An effective and efficient patient scheduling system can have a positive financial impact on a medical practice, but it's necessary for the front-desk person and the physician to work together.
How many patient appointments are scheduled each day at your medical practice? Dozens? Hundreds? Answering that question should provide a good indication of just how important patient scheduling is from both a delivery of care and practice management perspective.
Steven Peltz, founder and managing partner of Peltz Practice Management & Consulting Services, LLC, says patients in exam rooms form opinions based on their perception of how rushed the physician seems and how much time the physician spends with them.
“One of the ways to develop a relationship with a patient and decrease the potential of malpractice is to develop a relationship with the patient in the exam room,” Peltz says. “If you enter the room rushed, and if you answer or ask all the questions and the patient doesn’t get a chance to ask questions, then it’s not going to be a very highly rated interpersonal communication relationship.”
And that’s why patient scheduling is so important.
Communication and flexibility
Peltz says a key component to effective and efficient scheduling is for physicians to determine how much time they want to spend with patients. He recommends starting with 15 minutes for a follow-up, 45 minutes for a new patient visit, and between 15 and 30 minutes for a sick patient visit.
Sometimes those 15-minute follow-ups run only half as long as scheduled. When that is identified—which Peltz admits is not easy to do—then 2 patient follow-up visits can be scheduled during that 15-minute time slot.
However, sometimes during follow-up visits, physicians will detect something unbeknownst to the patient, requiring additional time and attention.
“When that happens, it’s up to the front desk to receive communication from the medical assistant that the doctor is going to be running behind,” he explains. “The front desk then has to inform patients who come in to register that the doctor is running a little behind because of a new problem with a patient, rather than not communicating anything to the patients waiting in the waiting room.”
A second conflicting problem occurs when patients simply walk in and don’t phone ahead. If your practice has a history of walk-in patients, set aside time at the end of every 3- or 5-hour session, such as 11:30 a.m., and don’t schedule any appointments, Peltz recommends. Doing so will afford the ability to handle not only walk-in patients, but to respond to visits that run longer than expected as well.
“About 4 years ago I was interviewed by National Public Ratio, and the whole interview was about customer service in a medical practice,” Peltz recalls. “And it all had to do with the training and the interpersonal communication skills of the front-desk person. They have to be able to analyze, identify, evaluate, and implement, which is not easy.”
At some practices Peltz visited, he noticed the practice stays open during lunch hours, but has very few patients scheduled between 11:30 am and 1:30 pm. In order to maximize efficiency, he recommends the practice close down 3 days a week between noon and 1 pm. Doing so will make the schedule more efficient because all patient visits will be morning or afternoon, and staff will have time to catch up or take lunch.
“You can also hold staff meetings then, so you don’t have to pay staff overtime to stay late or come in early,” Peltz explains. “You save money on reducing expenses and generating more revenue.”
When a new scheduling system is instituted, it’s incumbent on the office manager, not the physician, to assess it for at least 3 months.
“Any physician who has enough time to do that is not working hard,” Peltz says.
Establish benchmarks for the way scheduling is done, to the way phone calls are handled, and assess each month.
Peltz says an effective and efficient patient scheduling system can have a positive financial impact on a medical practice. If the patient scheduling system that exists is dysfunctional and a better one is put in, the physician will have the opportunity to see more patients in either the same amount of time or less. It also gives the practice the opportunity to schedule appropriately for the patients’ needs.
“So maybe instead of seeing 8 patients in the morning, maybe they can see 10 patients in the morning,” Peltz explains. “And if you see 10 instead of 8, with average reimbursement of $70, that’s $140 times 5 days a week, times 22 days a month, times 50 weeks a year—it can make a tremendous difference.”