Generally, physicians adhere to three scheduling approaches: 1) traditional, 2) wave (sometimes called steady stream) and 3) modified wave. Of course, there’s also a fourth option: chaotic. Hardly a viable approach, the chaotic method wastes physician and staff time while irritating patients forced to spend hours in the waiting room.
3 Common Approaches
Here’s a more detailed description of the three different approaches physicians commonly use:
Traditional. The traditional, or “standardized,” approach involves splitting the doctor’s schedule into consistent periods — for example, four 15-minute periods per hour, then scheduling one patient into each block. Sometimes also called “cramming,” the primary drawback of this method is that it doesn’t take into consideration the possibility of emergency patients, no-shows or late arrivals. It also doesn’t account for the fact that some procedures can be performed in five minutes, while others might require 30 minutes.
Wave. This approach has a number of variables, but the overall concept is to schedule several patients — for example, six — at the top of each hour. While staff members collect information and vitals from several patients, the physician sees the others. A variation is to spread the six patients over the hour, with two on the hour, two more 20 minutes later and the remaining two about 40 minutes into the hour.
Modified wave. This approach is similar to the wave. The primary difference is that the last 15 minutes of the hour are intentionally left open. Doing so allows time for dealing with patients who require more attention or any other issues that may arise — building in a break to catch up.
Practices also sometimes schedule specific days or blocks for certain types of patient visits — for example, some physicians may schedule new-patient visits or annual physicals for a specific day or time of day. Having staff triage the patient’s issues when he or she calls is also beneficial. The staff member who answers the phone should be able to ascertain whether lab tests, X-rays or other types of procedures are needed and, as such, determine whether a longer or shorter time slot might work better.
Scheduling often depends on physician style, the number of physicians and ancillary help, and their training and roles. How much ancillary help does the practice have? Can some ancillary staff take vitals and triage the patients while the physician sees patients? Can they do this in all cases or only in certain types of cases?
One thing to keep in mind: Physicians (and staff) need to be honest with themselves regarding what works most efficiently in their office. Some doctors are frustrated or bored if they do the same procedure over and over all day long. Others prefer specific lunch and break periods, while some are happy to just grab some food when the schedule permits.
In addition, because medical practices are also businesses, many physicians want to set aside a day, or a block of hours, to attend to business-related issues. Examples may include billing problems, correspondence, staffing matters and continuing medical education.
Effective and Efficient
Understanding the nature of the practice and the physician’s work style can be a significant factor in creating an effective and efficient scheduling system. If your schedule doesn’t work for you or your office, try to make adjustments to find the right fit.
Contact Kathy Walsh at firstname.lastname@example.org for more information.
Cohen & Company is not rendering legal, accounting or other professional advice. Any action taken based on information in this publication should be taken only after a detailed review of the specific facts and circumstances.