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What Medical Practice Workflow Changes Are You Ready to Make?


I know you're really busy, and this is time-consuming grunt work, but the sooner you figure this out, the quicker you'll build true patient loyalty.


There is one medical practice I dread visiting as I am guaranteed a 45 minute wait, worse in winter. As I sit there fuming with impatience, the "medical practice coach" in me is busy critiquing the details of how patients are greeted, how phon calls are handled, how long we are left sitting in the exam room after vitals are taken and how much eye contact is made during our check-in and check-out

All I can say is there's room for improvement!

Here's what lousy medical practice workflow looks like (mentally check off anything that applies to your practice):

  • the patient is put on hold for 5 minutes when she calls for an appointment
  • no-one looks up when she arrives at the front desk, other than super-briefly to tell her to sign in on a clipboard and to fill out (for the 3rd time this year) an insurance update form
  • she's called up to the receptionist who's on the phone making what sounds like an appointment with a deaf, elderly patient, and she is asked for her co-pay
  • she waits ... and waits ... and waits ... in the waiting room (I guess there is a reason for that name!) until someone, botching her name, calls her back, and walks her to the scale in the hallway to grab a weight
  • she is left waiting yet again, with tatty outdated magazines, in a paper gown in the exam room
  • she sees the doctor for 10 minutes (if she's one of the lucky ones). The physician (you??), intent on capturing everything in the EMR, seems distracted while typing in the details
  • she waits at the check-out desk while the clerk struggles with the computer to find her a follow-up appointment time, and to announce that she has an outstanding account balance of $106.25
  • she can't wait to get out of there!

What a miserable experience. It's no wonder patients, physicians, and medical practice staff are frustrated.

Here are a few suggestions for ways to evaluate and overcome your bottlenecks and delays:

  1. Ask yourself "How serious is this problem?" The best way to understand your situation is to create and distribute some patient satisfaction surveys. For the elderly, it may be necessary to use paper and pen. For a more digitally-minded patient group, you can use a tool like SurveyMonkey (for free!). Offer anonymity to get the best results. Have an independent 3rd party administer the survey and collect results.
  2. Survey your staff for their job satisfaction. Be sure to ask if they believe they have the tools they need to get the job done.
  3. Analyze the impact of telephone calls on your medical practice workflow. Who takes the calls? What is disrupted as a result? What types of calls are being handled? What happens to calls that drop into voice mail? How many calls are abandoned? How long is each call, on average? What are your peak days/hours for calls?
  4. Analyze how efficiently you have distributed job tasks across your medical practice. Do you have staff that is cross-trained in case of absence? Are tasks being duplicated, because each physician has to have "his and only his staff" take care of his patients?
  5. Discover what your medical practice scheduling patterns are. Are they creating bottlenecks? An example: in your practice, all 3 physicians schedule new patients first thing in the morning between 8:30 and 10:30 AM.

I know you're really busy, and this is time-consuming grunt work, but the sooner you figure this out, the quicker you'll build true patient loyalty ... and have happy staff who plan to stick around for a long time!

Here are a couple of resources to learn more:

MGMA: Top 10 tips to improve overall practice work flow and Workflow considerations

Sound Practice Podcast: Streamlining Workflow in the Medical Practice

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Victor J. Dzau, MD, gives expert advice
Victor J. Dzau, MD, gives expert advice