Final answer:
The appropriate step for a patient who is late despite previous warnings is to implement a no-show fee policy to encourage timely arrivals and maintain the office schedule.
Step-by-step explanation:
If a patient consistently shows up late for their scheduled appointments even after being spoken to about the issue, an appropriate next step could be to implement a no-show fee policy. This policy would charge a fee to patients who don't show up on time, which could incentivize them to arrive as scheduled. It's important to communicate the policy clearly and ensure it is enforced consistently to be effective. Refusing to schedule future appointments could be seen as too severe and may not be legally or ethically acceptable, while changing the office hours to accommodate one patient is impractical and unfair to others. Continually allowing late arrivals without any action would likely disrupt the office schedule and could be unfair to patients who arrive on time.