Reducing noncompliance to follow-up appointment keeping at a family practice center.

The team tested a simple money trick at a family clinic. They asked, "If we cut the next co-pay, will more people come back?"

They flipped the discount on and off four times. Each flip lasted weeks so they could count kept appointments.

When the discount was on, more patients returned. When it stopped, returns dropped. Turning it back on lifted returns again.

The clinic earned more money even after giving the small discount.

Cordova et al. (1993) tried mailed reminders and free parking instead of cash. Returns did not rise. The lesson: a tiny discount beats extra paperwork.

Winters et al. (2026) later gave bigger cash gifts for HIV visits. Attendance soared while cash flowed, then crashed when gifts stopped. Their result warns that bigger money may not last longer.

Geurts et al. (2008) moved the same idea to drug-use groups. Community staff handed out small rewards and session attendance rose. The token trick travels well.

You can copy this Monday. Ask your clinic to shave five dollars off the next co-pay if the client returns within two weeks. Track kept slots for two months. You will likely see a jump with almost no extra work.