Efficient and easy scheduling is critical to minimizing frustrations for patients and staff alike, as well as optimizing your private practice’s revenue. Having an optimized and well-managed patient scheduling template is one of the key aspects of running a successful private practice. Below, we cover what questions to ask when designing patient schedule, key topics for early and later career physicians to consider when examining their schedule to see if it is meeting their goals and objectives, and what to account for when you adjust your patient schedule.
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Optimizing your patient scheduling template
One of the keys in running a private practice that is both enjoyable for patients and clinicians as well as efficient and profitable is having an intentionally created and well-managed patient scheduling template. These are the directions and marching orders your staff follows when patients schedule an appointment to ensure that the day runs smoothly, that patient wait times don't pile up, and that you have a productive but pleasant day that allows you the time you need for each patient encounter.
In general, it is best practice to examine your patient scheduling template at a regular cadence and make adjustments to reflect pain points or areas for optimization. The more you fine tune and refine your patient template, the better your workflow will run in your practice for everyone involved, including you, your staff, and your patients. It will keep you from running behind, paying for overtime when you don't need to, and help you see as many patients as possible. When considering how to design or redesign your template, first consider:
How many patients do you typically see in a day?
How many of those visits are new patient visits?
How many procedures are mixed in throughout the day?
Are you double booked or single booked (or more)?
What is your clinic no show and cancellation rate?
Do you want to see specific patients or encounter types at certain times of the day?
Are there certain types of patient visits that tend to take longer?
What time do you want to start and end?
Do you or the staff need any breaks or built in times to catch up?
When you assess these questions, it’s important to consider first where you are in your career, and what your current career goals are, as this will help you answer the questions above.
Optimizing a patient scheduling template for an early career physician
If you are just starting out in private practice, you should have a scheduling template that allows you time to think, grow, and learn about your patients.
The worst thing you can do is rush in and out of the exam room, fail to think thoroughly through your clinical decision-making, and then feel pressed to move on to the next patient. You should dedicate significant time to honing your clinical decision making process and daily workflow early in your career.
Your staff also needs time to learn how you work, what your preferences are, and how to help you run more efficiently. You also need to figure out how you and your team will best approach specific workflow problems throughout the day.
These days, most clinic templates have double-booked patients, as clinical staff may be helping with some aspects of patient care while a physician is in with another patients, and to account for no show rates.
When you're beginning your career or just starting a new job, however, you may find that single-booking patients and/or allotting more time per visit are more prudent to allow you to focus on each individual patient and decide where you can do things quicker comfortably. Similarly, early in your career, adding extra time for small procedures will allow you to not feel rushed.
When it comes to the nitty gritty of your patient template, the first question is, how long does each patient encounter take? Typically new patient appointments will be scheduled for anywhere from 15 minutes to an hour depending on the type of appointment and specialty of the physician, and follow-ups are generally shorter.
Again, these can be single or double-booked, or sometimes triple booked depending on the specialty.
Sometimes, it makes sense to factor in same day appointment slots in the schedule. For other specialties, this is unnecessary.
The more precisely you can determine how long specific appointments are, the better you can predict your clinical efficiency. While it sometimes can be a lesson in humility, working with your office administrator to determine how long you genuinely take can reap rewards in refining your template and decreasing patient wait times.
When you start finding yourself with extra time, it's then time to start thinking about optimizing the template.
Assessing your workflow to optimize patient scheduling
As you start examining your workflow more carefully, it's time to start customizing it to reflect your habits, preferences, and patient population, as well as what gives you joy and allows you to avoid burnout. Areas to assess include:
What are the inefficiencies you see in your day?
Are the number of available exam rooms limiting you?
Is the number of available staff limiting you?
Where do you find yourself slowing down?
Do you find patients tend to build up a line at check-in and do you need to stagger arrival times?
Are there certain types of patient visits or consults that always end up running over?
Are there certain types of patient visits where you find that your role as the physician is limited because most of the visit is nursing or can be handled by the MAs?
When do you find yourself with downtime?
Note again that this is very much of an iterative process, and genuinely takes a few years to create, and will require constant refinement even into your mid and late career as your preferences and practice change.
Re-evaluating your patient scheduling template and assessing your workflow to minimize downtime
Depending on your employment model and contract, as well as your personality and lifestyle preferences, you may love downtime or hate downtime. One of the themes that many private practice physicians who are productivity based tend to echo is that while they're at work, they want to be working and generating as much revenue as possible. If this is your case, dig deeper into the times where you find yourself with downtime.
A common offender is no shows or last minute cancellations. There are lots of things to be done to minimize this disruption to your schedule, including:
Implementing a no show/cancellation policy, which may include discharging patients from your practice if they frequently no show or keeping a credit card on file for no show or last minute cancellation fees
Booking more patients in a day after you have enough data to show a typical no show or cancellation rate
Have your schedulers call patients who are scheduled for later in the week when you have cancellations.
While you want to be very sensitive to required downtime for your staff and their right to take a break, if you need less downtime in the day than your staff does, you can also consider doing things like staggering their lunch breaks such that you can keep going throughout the day.
If you are consistently finding yourself with downtime, it is time to think about updating your template. This may include shortening the time allotted for patient visits and procedures or opening up more slots for patients, knowing that you'll be able to catch up without significantly increasing wait times for patients.
If you do find yourself with downtime, make plans to tackle charting, calls to patients, etc so that you're not taking work home with you.
As you and your schedule continue to become more efficient, keep updating your template. Each time that you do this, it again resets the clock on evaluating efficiency.
Optimizing and adjusting the patient scheduling template for a later career physician
It’s important to periodically continue to re-evaluate your scheduling template and determine what your priorities are, even after you've settled into your practice. There are always additional changes that you can make to specific patient visit types and your own lifestyle modifications.
For example, eventually you may want to increase time for specific patient appointment types, decrease time on others, and create a new template that allows for more patients to be seen over the course of a day while still accommodating more time for the more complex patients.
As you mature through your career, you may want to reassess and optimize how you want to structure your day. Consider the following as you re-evaluate your scheduling template:
Do you want to start early and end early, or do you prefer to start later to allow for drop off for children at school but prefer to work through lunch?
Are there specific days you prefer not to operate so you can ensure an earlier end time, or do you prefer very busy clinical days and in exchange having a day off a few times a month?
One of the benefits of private practice is you should be able to manage these types of accommodations to your schedule so long as you don’t have expenses and overhead rise disproportionately.
Consider your staff, colleagues, and clinic flow when optimizing your schedule
It’s important to note that every time a patient template is altered, you have to accommodate for staffing issues. It is likely the schedulers and your medical assistants both will struggle with changes for some time before becoming adjusted to the new workflow. You should allow for this learning phase, and make sure to give your staff some grace as they figure out how to keep up with your increased pace. Make sure you respect their need for breaks as well, even if you don't need them. Hiring one more member of your staff will be well worth it if you can increase the number of patients you see significantly without burning out your existing staff.
Similarly, make sure you understand what the effects of altering your schedule have on the rest of the physicians and other clinicians in the practice. Do your changes divert resources from them, or cause their patients to have to wait more because patients are piling up for labs, imaging, front desk times, etc? Can the technologists doing imaging or labs handle the increased throughput? Are there parking issues if too many patients are in the office at a certain time? Be careful about making dramatic changes too fast, as you likely don't function in a vacuum.
Conclusion
Over the course of your career, you should actively think about, re-evaluate, and manage your schedule to meet your needs. In doing so, you should be able to optimize your workflow and efficiency, which can improve patient satisfaction, decrease potential burnout, and even help improve staff retention by creating a better environment for everyone.
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