Patients who stop coming: recall, drop-out and when to follow up
Some patients finish their care. Some simply stop. The difference matters, and so does when you reach out. This guide explains recall intervals and how to group lapsed patients.
Finished, or dropped out?
A patient who completes a plan and is discharged is not a lost patient. A patient who stops halfway, or who was due back for a review and never booked, is a different case. A recall process exists to tell these apart and to prompt the second group at a sensible time, not to chase everyone indefinitely.
A good recall process respects the clinician’s judgement: whether someone should come back is a clinical question first, and an administrative one second.
Recall intervals depend on the visit
One interval for everyone rarely works. The right time to follow up depends on what the patient came for. As an illustration only, not clinical advice:
| Visit type | Example recall rule | Why |
|---|---|---|
| Acute injury, discharged | Short check-in after a few weeks, then stop | Confirm it settled; do not keep prompting |
| Ongoing management | Prompt when the usual interval has passed with no booking | The patient’s own rhythm sets the clock |
| Review due | Prompt before the review date | A planned return that has not been booked |
| Long gap | Gentle reactivation, then personal call | The first message is rarely the last |
Each clinic sets its own rules, and the numbers above are examples, not recommendations. What matters is that the rule belongs to the visit type and the clinician, rather than being one clinic-wide timer.
Group lapsed patients by how long it has been
Messaging a patient who last attended three weeks ago in the same way as one who last attended a year ago works poorly. Grouping patients by time since last attended lets you use a different tone and channel for each group, and keep an honest view of who is truly lapsed. A simple way to start is three bands: recently overdue, clearly lapsed, and long gone. The cut-offs are for your clinic and clinicians to set, and they will differ by visit type. The point of the bands is to give each group a different first move: a light prompt, a more direct message, or a call from someone who knows the patient.
In Praxia, patients whose visits stop are grouped into recall cohorts by time since last attended, using rules the clinic sets.
What Praxia is doing with this today
We are careful with claims here. The recall cohorts are built, but the scheduled run is in dry-run by default. Recall and reactivation are part of the pilot product, and we switch them on for each clinic once it has checked who it would reach.
We also do not say that recall means more returning patients. We have no outcome data, and a reminder is a prompt, not a guarantee. What we can say is what the software does: it groups lapsed patients by your rules and keeps staff informed.
Respect the opt-out and the personal call
- Opt-outs. A patient who has asked not to be contacted stays off the list. Praxia records opt-outs and lets patients set their own communication preferences.
- Personal calls. Some patients are better reached by a person. Praxia’s attrition log shows which lapsed patients need a personal call, with the reason recorded.
- Feedback. Patients can give post-visit feedback, which can tell you why people stopped.
A practical starting point
If you have no recall process, start small.
- Pick your two or three most common visit types.
- For each, decide the point at which a patient who has not rebooked deserves a prompt.
- Write the message once, in plain language, and have a clinician read it. Keep a note of what was sent and when, so the next person does not start from scratch and a patient is not sent the same thing twice.
- Decide who calls the patients who do not respond.
- Review who has actually gone quiet once a month.
Questions clinics ask
How many reminders is too many?
There is no universal number. A single well-timed prompt, then a personal call for patients where it matters, respects people more than a long sequence. Review the replies and the opt-outs: if people are asking you to stop, you have gone too far.
Is recall a clinical decision?
The decision about whether a patient should return is clinical. The mechanics of prompting them are administrative. Keep the first in the clinician’s hands and let software handle the second according to rules the clinician agrees to.
What about patients who have simply finished?
Do not recall them. A good process excludes discharged patients, so people who are done are not nagged. If your system cannot tell the difference, fix that before anything else.
Where Praxia fits, and where this guide stops
Praxia is a pilot with Evolution Medical Care, a clinic run by Praxia’s founders, and is being onboarded to it now. We wrote this guide from how clinics work and from what Praxia is built to do. It is general information, not legal, clinical or financial advice, and nothing here promises a result for your clinic.
If you would like to see how this works in Praxia, request a walkthrough.
Related guides
Talk to us about your clinic
If you want to work out recall rules for your own visit types, bring them to a walkthrough with the founders. If it is not the right time, join early access and we will be in touch.