No-Shows, Drop-Offs, and Ghost Patients: The 3 Systems Every Sports PT Clinic Needs in 2026

Every sports PT clinic has the same three revenue leaks. The difference between clinics doing $40k per month and those doing $75k isn't always patient volume. It's often how well they plug these leaks. Here are the three systems you need to install.

System 1: No-Show Prevention and Recovery

One reminder call the day before isn't enough anymore. Patients are drowning in notifications from every app, every service, every subscription. Your single reminder gets lost in the noise. What actually works:

• Reminder at 7 days out (sets expectation)

• Reminder at 48 hours (confirmation request)

• Reminder morning of (final touch with easy reschedule link)

Each message should include a one-click reschedule option. Make it easier to reschedule than to ghost. But prevention is only half the system. Recovery matters just as much. When someone does miss their appointment, reach out within 2 hours. Not to scold. To help. "We missed you today. Everything okay? Let's reschedule for later this week." This simple follow-up recovers 30 to 40% of no-shows who would otherwise disappear forever. That's not a guess. That's what the data shows across dozens of clinics.

System 2: Plan of Care Completion Check-ins

The moment that determines your POC completion rate happens around visit 4 or 5. The patient says: "I'm feeling better. Do I really need to keep coming?" Wrong answer: "Well, it's up to you..." Right answer: "Great progress. But we're at 60% of your plan. The work we do in visits 7 through 10 is what prevents this from coming back in 4 to 6 weeks. Let's finish strong." Your therapists need to be trained on this conversation. And your systems need to flag patients who are approaching the typical drop-off point. Proactive check-ins between visits also help:

• Brief text after visit 3: "How's the shoulder feeling between sessions?"

• Quick call at visit 5: "Just checking in. Any concerns about completing your plan?"

These touches take 2 minutes each and can save thousands in revenue per patient.

System 3: Lapsed Patient Reactivation

Your EMR is full of patients who haven't visited in 6 months or more. They're not dead leads. They're people who:

• Had a good experience with your clinic

• Already know and trust your staff

• Live in your service area

• Probably still have the same body (and its issues)

A quarterly reactivation campaign doesn't need to be fancy. Simple message: "Hi [Name], it's been a while since we've seen you. How's the [knee/shoulder/back] doing? If you're still dealing with any issues, reply and we'll get you scheduled." No discounts. No marketing speak. Just a genuine check-in from someone who helped them before. 10% of your lapsed list will respond to this. That's 30 patients from a list of 300. At 5 visits each, that's significant revenue from people you've already earned.

Why These Systems Fail

The systems themselves are simple. What makes them fail is relying on your front desk to execute them manually. Your front desk is already:

• Checking patients in and out

• Answering phones

• Dealing with insurance questions

• Managing schedule changes

• Handling walk-ins and emergencies

Asking them to also track chronic no-showers, send multi-touch reminders, follow up within 2 hours of every missed appointment, run reactivation campaigns, and have POC completion conversations... it's not realistic. It's not a people problem. It's a systems problem. These processes need to run automatically, with humans stepping in only for the conversations that require a human touch. This February, I'm running a free 30-day sprint for 3 sports/ortho PT clinics. We install the follow-up system (no-shows, drop-offs, reactivation). Your team approves messages, we handle the setup. No cost, no contract, no catch. DM me or visit wiebe-consulting.com if you want the details.