Q&A: Active patients

June 4, 2010

How to count number of active patients.

Q: I am considering a merger with a hospital. They want to know how many active patients I have. My biller counted 23,000 single patients on the register in the past two years. The hospital doesn't believe it. They say a solo family physician, as I am, with 31 years of private practice working full time with a four-day-a-week nurse practitioner should have no more than 7,000 active patients. Active consists of patients registered with me in the past two years. We see about 9,000 visits per year. Who is correct?

A: No physician can have 11,500 different patients per year for two years in a row. The 90th percentile of just visits nationwide in family medicine from a study on approximately 6,000 family physicians is around 5,000, and most patients average around two to three visits per year. Most full solo family practices have 2,000 to 3,000 patients total in their practices. A nurse practitioner can at most equal a physician in productivity, and most see fewer visits than a physician. It is conceivable that a physician plus midlevel, both in the top decile of productivity for their specialty, could have a combined 11,500 work relative value units, but that is still extraordinary.