A group of doctor surgeries in Pembrokeshire has warned patients they could be asked to leave the practice if they repeatedly miss appointments.
The Argyle Medical Group, which runs three practices in Pembroke Dock, Neyland and Pembroke, said more than 500 appointments were missed last month
GP Dr David Wilson told BBC Radio Wales the missed appointments cost the group "roughly" £60,000 a year.
Argyle have posted a Facebook appeal to patients not to miss appointments.
The post said the failure to attend appointments had a "severe impact" on other patients.
He said there was a "hard core group" who tended to miss appointments.
"Obviously the summer holidays are here and I think we notice our DNA [did not attend] rates pick up in the summer because people obviously go off on holidays," Dr Wilson told BBC Radio Wales' Good Evening Wales show.
Asked if the surgery would consider removing patients, he added: "If it becomes an ongoing problem then we would look, probably look, to see if we could do that."
The 500 no-shows included appointments with GPs, nurse practitioners, nurses and health care assistants.