At 12:19 AM 8/20/2006, you wrote:

I'm running just at that 1% also, John.. I have a panel of about 1000-1100 ( I'm uncertain now as  I'm trying to weed out the lost souls right now). My average number of visits/ day was 11 in July, 10 in June. My peak month was February this year, averaging 13 visits/day. My figures become strangely skewed, as my "half days" on Monday and Friday tend to be high demand, so I may see 8-9 patients in 3 hours instead of 5-6.

 I'm changing my schedule on Monday as time increases to make more hours available. The efficiency of those fast moving high-demand days is appealing also, though, so I'm changing my entire schedule starting next month, working several days in the week for 5 or 6 hours straight, starting at 11 AM. It will be interesting to see how that works. . . it's fun to be in charge of my own schedule and I haven't taken enough advantage of that yet (though I certainly don't ask anyone's permission when I want to go out of town).

Nancy Guinn

 

Re: Fundamentals of supply and demand in office scheduling

 

Nancy's observations and adjustments are a fabulous example of manipulating supply to meet demand, which is the keystone of achieving and maintaining open access scheduling.

The other critical component is not accepting more patients into the practice than can be managed beautifully.

Nancy -
I see that you anticipate the seasonal surge in February.  How do you manage this seasonal variation?
Gordon

 

RE: [Practiceimprovement1] Re: Fundamentals of supply and demand in office scheduling

 

What about manipulating demand to meet supply?  I have found even in my first year, that with the summer lull in acute visits I was able to spend more time going over my charts and rousting up followup visits, especially for those with chronic diseases.  One good example is encouraging all of my asthma patients to come in for baseline spirometry testing.  I hate to compare micropractices to the status quo of 1-2 patient visits per year per patient.  Shouldn't we be using our availability to encourage our patients to come in more frequently? What about offering more services that require a higher frequency of visits, like basic family counseling, (or in my particular case, acupuncture).  Actively encouraging more visits per patient not only improves a micropractice bottom line, it helps establish stronger doctor patient relationships and, (copays aside), might let people feel like they are getting more of their money's worth from their insurance plan.


Scott Clemensen MD
Clemensen Family Medicine
181 South Main Street, Suite 5
Phone/Fax:(866) 269-4810
www.clemfm.com

 

 

 

Re: [Practiceimprovement1] Re: Fundamentals of supply and demand in office scheduling

 

I manage seasonal surge in the usual way for same day access - becoming more accessible. I will come in a bit earlier and see patients a bit later when they call in for acute care. Those end of day visits tend to be quite efficient and are my rare 15 minute visits. When someone calls at the last minute, my receptionist lets them know I'll stay late to see them that day, which they appreciate alot. On my 11 am start days, my receptionist also knows when it's ok to add in an urgent 10:45  or 10:30 based on early AM demand. Fluidity is the key. 

 

I did the same thing Scott mentions and sent out all my "i haven't seen you in over a year" letters at the beginning of summer. Smoothed out the dip - actually kept me from the lazy days I had anticipated!

 

Nancy Guinn

 

From: "Michelle Eads" <michelle.eads@worldnet.att.net>
X-Yahoo-Profile: meads1521
Sender: Practiceimprovement1@yahoogroups.com
Mailing-List: list Practiceimprovement1@yahoogroups.com; contact Practiceimprovement1-owner@yahoogroups.com
Delivered-To: mailing list Practiceimprovement1@yahoogroups.com
List-Id: <Practiceimprovement1.yahoogroups.com>
List-Unsubscribe: <mailto:Practiceimprovement1-unsubscribe@yahoogroups.com>
Date: Mon, 21 Aug 2006 19:12:59 -0600
Subject: [Practiceimprovement1] supply and demand
Reply-To: Practiceimprovement1@yahoogroups.com

I too have found the techniques used my Scott and Nancy work well.  To manage the surges that occur (including sporadic ones and anticipated ones), I either come in early and/or stay late.  My MA knows when/where I can be flexible for the most part. I also have scheduled a 2 hour lunch on Mondays, as those are the days that sink me (because of the bolus of documents that arrived over the weekend re ready for sign-of, the usual higher demand of Mondays, etc).  With that block of time, I can easily see an extra pt or 2, like I did today, or get caught up with other tasks.   Another helpful trick to spreading out demand is to pull tomorrow’s work into today (to use a ‘Gordonism’).  If we have a cancellation, my MA looks at the future schedule and sees if she can pull anybody in to that slot today.

 

Michelle A. Eads, M.D.

Pinnacle Family Medicine, PLLC

(719) 687-8752 phone (719) 687-8753 fax

P.O. Box 7275

Woodland Park, CO 80863