I too am confused.

First of all, keeping track of your appointments is your responsibility not that of the clinic. While some do provide courtesy calls it is not the norm and certainly not your right that they do so.

I have a terrible memory. Firstly, all my appointments and events are entered in my phone (which syncs to my other devices). I have set reminders a day in advance. Second, I have the events written on my calendar. I also go so far as to write down reminders and stick them to the fridge. That way, there is certainly no blaming anyone when I forget.

Is it necessary to have an appointment for a prescription renewal in the first place? I simply advise my doctor I am out of refills at the pharmacy and he calls one in.

If you are concerned about not getting a medication refill that can be handled entirely by your pharmacy. First of all they should be advising you when you run out of refills. At this point it is the usual practise to ask how to proceed. Will you be contacting your doctor or should they contact your doctor for a new prescription. Finally, in the event there is some reason you can't most jurisdictions now allow for a pharmacist to write their own one time prescription. Talk to your pharmacist about doing this for you.