Reimagining no-shows as a symptom and not a diagnosis: A strength-based, trauma-sensitive approach

Reconceptualizing No-Shows

The problem is not the term “no-show” as a descriptor, but instead the conceptualization of and response to the patient labeled as a “no-show.” As clinicians in an adolescent shelter, we bear witness to the harm placed on youth when health care institutions do not provide the tailored support needed to convert a no-show into an impactful patient entry point to care. Supporting, rather than inadvertently shaming adolescents with multiple no-shows promotes more equitable health care access.

Institutional variations in their no-show policies may contribute to different degrees of age, sex, race, ethnicity, geography, and socioeconomic status bias that in turn may create, maintain, or exacerbate existing health inequities. The remedy is not to place blame on patients through punitive, consequence-oriented strategies. Instead of having medicine subverted to serve the marketplace, it has to center on the needs of patients. Medicine must move beyond a transactional business model and honor patients as people.