Do I get behind schedule? Of course I do, sometimes. Still I feel like there are ways to avoid getting behind schedule that can be taught and learned.
When I meet with young physicians, physician assistants, and nurse practitioners joining our practice one of the first things I tell them is that the key to staying on schedule is to allow the easy visits to be brief. Every day I see patients who come to see me for a very simple problem. They know and I know that we don’t need to spend a lot of time to give them the care that they need and want. Other patients come to the office with problems that they may feel are simple, the person making the appointment may have felt would be quick and simple, but is actually quite complex and requires more time than anticipated when the appointment was scheduled.
It is almost impossible to know in advance who these patients are going to be. In my practice, as in many physician’s practices, I schedule a fixed number of patients each hour. It is very easy, and very common unfortunately, for physicians to run far behind in their schedule because of this dilema. I am convinced that the trick to staying close to on time is to not be reluctant to make the easy visits easy.
I really try to give every patient exactly as much time as is needed to adequately address their concerns at each visit. In order to be able to give one patient more time than is allotted for their appointment and still not fall far behind, it is necessary to give another patient less time than is allotted for their appointment. Many physicians are reluctant to adopt this strategy to make a visit that can be managed briefly really short. Then they get far behind and have no way to catch up except if a scheduled patient fails to show up.
This approach also has additional benefits. By not taking more time than is needed to deal with acute concerns it allows me to take extra time to check for preventative services my patients are due to receive and encourage them to get these done. I feel I am providing more value to my patients by ensuring they get their immunizations, are current on their mammograms, colon cancer screening and cholesterol screening than by spending more time counseling them about their athlete’s foot or sinusitis.
In short I feel one of most effective strategies at staying on schedule is to avoid falling into the trap of filling up the time of an appointment with discussion of the current problem that adds little value, and using that time for either other patient’s more challenging problems or for the patient in the room’s unmet need for preventative or disease management services.
Let me know what you think about this strategy. I love comments on this health blog.
Good advice.
You should always touch on the patients ongoing medical issues, but no need harping on adults. They know what they need to do to improve their health by now and you can’t squeeze blood from a turnip.
I think this is a good strategy. I saw it in action the other day. I was having some issues with pain in my side and after reading your blog decided to try Metamucil to get more “regular” if you will. This improved my issue greatly but I did not have sufficient time to cancel my appointment. (But I had another issue to inquire about anyway.) At my appointment we covered the original issue quickly and the other issue was deemed a “I am not worried and would take not action.” This worked great for me as I trust my doctor. So this appointment was a quick 5 minute thing. This strategy may be more difficult to implement for new patients or those who are older or unsure of the strategy to solve the issue or problem.