Strategies For Getting Your Practice To Stay On Schedule
When I am called into a practice to analyze office flow, one of the areas I investigate is why the schedule gets backed up. I start to pinpoint the suspected bottlenecks by asking the same question to both doctors and staff: “In your opinion, where do you see the problem?”
If you were to guess that the doctors blame the staff and vice-versa, you would be right. The staff might say “(The doctor) spends too much time in the room with the patient.” The doctor might say “(The staff) doesn’t schedule properly.”
Looking for someone to blame is not only irresponsible, it is not constructive. The truth is that keeping your office on schedule requires a team effort. Backups are not generally a result of just one thing or one person. Let us stop pointing fingers and concentrate on implementing some proven strategies for improvement.
Start on time. Did you know that starting late is the single biggest cause of running behind? If the first patient is scheduled at 8 a.m., doctors need to set an example and arrive before then. Allow yourself the time to do what you have to do before the day starts and be ready before that first patient comes in. By the same token, if the staff does not have that patient checked in and set up in a treatment room by 8 a.m. (or sooner), the schedule is already compromised.
Scheduling protocol. Staff should have adequate policies and protocols to follow that allow them to manage the schedule properly. That means not scheduling a new patient for 15 minutes if it really takes 30 minutes or not scheduling a postoperative redress for 15 minutes if it only takes five minutes. Scheduling should happen according to facts, not guesswork. Take your five or 10 most common procedures and assign a time to each one, based on monitoring the average time you spend with each one. Then schedule accordingly.
How Interactions With Patients Affect Scheduling
Reining in the “two for one” attempts. “Doctor, can you also look at little Jimmy’s foot while I have him here with me?” This is a common request from patients who have dragged their son with them, hoping to get both the parent and child visits together (in an effort to save time and/or another co-pay). You should handle this properly or it is a surefire way to throw your day off.
After having a brief dialogue about little Jimmy’s problem (while you are working) and determining it is not an emergent situation, the best response you can give your patient is, “In order for me to give Jimmy the proper attention he deserves, I suggest you ask Carol at the reception desk to schedule a separate appointment for him.” If your response is such that the patients feel it is in their best interest, they will cooperate. Of course, if it is an emergency, all cards are off the table. Realistically, how often does that happen? If it were an emergency, the mother likely would have called ahead.
Streamline your check-in process. Insist that your new patients present with their patient registration paperwork completed. The national benchmark for completing new patient paperwork is 14 minutes. How does your practice rank in this regard? If your form is very comprehensive and/or several pages long, it may lead to delays.
For example, a practice that sees four new patients a day and can shave 14+ minutes off each one of those visits can gain almost another whole hour in the day. Of course, the most efficient way to accomplish this is to have your own Web site where patients can download the form and better yet, a patient portal, where patients can complete their forms online. If patients do not have Internet access, the staff can mail the form to them or tell them their “appointment time” is 15 minutes earlier than what they have actually recorded in the schedule. This way, there is time actually “built in” to the schedule for this patient paperwork.