One of the most frequent responses we receive when proposing improving processes and systems to our clients is “your systems require seeing more patients in a given day. Won’t that compromise the quality of care for my patients.” At MyPracticeEngine, we know that your most important job is to provide the highest possible level of care and we are very sensitive to that fact. As these improvements are proposed, a keen eye is directed toward ensuring sterling treatment and outstanding results.
When we propose methods for practices to increase the patients seen per day, most initially look at the proposal and say “we can’t handle that.” Once they put new processes into practice and get comfortable with them, those same practices report on the ease with which they can handle a new patient load.
The process for increasing volumes can get intricate and very specific to the design of a practice, its patient base and staff, but here are 3 of the big suggestions that usually turn up your practice’s “bandwith” no matter what the particular circumstance:
1. Leverage your clinical assistants – Historically, about 80% of total time spent on procedures can be performed by the clinicians in the practice. Keep in mind that the doctor is the most expensive person in the practice and with only one usually in an office on a given day, his or her time is the limiting factor on the growth of the practice. For example, if a doctor said that she wanted to handle all short appointments from beginning to end, the practice’s production would be limited to how many shorts a doctor could handle in a set period of time. However, if you restrict the doctor to only the procedures that he or she is required to handle and review of the work done by the clinicians, the practice can handle a greater number of patients because the doctor now has more available time.
There’s another aspect to this. If you have 3 clinical assistants in the office, it would stand to reason that the volume could increase by 33% if you add a fourth assistant (obviously, available chair space and the availability of patients affect this). So, in practice, as the practice grows, additional clinician talent can expand the capacity of the practice without having to add a new doctor or a new office – provided you have the space. Of course, you want to be careful not to make the additional investment in personnel and equipment without patient volume being at appropriate levels.
2. Have the patients move around, not you – Quite a number of practices have the patient go to a chair and then have the clinical assistant and/or doctor to them for treatment. This takes time not only to move from place to place, but also creates an opportunity cost because you could have been preparing for the next patient in your chair instead of moving around. A number of practices have told us that the movements take only a few seconds. But a few seconds add up and when you combine that with the opportunity cost described above, you start incurring real cost. We’ve done the time and motion studies on it and can tell you that this factor can add at least an hour of available time to the day, maybe more AND enables you to spend more time with a patient than in other scenarios.
Rather, have the patient (with chart in hand if necessary) move from an on-deck area to the clinician’s chair. When complete, go back to the on-deck area. When the doctor is ready for that patient, the patient moves from the on-deck area to the doctor’s chair. The doctor does his or her review and then sends the patient out of the treatment area. Now, by sitting and waiting for patients to come to you, you as a clinician or doctor can get prepared, have your instruments organized the way you want them at all times and focus directly on the patient instead of moving around.
3. Use technology - Obviously, a substantial number of technologies exist to eliminate administrative time and let you focus on patient interaction and patient care. Things like electronic charting remove the need to dig through files for charts (during or before a patient day). Patient check-in eliminates some administrative check-in time and allows for more personal patient interaction. Queuing systems keep the front and back coordinated as to who is in the office and whether or not you are staying on schedule. Digital X-Rays speed the time to take X-rays with a higher quality of product. All of these reduce administrative time so that you can focus on seeing patients. And with more patient time available, you are able to see more patients.
One other aspect that we have not discussed here is a well-designed daily schedule template with longs, shorts, etc. divided up among the clinicians that will be on that day. The front desk person simply places each patient for that day into a slot with an appropriate appointment. This allows everyone to be on the same page with an effective schedule, but not one that causes the office to be backed up or feel like it has to compromise patient care to see the load. In the near future, we’ll get some templates on the site for you so that you can have them to tweak for your own practice.
Questions? Comments? Need additional guidance? Let us know.
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