Dr. Susan Shauger at Lakeline Vision Source pretends to be frustrated with her schedule. Photo courtesy of Dr. Laurie Sorrenson
Can pre-appointing benefit your practice? A breakdown of when it makes sense and when it doesn’t
By Laurie Sorrenson, OD, FAAO
Jan. 29, 2026
I’ve spent a significant amount of time over the last few months digging into pre-appointing. Specifically, I was looking for any research on whether automatically scheduling a patient’s next annual visit at the end of the exam helps grow your practice and the advantages and disadvantages.
I could not find a clean, well-designed, randomized controlled trial that definitively proves or disproves pre-appointing is the answer to practice growth. I looked. A lot. What I found instead were peripheral studies, health care data and plenty of anecdotal evidence that suggest my premise is probably sound. Let me tell you what I believe about pre-appointing.
When Pre-appointing Makes Sense
If you are in a new practice—whether you opened cold, purchased a practice with low carryover or you’re a new associate doctor trying to build your own patient base—pre-appointing makes a lot of sense to me.
The number one problem in a new practice is not capture rate, average revenue per exam or even optical conversion.
It’s patient volume.
If you don’t have enough patients walking through the door, nothing else matters.
At the end of an exam, when you’ve just established rapport and trust, saying “I want to see you in one year, I am going to reserve you an appointment. Don’t worry, we will remind you and we can reschedule if necessary” and then scheduling that appointment is logical, efficient and patient-friendly. It makes sense that this will help grow your practice more quickly. Many practice management experts have recommended this approach for years.
At that point in a practice’s life cycle, pre-appointing serves as a stabilizer and can help get the books fuller, faster. This takes a year to see the results, which is why so many of the new practices I talk to, don’t do it. Then a year comes around and they are struggling… at that point, they always wish they had been pre-appointing a year in advance since the beginning (I refrain from saying “I told you so!”).
Where the Strategy Can Start to Backfire
I see this often! But here’s the part that doesn’t get talked about enough.
At some point, pre-appointing can become a constraint instead of a growth tool.
If your appointment books are filled months in advance with patients who were automatically scheduled last year, you may suddenly find yourself with very few openings for new patients. And you have to have new patients to grow (assuming you want to grow).
When access becomes limited, growth slows. Online schedules will show “no availability.” And the very system that once helped you grow now will definitely cap your growth.
There’s another, more subtle effect I’ve noticed as well, and other practice management experts have talked about.
Patients who are pre-appointed often come in because the calendar told them to—not because they felt a need. They may not perceive a strong reason to purchase glasses, update contact lenses or pursue treatment for chronic conditions like dry eye.
Compare that to the patient who schedules an appointment on their own because something isn’t working anymore. Those patients are far more likely to be emotionally and financially ready to move forward with eyewear, contact lenses or treatment plans.
What We Do At Lakeline Vision Source
We have 9 doctors seeing patients in our one location. Some doctors have been with me for over 20 years. Those doctors almost never pre-appoint patients, except for medical care like glaucoma care, etc. They don’t need to because when they get to the office, they almost always have a full schedule of patients.
But we also have doctors who have been in our practice for less than 5 years. During our “slow months” their schedule is not always booked when they get to work.
Those months are where pre-appointing becomes incredibly strategic.
During those slower periods, I ask those doctors that when they get to work, and they have more than a couple appointments available, to intentionally pre-appoint patients that day—not everyone, but selectively. The guidance is simple:
Pre-appoint the patients who:
- Show up on time
- Are loyal to the practice (Consistently purchase eyewear or follow treatment plans)
- And, frankly, are people you genuinely look forward to seeing again
By pre-appointing those patients into historically slower months, we help smooth demand across the calendar and the peaks and troughs even out a bit.
My recommendation about Pre-appointing
Early on in your practice, pre-appoint almost every one.
As you get busier, start getting pickier about who you pre-appoint.
And if you are an established practice, consider doing it only during your slow months, slow weeks or even slow days.
And if you are booked out weeks or months year round and you utilize year-out pre-appointing, my strong recommendation is to stop!
Pre-appointing isn’t right or wrong in my opinion. I know there are different ways to be successful. I believe that pre-appointing can be extraordinarily useful in filling your books. I just don’t believe it is the permanent solution to growth.
References
National Library of Medicine
Advanced access scheduling outcomes: A systematic review
Patient-Centered Appointment Scheduling: a Call for Autonomy, Continuity, and Creativity
Read another column by Dr. Sorrenson here.
Read more insights from our editors here.
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Laurie Sorrenson, OD, FAAO, ABO, is president of Lakeline Vision Source in Cedar Park, Texas, CEO of ODs Care working with Half Helen, Director of Practice Management and Austin Administrator of Vision Source and the Professional Editor of Review of Optometric Business (ROB). To contact her: lsorrenson@gmail.com |
