In a comment from Dr. Brown from my recent post on "door knob questions," he asked how long my consultations were. This is actually a very timely question as I have been playing around with my schedule a fair amount lately.
US physicians have a number of different models they can use to create their patient schedule, and as when there are many laboratory tests that can be used for a diagnosis, this means that none of them work well. There are wave models, modified waves, and open access schedule, but the most traditional is just to schedule a patient every fifteen minutes or so.
Up until a month or two ago this is what I did. Preventive exams, well child visits, office procedures, and new obstetrical patients were 30 minute appointments and all others 15. I did have a small list of medical complicated or verbose patients who received half hour slots as well. I would have between 22 and 24 appointments on any given day depending on how many 30 minute appointments were scheduled.
In an attempt to improve access and increase revenue I switched to 10 and 20 minute appointments. At the top of each hour I now have 20 minute appointments and the rest of the hour is one person every 10 minutes. What was a 30 minute appointment I now see in 20. I've also added to the 20 minute list a wider range of more medically complicated patients that I previously saw in 15 minutes. Patients in for a 10 minute appointment are strongly encouraged to only have one or two issues to discuss. Those patients who are unable to do this are scheduled for 20 minutes. With only 6 longer appointments and 24 shorter appointments a day, it is much easier to get in to see me for 10 mintues than 20.
In many ways I wish I could just see people and go through their laundry list of medical issues until our hearts' content, but the economics of the US healthcare system go against this approach. Like I said at the outset, there are many ways to organize a schedule and none of them is entirely satisfying.
The Country Doctor
US physicians have a number of different models they can use to create their patient schedule, and as when there are many laboratory tests that can be used for a diagnosis, this means that none of them work well. There are wave models, modified waves, and open access schedule, but the most traditional is just to schedule a patient every fifteen minutes or so.
Up until a month or two ago this is what I did. Preventive exams, well child visits, office procedures, and new obstetrical patients were 30 minute appointments and all others 15. I did have a small list of medical complicated or verbose patients who received half hour slots as well. I would have between 22 and 24 appointments on any given day depending on how many 30 minute appointments were scheduled.
In an attempt to improve access and increase revenue I switched to 10 and 20 minute appointments. At the top of each hour I now have 20 minute appointments and the rest of the hour is one person every 10 minutes. What was a 30 minute appointment I now see in 20. I've also added to the 20 minute list a wider range of more medically complicated patients that I previously saw in 15 minutes. Patients in for a 10 minute appointment are strongly encouraged to only have one or two issues to discuss. Those patients who are unable to do this are scheduled for 20 minutes. With only 6 longer appointments and 24 shorter appointments a day, it is much easier to get in to see me for 10 mintues than 20.
In many ways I wish I could just see people and go through their laundry list of medical issues until our hearts' content, but the economics of the US healthcare system go against this approach. Like I said at the outset, there are many ways to organize a schedule and none of them is entirely satisfying.
The Country Doctor