The desk staff tries to get the person to reschedule with the same therapist at least within the same pay period, but because some people are only there a few days a week, there's a chance they could end up with another therapist if schedules don't work out. Overall it really hasn't been a problem for us. I'll lose an appointment on occasion, but eventually I'll end up with someone else's client who had to reschedule on them. That happens so infrequently though that I figure it'll balance out in the end.
When appointments are booked, there's a check list of info that the desk staff has to go over with the client. One of the things is to tell them that there's a 24hr cancellation policy. If they cancel less than 24hrs before the appointment or no-show, their account will be charged full price (or if they have a package, one of the sessions will be marked off). For non-members, they're aware that the credit card number they used to secure the appointment will be charged. No one likes to have to charge out on people, so if someone does call to cancel the desk staff will try to talk them into rescheduling instead. Usually saying "because of our 24hr cancellation policy we'll have to charge you for the appointment, so can't we get you in later in the day/tomorrow/sometime soon?" will get the person back on the schedule. If they still won't, then chances are they're getting charged for it. We don't tell people ahead of time that they can probably get away with rescheduling within the 24hr window, so by offering that it at least shows them that we're trying to work with them as opposed to just saying "screw you - I'm taking your money!" lol No-shows don't get that consideration - they just get charged.
It can suck sometimes to have that unexpected loss of a client and an empty spot, but life happens. This past Sunday we had a husband and wife book massages at the same time with another therapist and myself. The husband called about an hour and a half before the appointment to say his wife (my client) was throwing up and couldn't make it. Honestly - in that case I thought "KEEP HER HOME!" lol - I don't want a sick person coming in! I let that one slide because it actually benefited me that she not come in.
All that said, we did have a client a couple years ago book and reschedule through 3 different therapists before he no-showed. When the therapist called to see if he was running late, he said he was in a different state on business and had forgotten about the appointment. He was charged for that one, and his file marked so that he wouldn't get anymore free passes in the future.