Why Do Psychologists Need 24 Hours Notice To Cancel An Appointment?

Question: Why do psychologists need 24 hours' notice to cancel an appointment? I rang at 9am to reschedule an 11am appointment and 2 days later received an invoice in the mail for the missed consultation. I was told that this is standard practice policy. I could accept it more easily if I forgot to turn up or neglected to call but I don't understand how the fee can still apply when circumstances that made it impossible for me to attend, didn't arise until the day. Doesn't seem fair or ethical. Matt

Answer (1) Hi Matt. The decision to charge a cancellation fee by practitioners is largely a business decision. When appointments are cancelled at the last minute, it is virtually impossible for us to contact another client to fill that appointment time. However, it can also reduce the number of cancellations by people with fairly trivial reasons, such as, "I forgot", "Something came up", and so on. From a purely business perspective, if a practitioner experiences a number of cancellations in the same day, they can find themselves out of pocket for expenses such as room rental and petrol to their rooms, and also be struggling to pay their mortgage. I suspect that cancellation fees aren't an attempt to earn money for nothing, but to reduce the number of cancellations that aren't essential, so as to make the business sustainable. However, your psychologist should have explained their cancellation policy to you in the first session. It's not reasonable to charge a fee to clients if they're not aware of the policy. I always provide my clients with written information about fees, cancellations, confidentiality and privacy in the first session. Also, I think a degree of flexibility is required on the part of the practitioner - if a client's car breaks down or they have to rush their child to the hospital, I'm not going to charge them a cancellation fee.

Answer provided by Graham Cox, Psychologist

Answer (2) Most therapists I know do use some discretion in charging a cancellation fee and take the circumstances into account. I personally believe a rigid blanket policy in this regard is a bit unreasonable and can be felt by clients to be punitive and exploitative. The rationale behind it is that if someone cancels with very short notice, that hour that would have been used and paid for, becomes just dead time. If sufficient time for planning is available, that hour may be used productively for something else. The cancellation fee is an attempt to recoup lost income. However, I would certainly talk this over with your psychologist, as it could very easily become a source of resentment and interfere with the work in hand.

Answer provided by David White, Psychotherapist

Answer (3) I can understand your resentment. However cancellation fees or "broken appointment" fees are charged because less than 24 hours is not enough notice to give the appointment to someone else. Consequently the counsellor is out of pocket. Overhead costs in a psychology practice are often quite high, e.g. 30-55% of the consultation fee, when costs are averaged over a year. I suggest that you talk directly to your counsellor.

The client should be made aware of the counsellor's cancellation practice before or at the first session, preferably in writing. It is my experience that distressed people often don't cope with this kind of detail no matter how it is presented, and often they are not good at keeping appointments. On a bad day the counsellor could have several broken appointments, e.g. during school holidays or during "flu/bad virus" epidemics. In these circumstances, the psychologist is not allowed to claim payment from third parties e.g.Workcover, Medicare, who sometimes pay for counselling.

The Australian Psychological Society suggests that clients receive a consent form before or at the first session. This should outline the rights and responsibilities of both parties. The client signs the form when they have had time to digest its contents. The form covers access to your records; confidentiality; fees; payment expectations; what the fee covers: the cancellation policy; arrangements for third parties to pay for sessions; and the client's liability to pay if the third party will not pay.

Answer provided by Margaret Lord, Psychologist