Fees & Policies> Why We Have A Cancellation Policy

Managing Appointments: Why Our Cancellation Policy Is Key

At Tsumugi, we believe in providing the best possible care while maintaining respect for your time and ours. Our cancellation policy helps ensure that we can continue to offer personalized treatments to every person who needs them. By understanding and supporting this policy, you help us keep our practice sustainable, accessible, and focused on your long-term well-being.


This page shares the deeper reasons behind our cancellation policy and how it affects everyone involved. You’re welcome to scroll through or click below to jump to the section that interests you.

Why Cancellation Policy Matters

Why We Have a Cancellation Policy

Cancellation policies are common across many industries that sell time, space, skill, and/or knowledge. Flights, events, hotel rooms—all typically come with policies that limit or exclude refunds after purchase or within a certain time before the service is rendered. These policies allow businesses to stay afloat and continue serving their communities.
As a community-based healthcare service, our Chinese Medicine and Massage Therapy practice falls under this category. It is a self-funding and fee-for-service business - a micro one-(wo)man show. People who receive our care book the space and the practitioner’s presence for a specific time period on a specific day to receive a treatment that uses our skills and knowledge. Thus, we have a cancellation policy in place just like any other businesses. It is hard to fill suddenly emptied spots on short notice even with a waitlist.

Behind the Scenes: How Our Work Is Structured

In our industry, working at a clinic doesn’t mean most practitioners are salaried. More commonly, we either rent a room and run an independent business under the clinic’s brand, or provide care based on a commission or fee-split contract.Either way, the only source of income is the fees collected from our patients. We don't get paid an hourly salary whether patients are scheduled or not. If a clinic doesn’t respect the cancellation policy and collect the fees, practitioners don’t get paid.
This also means independent contractors don’t get sick or vacation pay. No benefits either, unless we pay for them ourselves (or are under their family’s insurance plan). Yet we still face inflation like everyone else does, and we also have monthly and yearly overheads to maintain our businesses.

Difficult Truths About Missed Appointments

Despite this, many practitioners encounter some degree of resistance from people when we enforce the agreed upon cancellation policy or charge for no shows. For each of them, it happens just once or on very rare occasion for a very legitimate reason, so they can feel that the fees should not be charged to them.
Many colleagues or clinics don’t attempt to honour the policy to collect the losses. We were used to be in this group, we have waived the fees multiple times for the same patient to avoid push back, feeling uneasy to enforce it, or potentially losing their business with us.
But over time, the number of last-minute cancellations and no-shows increased to a point that became unmanageable.

Maintaining Professional Boundaries

Colleagues in our profession speculated that one reason for the resistance might be partly (or largely) because patients have developed a rapport with their practitioner through their therapeutic relationship. Thus the policy is taken personally, leading to the resistance.
We do feel close to the people see and care for them, but the relationship between the practitioner and them will never be a friendship or personal. There are boundaries to be maintained when the therapeutic relationship begins and the cancellation policy is agreed upon. The practitioner and care participant relationship must be respected.
A healthcare appointment is fundamentally different from casual plans to meet friends for coffee.
It is important to establish and respect boundaries.
You might now wonder if this whole thing is all about money. It isn’t. We would rather be paid for the treatments we provide. All we want is to provide care to the people we deeply care for. Income from cancellation fees isn’t rewarding, but it does help us meet our basic financial needs.

The Ripple Effect of Missed Appointments

We also roughly estimated that the annual loss from uncollected fees could be as high as a month’s worth of income. We have had more than half of appointments cancelled at the last minute on a particular day and no fees were recouped. We were left unpaid wondering how we are going to pay bills.
After the initial shock and survival response, we reflected on how our patients’ health might have been affected by their missed appointments.

Then we also thought about other people who might have wanted to receive the treatment that day if the schedule had been clear.

This was another moment of realization about how impractically this community-based pay-per-use health profession is structured and operated, and then we were reminded of this saying:

Last minute cancellation hurts 3 people;

  • The person who missed their appointment

  • The person who might have been able to get it otherwise

  • The practitioner

What Happens When Fees Aren’t Collected

And here are some important facts about the cancellation policy that actually have a direct impact on all of us including YOU.

When the cancellation fees are not collected, we might potentially face:

  • Fee increases: Service fees may rise significantly—beyond the rate of inflation—as the business or practitioner tries to recoup losses from uncollected cancellation fees.

  • Less availability: Your practitioner might consider picking up another, more stable job to supplement income, which would result in fewer hours for the health business

  • Loss of access to care: A clinic/practitioner might go out of business or retire early due to insufficient resources or burnout, and you health journey could be interrupted as a result

The good news is these consequences can be avoided if everyone shows up to their appointments and all last-minute cancellation fees are collected.

What You Can Do

Here are a few recommendations to manage your health appointments and maximize your healing opportunity.

  • Commit to your health: Health is of utmost importance and keeping your appointment is your responsibility. Put your health on the top of the list and plan things around it.

  • Plan ahead: It might be helpful to go over your upcoming schedule each week so that appointment reminders don’t come as surprise

  • Try the waitlist: If you don’t see availability for your preferred day/time, add yourself to the waitlist. Otherwise there is no way of knowing that you might have wanted to receive care on the particular day and time to let you know that the appointment became available

  • Re-evaluate your treatment plan: If your current treatment plan is not working for your lifestyle, talk to your practitioner to re-evaluate the plan so that your visits can be reduced with more strategy- based interventions.

  • Same day booking: If your life/schedule is truly unpredictable, wait to check availability on the day you’re free. Also discuss your situation with your practitioner so that together you come up with solutions. This is not the most recommended strategy as there is no guarantee that there will be an appointment available, but it’s still better than missing appointments you can’t make.

Our Commitment to You

Lastly, we offer the following as a care provider at our business to help your cancellation policy:

  • Virtual/phone appointments. you are encouraged to switch to this type of appointment if you cannot be physically present at our office for their appointments. Working on strategies is an investment, and it is just as important as (or even more important than) getting needles or my hands on your body. We are also capable of helping minor acute conditions - most of them can be effectively dealt with virtually. Please take every opportunity to support your health

  • Donation: Upon request, we will donate 30% of any collected cancellation fee to a charity of our choice. You’re welcome to suggest a cause, or we’ll choose one that supports community health and wellbeing.

Hopefully by now, you can see that enforcing a cancellation policy is not meant to be a punishment for something you had little/no control over. Rather it is in place to ensure that the healthcare business survives to continue to serve you.

Thank you for respecting and complying with cancellation policies of all businesses and helping us stay afloat.

Together, we can keep the treatment fees affordable, as well.

In health,

Tsumugi Healing Arts