Health dept. battles no-shows

Patients who miss appointments must attend a class to be allowed back
Tom Jackson
Apr 2, 2014


Officials at the Erie County Health Department are trying to teach patients at the new dental clinic that it’s important to show up for appointments.

To do this, they’ll have to figure out how to get folks to show up for class.

Janet Mesenburg, who directs the health department’s dental clinic, told Erie County’s health board Tuesday about the results of the department’s first class for “no-show” patients who have been suspended for missing appointments. Ten students were enrolled, but only three showed up.

Another class will be held in April, said Mesenburg, the health department’s director of nursing.

Dealing with no-show patients can be challenging, but Joe Liszak, CEO of Community Health Services in Fremont, said he believes Erie County will be able to make inroads on the problem. Erie County’s program is modeled on the Fremont center’s, which succeeded in sharply reducing the clinic’s no-show rate.

Last year, Erie County’s health department unveiled a new dental clinic that’s open to everyone, regardless of ability to pay. It serves many patients who are on Medicaid, or who don’t have any health insurance at all.

The dental clinic, and the department’s medical clinic, have both had a no-show rate of about 15 percent to 20 percent, said Pete Schade, Erie County’s health commissioner.The department’s policy for the dental clinic is that new patients are suspended from the program if they miss their first appointment. Existing patients are suspended if they miss three appointments.

To get back in, they have to attend Mesenburg’s no-show class, an hour-long program that aims to teach responsibility and explain how it’s better to cancel an appointment than to just not show up.

“Of course, we don’t want any idle time,” Schade said. “I don’t want people sitting around”

The Register tried to find out how much of a problem no-shows create for the Medicaid program nationally. A spokeswoman for the federal Department of Health and Human Services said the department doesn’t track the problem. A spokesman for Ohio’s Medicaid office said the same thing.

The Kaiser Family Foundation also had no information, although it referred the Register to Liszak’s program.

Liszak said when his Fremont clinic encountered no-show rates that were higher than 30 percent of the appointments, it sought help in figuring out how to deal with the problem. It could not find anyone who could offer help.

So the clinic solved the problem itself, setting up the policy that Erie County has now adopted: Patients are suspended if they miss an initial appointment or miss three appointments, and they must attend a class to get back in the program.

Liszak later published an article on the program, “A Model Program to Reduce Patient Failure to Keep Scheduled Medical Appointments,” in the Journal of Community Health.

The paper explained once the Fremont clinic carried out its new policies, the no-show rate for its medical clinic dropped from 18 percent in 2003 to 11 percent in 2010. It went from a high of 54 percent in 2003 for the dental clinic to 15 percent in 2010.

Schade said the health department is also trying to deal with no-shows by overbooking appointments.

That can create its own problems, the Liszak paper warns. Sometimes overbooking can give a clinic more patients than it can handle, resulting in delays and overtime payments for staffers who have to work longer hours.



Why should anyone take responsibility? The White House just said we "can choose if we want to work". We can choose if we want to show up!


Meanwhile, people are having to wait 6 weeks to get in for an appointment.


This service is free and they can't even show up. The Health Department should have the next day patients on call if someone doesn't show up.


It is free to them at our, the taxpayer's expense. How about another 6% annual raise for Mr. Schade and company.

The Bizness

It is not free for the patient.


Next they can get another gov't agency to write them an excuse for missing the class!


Well it's obvious most of you that have commented don't have a clue. It is NOT free. No matter what, if you have an income or have zero income, you MUST pay $20.00 up front each and every time before you are seen at the clinic. Also if you are there to see the dentist, you MUST pay $30.00 upfront each and every time, or you won't be seen. When it comes to the dental side, you have an initial appointment in which you must pay $30.00 up front. Lets say you have a cavity, you will then have to schedule another appointment for that, which is another $30.00 that you MUST pay before being seen. However, there policy is that after the initial appointment you have to schedule a cleaning, which is again $30.00 up front, before you can schedule the appointment, for the cavity repair. So this "free" service, will cost you at least $90.00 out of YOUR pocket. This is a great service, that is appreciated by many. It's also a lot cheaper than going to a regular dentist, but it is by no means "FREE".

Dr. Information

Teeth are YOUR responsibility to take care of. If you cannot afford to see the dentist OR lay off the Mt. Dew and loaded with sugar drinks and food, I see it as YOUR problem.

Try going to the dentist with no insurance and having to fork over 1600 for a root canal and then another 1300 for a crown, just for one tooth or 150 for a cleaning and x rays.

I'd take your 30 dollar appointments for everything to get fixed any day of the week.


Dr.-- I'll bet that most "bad teeth" arise from a person's genes/heredity more so than sweets, etc. I know of quite a few people who brush/floss religiously yet deal with mouth/teeth issues constantly. I brushed once a day for about 20 seconds as a kid, ate my fair share of pop/sweets and didn't get a cavity until I was pregnant at age 28 (I blame my child for giving me my cavity :} )
I do think that dentists charge way too much for a simple exam, cleaning and x-ray though.


I have personally went there to have a look around. The day I was there Peter Schade warmly greeted me. I heard a lot of the clients speak with the receptionists with a presumption that their fees would "be taken care of" because "They were out of work". The people who are paying the fees are the lower class working poor.


The Sandusky Register is wrong on this. There is a mandatory fee of $30.00 per visit, that must be paid prior to any service rendered. The cost of the visit then varies based on your income, or lack there of. No matter who you are, or how much money you make, you MUST pay $30.00, every time you go there, period. The reason why I know this to be a fact , is because I have went to the health dept. and paid the $30.00, so that a homeless man with NO income could receive services. Dentist are very expensive, and thats why this program is so wonderful. Maybe Tom Jackson of the Sandusky Register, will check into this, and update/correct his story.


You are wrong. Call the health department and tell them you are a Perkin's Fireman and have private insurance. You pay nothing up front, they run your insurance and send you a bill for $20


Well that would be great if I was a LIAR. I try to help people, not rob, steal, lie, and deceive them. So SanduskyGuardian you are wrong. I did just call them and they confirmed what I said. Whether your rich or poor, it's $30.00. If you have insurance, then you pay whatever your office visit fee is per your policy. My point was that someone couldn't go in there and say, hey I dont have a job or any money, and they would treat them anyways. Not that they disregard the laws and rules of insurance companies. If you have an insurance policy that states your office visit deductible is $5.00, well then you pay $5.00. That was not the issue nor was it part of the discussion. Sorry to get your panties in a bunch, pick you wedgie, you'll be ok.