When Maria Lopez left her doctor's office in Austin last January, she didn't have to worry about calling weeks later to book her next appointment. Her doctor clicked a button right then and there, scheduling her follow-up before she even stepped into the parking lot. That small act is part of a quiet shift happening in 37 clinics across Texas, where doctors are now rewarded for booking follow-up visits the moment patients are still in the exam room.
This approach, called "prioritized follow-up," is solving a common frustration: the long wait times and dropped care that happen when patients try to reschedule on their own. Dr. Diwakar Gupta from the McCombs School of Business at The University of Texas at Austin led a study showing that when doctors schedule follow-ups during the visit, patients are far more likely to keep seeing the same provider. That continuity isn't just comforting—it's critical. It means fewer missed diagnoses, better management of chronic conditions, and stronger trust between patients and doctors.
The research team analyzed a full year of appointment data and found that for every 10% increase in prioritized follow-ups, continuity of care jumped by 10.7 percentage points. That's a big win for health systems, especially as insurers increasingly reward clinics for keeping patients connected to their doctors. But there's a catch: doctors were hesitant to book too far ahead, fearing no-shows or cancellations that would cost them income. After all, they're paid for visits that happen—not for slots that sit empty.
So Gupta and his colleagues tested a new idea: what if doctors got a bonus for booking these in-visit follow-ups? Drawing from sales incentive models, they designed performance contracts that reward doctors based on the share of prioritized follow-ups in their schedule—not just the total number. The best contracts focused on ratios, not quotas. The result? Clinics saw higher continuity, more completed visits, and greater overall profits—even after paying out bonuses.
"If you want to achieve high continuity of care, look at ratio-based contracts and only give incentives for prioritized follow-ups," Gupta says. And the system is easy to track: any appointment made on the same day as the office visit counts. No extra paperwork, no guesswork.
This isn't just about convenience. It's about redesigning incentives so that what's good for the patient is also good for the doctor and the clinic. As more health systems adopt this model, patients like Maria won't have to navigate phone trees or face empty calendars. They'll leave their appointment with a plan—and a date already on the books.