Balance patient demands with practice capability
Balance patient demands with practice capability
A schedule for success
It’s all a delicate balancing act, says Will Latham, a consultant in Charlotte, NC, when describing medical practice scheduling. Patients want easy access and short waits, physicians want adequate time with each patient, and falling reimbursement demands that the doctors see more patients to bring in the same amount of revenue.
Latham says there are some easy steps you can take to make the most of the hours you have in the day.
1. Schedule for emergencies.
Emergencies often claim a couple hours a week from each physician, says Latham. During this time, the doctor may be out of the office. "It only makes sense to include a block of about two hours to handle the rescheduling of patients," he says. If it is unused for emergency rescheduling, then it can be used for walk-in appointments or for catching up from earlier delays.
Latham recommends that you schedule the blocks twice a day just before the end of the day and one other time either late morning or midday.
2. Try appointment reminders.
Latham doesn’t remember where he read it, but he says that one study showed that reminder calls or cards reduced no-show rates at medical practices from 24% to 14%. Some computer scheduling systems can automatically produce postcards that remind patients of upcoming appointments.
If the appointment is a repeat visit, you can have the patient fill out a post card with his or her address before leaving the office. This works especially well with pediatric patients or early prenatal visits.
There are also more expensive computerized calling systems, says Latham, which run in the thousands of dollars. "And even more expensive is a human calling. This is a nice way to do it, but you really have to dedicate one person for this purpose."
3. Deal with tardy physicians.
Latham says you should start by reminding them of the negative feelings which arise when doctors are late. You can also take charge of the situation and reformat the offending doctor’s schedule.
If physicians are often late after making rounds at the hospital, try scheduling one or two long visits in the morning rather than four to six shorter ones. This allows the doctor to catch up more easily, and it reduces the number of patients waiting in the reception area.
(For more on how to keep doctors on time, see related story, at right.)
4. Record no-shows and cancellations in charts.
There are important legal reasons to document no-shows and cancellations. Latham says you can have stamps made that say "Patient missed appointment" and "Patient canceled appointment." If the problem is consistent, start by calling and asking why. If it continues, consider discharging the patient. (See Physician’s Marketing & Management, June 1997, p. 81.)
5. Send out new patient packets ahead of time.
Send out your patient and medical information sheets when the initial appointment is set. This not only gives you a chance to send a welcoming note, but it allows patients to find all the needed information at their leisure and keeps people waiting in your reception area to a minimum.
6. Change to a modified wave schedule.
Modified wave scheduling allows your scheduler to estimate how long a given appointment will take based on information provided by the physicians. The scheduler can then intersperse long and short visits within a given hour.
Latham says this encourages communication, which can help alone to eliminate scheduling problems. "No one writes down how to schedule," says Latham. "Doctors want one thing, and the staff want another. But if the physician helps them to understand what kind of appointments need how much time, you can solve a lot of problems."
One warning, however: Latham says physicians should limit the number of appointment lengths to three or four and be clear about which kind of appointment needs which length of visit.
7. Don’t overbook.
Many practices fill their appointment schedules up to the brim and make no considerations for emergencies and walk-ins. Most physicians feel harried by this kind of schedule, and nearly all fall behind. Latham says you should track walk-ins and create specific slots for them in your schedule.
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