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Don't keep your patients waiting.

Consumer Reports surveyed its readers last year regarding their satisfaction with their medical care and found that the "overwhelming majority ... were highly satisfied with their doctors." Of course, they did have some complaints.

As you might expect, their top complaint was the time spent waiting to see their doctors--24% said they frequently waited 30 minutes or longer. Here are some suggestions to help keep you on track:

* Start on time. That seems obvious, but I'm always amazed at the number of doctors who admit to running late who also admit that they start late. If you're in the hole before you start, you can seldom dig yourself out. Sometimes an on-time start is the solution to the entire problem. Try it.

* Book realistically. Everyone works at a different pace. Determine the number of patients you can comfortably see in an hour, and book only that number. If you want to see more patients, the solution is working longer hours or hiring physicians or physician extenders (or both), not overloading your schedule.

* Time-stamp each chart. Every office should have a time clock, not only for employees, but for patients as well. As each patient arrives, have your receptionist timestamp the "encounter form" that goes to the back with the chart. As you take each chart off the door and enter the room, a quick glance at the time stamp will tell you how long the patient has been waiting.

* Schedule all procedures. If you haven't scheduled the time necessary for a procedure, don't do it. It may be tempting to squeeze it in because you feel guilty that the patient has had to wait for you, but every unscheduled procedure puts you that much further behind. And hurrying increases the risk of mistakes. Tell the patient the procedure requires extra time and can't be rushed, so you will have to schedule.

* Work-ins come last, not first. Patients with urgent problems should be seen after scheduled patients. Receptionists often assume it's better to squeeze them in early, while you're still running on time, but doing that guarantees you will run late, and it isn't fair to patients who have appointments and expect to be seen promptly Work-ins expect a wait because they have no appointment. We tell them our schedule is full, but if they come at the end of hours, they'll see a doctor though they may have a wait. Far from complaining, they invariably thank us for seeing them.

* Seize the list. You know which list I mean: "No. 16: My right big toe itches. No. 17: I think I feel something on my back ..." When a list is produced, the best option is to read it yourself. Identify the most important two or three problems and address them. For the rest, I will say, "This group of problems deserves a visit of its own, and we will schedule that visit." Ask if you can place the list (or a photocopy) in the patient's chart. It is, after all, important clinical information. All of these problems are important to the patient and should be addressed--but on your schedule, not the patient's.

* Avoid interruptions. Especially phone calls. Unless it's an emergency or an immediate family member, my receptionists say, "I'm sorry, the doctor is with patients. May I take a message?" Everyone--even other physicians--understands. Just be sure to return those calls promptly.

Pharmaceutical reps should not be allowed to interrupt you, either. Have them make an appointment. Don't stop to open the mail, do paperwork, or perform any other task that can be delegated.

There will be times, of course, when you run late, but they should be the exception rather than the rule.

Incidentally, the other leading patient complaints in the Consumer Reports survey were: couldn't schedule an appointment within a week (19%), spent too little time with me (9%), didn't provide test results promptly (7%), and didn't respond to my phone calls promptly (6%).

Now would be an excellent opportunity to identify and address any of those problems as well.


DR. EASTERN practices dermatology and dermatologic surgery in Belleville, N.J.
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Title Annotation:The Office
Author:Eastern, Joseph S.
Publication:Family Practice News
Geographic Code:1USA
Date:Dec 15, 2008
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