How to save time, see more patients, and make more money

January 8, 2010

There is no reason you can't provide high quality care in a timely fashion. Ten to 15 minutes is plenty.

These are not "hello, don't answer, goodbye" visits either. I look, listen, feel, and finish every visit with "Did I do everything? Is there anything we haven't covered?" My patient satisfaction scores are high and I am NCQA certified in both diabetes and hypertension/stroke. Most low-volume doctors use "quality of care" as an excuse. There is no reason you can't provide high quality care in a timely fashion. Ten to 15 minutes is plenty.

How is it done? Here are my tips and perhaps some will work for you.

1 If you want to stay on time, start on time. Don't roll into the office 20 minutes late, you'll never catch up. I arrive 15 minutes early, I review yesterday's labs, last night's faxes, and get working. I work with a good, fast MA. We work out of three rooms and keep them turning over. Patients should never "camp out" in a room.

2 Never have a Pap smear or a new patient as the first visit in the morning or the first visit after lunch. There's always a time lag as the patient changes clothes or fills out forms. You could spend that time seeing a blood pressure follow up or a sore throat.

3 Have patients fill out their own history forms in the waiting room. These are adults and they can fill out a history and review of systems form as well as I can. I just clarify it with them during the visit.

4 Complete Physical Exams are well visits. Patients need to understand that a CPE is a "wellness visit." It is not an overhaul where they can expect me to address every complaint they have had in their entire life. I don't know where you go for that visit.

5 Do your procedures as your last visit before lunch. I do skin biopsies at these times. If they run over, I am just cutting into lunch. I am not backing up my schedule or clogging up the waiting room if I run into a complication.

6 If you have a patient with a list of complaints, take the list from them. Often the patient will want to discuss every complaint completely, in order, one at a time. They are controlling the pace of the visit, not you.

I say, "Well let me review your list as seeing all your complaints at once often lets me come to a more accurate diagnosis." I review the list and look for the most life-threatening complaint. I want to get to that first. My next line is, "One of my jobs as your family doc is to evaluate what can kill you first and then take care of what's bugging you later."

7 Keep up with your paperwork and keep your desk clean. I complete my notes in the room and clear my desk multiple times daily.