago I started going to a new doctor, and was made to sign a document explaining their late fee policy. It was unique. If you miss a scheduled visit, you are charged a $20 fee. If you are late by more than 10 minutes, that qualifies as a missed session. But the doctor's office doesn't keep the money. All money from late fees is donated to the local children's hospital.

I haven't missed a visit, but if I did, I can't imagine arguing with the penalty. I think it's brilliant. It turns the debate from a me vs. them fight for my money to a decision about whether to give money to a third party charity. In essence, it diffuses customer anger while still imposing a penalty. It reminds me that innovative solutions to business problems do exist, but they sometimes require you to step a little bit outside the lines of conventional wisdom.

  • How about turning it around: maybe doctors should reimburse the patient for the value of his time if waiting time is more than a certain reasonable value.

  • And if you arrive on time and the doctor isn’t ready to see you for 10 minutes, does he make a donation?

    I’m all for late fees that go both ways — my time is valuable, too.

  • Though its a good idea to donate the money that they charge from patient but what if Doctor’s miss out an appointment. Is he gonna pay the money for charity? tell me

  • Jay

    What others said about doctors! I don’t need more than one hand to count the number of times in the past 4 years my doctor has run on time and my being sometimes even as long as an hour or so late would matter. We’ve even had late appointments that were the first of the day, though that’s safer than most, and not likely to be an hour or two behind.

    I’ve also never heard of a late fee from someone like a doctor; only a missed appointment being charged as if it happened if you failed to cancel ahead of time – technically 24 hours notice required. I’ve never thought that was objectionable.

    I would expect that an hourly professional could charge from the scheduled time if he is there and the client isn’t yet.

    I like the charity angle you described.

    My new business is likely to involve scheduling, and requiring people to be present at a specified time, so it’s food for thought. But it’s complicated by the fact that when an appointment ends will be unpredictable and there will be unscheduled emergency calls involved. That’s among the many details percolating as I informally plan things out.

  • Rob

    Wow, lots of scorned patients out there. I guess there should be a flip side, but I didn’t think about it because I’ve never had to wait more than a couple of minutes at this office.

    It reminds me of that Seinfeld episode where George gets charged a fee for not canceling with a 24 hour notice, then when the Dr. cancels, he tells them he requires a 24 hour notice too.

  • Sharpshooter

    I second the previous commnets about making the fees reciprocal.

    Another would be changing fees to the compnaies (at least one a month, often tow or three) the fould up my billing, ALWAYS in their favor.

  • callie

    I run a surgical clinic, and I can’t tell you how many times a new consult for surgery decides to cancel his or her appointment.

    The problem is that they’ve taken up time. We’ve had to check with their insurer to determine eligibility and also any copayments or deductible, we’ve taken all their demographics over the phone upfront (because we run a paperless office), and we’ve arranged to have their records or test results sent in. When a patient decides not to show up the problem is we’ve spent a lot of time preparing for their visit, which translates into staff time, which after all, is money.

    The other problem when they cancel is that they’ve taken up the time that could have been given to someone else who is equally or in greater need of requiring an operation. That’s right. There’s a list of people who need to get in, and by blowing us off, you’ve inadvertently delayed someone else’s consultation and also their surgery date.

    So we charge a fee of $75. And we tell them over the phone, and we keep record whether or not they agree. If they don’t, we don’t book. Plus we send them a confirmation postcard and it’s on there. It’s also on our financial policy statement, which each patient receives.

    There are many reasons for a doctor being late. Perhaps the person(s) before you needed more time than had been expected, maybe they had a complication, perhaps they came in and as it turns out need to be booked into the hospital right that moment. Sometimes, the doctor was in the OR (Operating Room) at the hospital, and THEY were late. His operation got pushed back, hence he’s running late for clinic. Literally running!

    However, when this happens the receptionist should tell you, Dr. B is running late. I can either reschedule you or you can wait.

  • What a joke

    So how come the patients don’t get any fees when the doctor’s offices are late seeing the patient? The only people who agree with this line of thinking are doctors…I have never been in a doctor’s office where they see me when the appointment is…you usually wait 15-20 minutes in the entrance area, then are brought to a private room, where you wait another 10 minutes, and in the end, you see the doctor at 2:30, yet your appointment was for two…this is the norm in any big city.

    So whee’s my fee? My time is as important as the doctors, if not more in my eyes, I had no idea adding a DR. in front of your name means your time is worth more than others…yet we just have to wait for the doctor to see us…but if we’re late, EGADS!!!, the Doctor’s want a fee.

    What a joke.

  • Anon

    To all of you that say you run a business that involves scheduling. You chose your business, you know the risk vs reward (and for the medical industry that is always on your side). If you charge a late or cancellation fee, you should be willing to pay one. That simple. You are not a special little snowflake.

  • Emily Westbrook

    Many of these doctors charging fees for being 10 or 15 minutes late are doing nothing more than running a scam. That’s cash in their pockets that is not being reported to the IRS and some are even put in a “Petty Cash” account to be distributed among the staff at the end of the year for their bonuses! A clinic in Fayetteville, AR I have to currently see every couple of months, bills patients $20 if they’re 15 minutes late; I didn’t even know they were doing this for a long time until I watched a patient as she protested the $20 fee. She stated she was not late, and the clinic had the clock on their wall set 15 minutes fast. I couldn’t believe what I was witnessing, they had the woman in tears, apparently they had charged her many times, and she has to drive an hour or so to get to the clinic. She was NOT late that day and THEY DID INDEED have their clock set 15 minutes fast, and they treated her like a leper! They even forced her to sign a statement that she was aware of the fee when she WAS NOT. Since that day, each time I go to the clinic, I get names and contact info of patients who have been charged a fee when they know they weren’t late or patients who disagree with what their doing, etc. and I am planning a Class Action Lawsuit against this clinic. I was finally able to get the contact info on the lady I mentioned above and she told me she set her clocks to their time, trying to avoid their fess, but to know avail! She said they put one her AGAIN on her last visit; she was 12 minutes late according to THEIR TIME, but when she arrived, one of the staff members was sitting in a chair with the clock in her hand so that she couldn’t see it and the receptionist told her she was 15 minutes late and was going to be charged another fee! She asked where the clock was, even though she saw the other lady holding it in her lap, and the receptionist NOW said she was going by the time on her computer! I feel like, and she feels like she is being harassed by the staff. That same day she was 12 minutes late and charged another $20 fee, she sat waiting in the lobby for 10 minutes and in a room for 10 more minutes…Why is her time not valuable? Why is there not any synchronization on the time? I have a law degree and I know what harassment is…I have encouraged her to file a lawsuit against this doctor in addition to joining the class action law suit I’m forming, but she isn’t willing to do that, yet, because she says she cannot sue her doctor when she’s not even sure her doc knows what her staff is doing! I personally believe what they are doing is not legal and am currently working on getting patients who disagree with these charges to form a group for a Class Action Law Suit against the one doctor I’m speaking of in this situation, and hoping it will extend across the State of Arkansas. If these doctors are going to be so petty, so disrespectful of their patients, and if this is going to be allowed by Arkansas Law, then it needs to be put in legislative law…the maximum amount they can charge, how late the patient must be before they can charge the fee and the synchronization of time should be managed, etc.! If our legislatures are going to allow doctors do this to us, then they need to have us punch “time clocks” so there will be valid PROOF that a patient is 15 minutes late, rather than the staff change the time on every visit as my doctor’s staff is doing! I’ve already written my local congressman and one Senator whom I have an established rep-or with, and the communication I’ve received back from all of them is they would rather stop these doctors altogether from charging the fees altogether, than to legislate the whole mess. Many of the newer, younger Doctors have become GREEDY. Many patients who have to attend these pain management clinics are disabled and live on less than $1,000.00 per month, and these doctors live on hundreds of thousands of dollars per year and they want to take every penny they can from us. Something is right about that!!! I am certain I will get this class action suit against this doctor filed in court by the end of this year, but we’re working on getting it done state wide, so if you read this and have a complaint against a doctor in Arkansas charging you fees for being late and disagree with it, please contact me at with your contact info and complaint info, I will do my best to get back to you as soon as possible.

  • Emily Westbrook

    I just read Dr. Emily’s story above and it makes me sick to know a doctor allows this to go on or even worse, is the authority behind these actions! If the staff has repeatedly charged this woman with these $20 fees, using different methods of time for determining whether she was late or not, e.g. clock on wall, then time on computer, has brought her too tears, insulted her, etc., And, EVEN WENT SO FAR AS THAT ONE STAFF MEMBER HELD THE WALL CLOCK IN HER LAP UPON THIS PATIENTS ARRIVAL…THIS WOMAN HAS AN IRON CLAD CASE FOR HARASSMENT AND I HOPE SHE FILES IT IN CIVIL COURT IMMEDIATELY! THE STAFF MEMBERS PARTICIPATING IN THIS BEHAVIOR ARE SMALL CHILDREN! BETTER, YET, THEY ARE ADULTS WITH TINY LITTLE MINDS TO BEHAVE THIS WAY! THIS WOMAN CAN MOST DEFINITELY file charges for Harassment against the doctor, even though the staff is harassing her. Arkansas Law regarding Harassment:
    ยง 5-71-208. Harassment.
    (a) A person commits the offense of harassment if, with purpose to HARASS, ANNOY, or ALARM another person, WITHOUT GOOD CAUSE, he:
    (1)…; or
    (2)…; or
    (3)…; or
    (b) Harassment is a Class A misdemeanor.
    (c) It is an affirmative defense to prosecution under this section whenever the actor is a law enforcement officer, licensed private investigator, attorney, process server, licensed bail bondsman, or a store detective acting within the reasonable scope of his duty while conducting surveillance on an official work assignment.