See more patients with same day appointments

No one knows for certain what the future holds for American medicine. With cutbacks again on the horizon, we do know that reimbursements are going to decrease in the near future resulting in a decrease in income.   An effective way to maintain our incomes is to increase the volume of patients seen but also to increase the income per patient that is seen in our offices.  One of the best ways to accomplish both goals is to see more new patients.  We all know that seeing a patient in the 90 day global period is not as productive as seeing a new patient who is likely to need a work up, evaluation, and perhaps a surgical procedure.  Remember there is no income generated by suture removal.  I will discuss the same day appointment (SDA) process and how to consider implementing this in your practice.

Why are same day appointments important?

SDA is what our patients want.  Even a urologic patient with asymptomatic microhematuria experiences anxiety about their condition and wants to be seen as soon as possible.  Most patients do not wish to wait weeks or months for an appointment regardless of the fame and reputation of the doctor.  Let us not forget  that doctors are in a service industry and it behooves us to cater to our patients’ needs. If we are honest with ourselves, doctors who have long waiting times from weeks to months to see a new patient are merely stoking their egos.  However, this philosophy and this practice of making patients wait to receive an appointment will not enhance patient satisfaction nor improve a practice’s performance.  Patient satisfaction is vital in order to build and maintain a successful practice.  You can be the most talented robotic surgeon and have a reputation for doing a radical prostatectomy in less than one hour with perfect continence, cancer control, and erectile preservation, but if your patients are not satisfied with your care before and after their surgery you may find large gaps and openings in your schedule and a decrease in the number of surgical procedures you perform.

I see 35-40 patients per day, which may include 8-12 new patients and 2-3 are patients who call for SDA.  If you want to have a SDA strategy, you must have a sufficient number of the staffers with the right attitudes while providing them with the appropriate tools to do their job and accomplish their goals.   However, a robust staff allows me to accommodate SDA in addition to seeing follow-up appointments and performing office procedures.  I have motivated my employees to know that accommodating SDA is expected and I am willing to provide them with adequate staff, tools and incentives to see the extra patients.

SDA requires the proper attitude, which includes a positive, can-do spirit by the doctor.  It starts at the top, with the doctor.  It begins with the doctor arriving and ready to see patients on time.  If the patients are to be seen at 9:00, that means patients are placed in the room and the doctor is ready to begin seeing patients at 9:00 and not 9:15 or later.  If the doctor is late, you can be sure that the day will contain significant delays and the ability to accommodate SDA will not be possible. I try to anticipate how many additional slots my practice will need by leaving openings to accommodate new patients.  This takes minimal analysis of patient appointment demand patterns.  For example, I leaves 2-3 additional slots on Monday afternoons as I know that a few patients seen in the ER will likely be calling Monday morning for follow up appointments.

What are the advantages of SDA?

First of all there is marked improvement in patient satisfaction when new patients or existing patients with urgencies and emergencies are seen the day that they call for an appointment.  I have surveyed my patients and one of the comments frequently made by his patients is how much they appreciate same day access to urologic care.   When a patient calls with a request for an appointment and can be seen the same day, they invariably keep the appointment.  Compared to patients who call and request an appointment that is weeks or months in the future will frequently be a no-show leaving costly gaps in your schedule. SDA creates positive word-of-mouth marketing buzz about your practice.  You will attract more patients to your practice if you have a reputation of providing timely access to care.  Finally, you can anticipate increased productivity and revenue when you grow your practice by offering SDA.

Increasing the number of new patients seen each day is process that can be accomplished by nearly all physicians. By offering SDA you will significantly enhance patient satisfaction.  SDA offer you a tactical and strategic advantage and will make you more productive, more efficient, and ultimately a happier doctor.

Neil Baum is a urologist at Touro Infirmary and author of Marketing Your Clinical Practices: Ethically, Effectively, Economically. He can be reached at his self-titled site, Neil Baum, MDor on Facebook and Twitter.

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  • Anonymous

    35-40 patients daily?  Sorry, I’m in adult medicine and 22 is the max as I see patients with at least 5 health issues, if not more, at each visit.  If I could limit patients to one problem, my patient satisfaction would drop for sure.  One size does not fit all.

  • Anonymous

    Primary care SDAs are great in theory, tough in practice.  The main problem is that physicians and nurse practitioners are actually human beings, with absurd but nonetheless real needs such as sleep, food, rest, bathroom breaks, pleasant human interactions, and so on. Pathetic, I know, but there it is.  
    In my little world, if I had a complete open door policy, my income would go up some and my life would be in ruins.  I suspect other docs might have similar thoughts.  We can’t solve the primary care shortage on our own, but we could kill ourselves trying.

    • Anonymous

      “but we could kill ourselves trying”

      There you go pushing the PCMH again!

  • http://twitter.com/livewellthy Stewart Segal

    I have had an open door policy for 28 years.  It works well in primary care but takes some getting used to.  It also means that you have to triage patient complaints, handling the 2-3 most important complaints today and have the patient come back for 4th – 10th complaints.  On busy dasy, patients will complain that they waited 1 – 1 1/2 hours.  I point out that 1 1/2 hour is better then waiting a day.

    • Anonymous

      Watch out.  You may start having patients charge you for being behind.