Failed appointments disrupt office operations. Most studies involved hospital clinics with low socioeconomic populations, which have shown fail rates between 19 and 28 percent. Family practice centers report fail rates which vary from 5 to 11 percent. Young adults, adults with young children, and patients in low socioeconomics groups tend to increase the fail rate. Sex and race are probably not a factor. Reasons for failing appointments include communication problems, the absence of a sense of urgency for keeping the appointment, and the lack of a personal physician. An interval greater than two weeks between appointment scheduling and the appointment date places patients most at risk for failing the appointment. Mail and telephone reminders significantly reduced the fail rate and are cost efficient. Incentives are also used in reducing the fail rate. By examining the process, the patients, the provider, and the environment with respect to appointment keeping behavior, a more quantitative approach to research on the subject can be effected.