Fact Check: Running On Time Is Not Important

In the second part of a series looking at common practice management claims made by physicians, I will examine the importance of time management. 

Claim #2: It doesn’t matter if we start late. We always finish by the end of the day.

Patient wait times are more costly than one thinks and the ability to merely finish by day’s end is no measure of success. While you may disregard complaints thinking, “patients expect to wait,” routinely doing so is entirely unnecessary and preventable. Patients know this. To ignore the problem or make excuses is not in the best interest of the practice. It pays to be mindful of the changing health care landscape. Insurance companies now rely on customer service surveys to determine whether a doctor should remain on their plan and on-time schedules are a factor. 

If you think patients do not mind, they do. Vitals, a company that provides a platform for selecting affordable health care options for consumer, released a report in March 2018 based on a patient survey of 675 online respondents.¹ The survey reveals:

• One in five patients switched doctors because of long wait times.
• Thirty percent of patients left a doctor appointment because of a long wait.
• Eighty-four percent of people believe that wait time is either “somewhat important” or “very important” to the overall patient experience at a doctor’s office.

If you do not need one in five patients oryou are okay with patients leaving before being seen for their appointments, running behind is not an issue. Yet, if those are not enough reasons to keep to a schedule, negative patient reviews are worth considering, especially in this age of quickly disseminating social media. (Would you dine at a restaurant that received only one star and a boatload of nasty comments?) Furthermore, if you are constantly running late, it likely affects not only you but staff, payroll, family, and stress levels across the board.

How does one address the issue of running late? Do not underestimate your staff. They are on the front lines and can observe where many problems originate. In addition, they get an earful of patient complaints regularly. 

Here are some comments that I hear often from office staff at podiatry offices. 

• The doctor insists we schedule patients every 15 minutes regardless of the patient's condition but thinks nothing of spending 30 minutes or more per patient visit.
• The doctor arrives late in the morning, anywhere from 10 to 20 minutes after the first patient is scheduled. Boom! We’re already behind schedule.
• When the reception room starts backing up, the patients start comparing appointment times and complain that several were scheduled at the same time.
• It doesn’t seem to matter that we work through our lunch hour. We still always finish our work day an hour or more later than planned.
• The patients are angry and blame the staff for overbooking patients, but they say nothingto the doctor!
• We do not have authorization to properly manage the schedule. When the schedule backs up, it is stressful and makes us look incompetent.
• When we are clearly running behind, we advise the doctor, but he or she insists there is nothing he or she can do to move things along (and blames improper scheduling).
• When we try to discuss it with the doctor, the response is, “Patients never complain to me about waiting. They know I am worth waiting for!” 

If your office is among those that make it a point to stay on schedule, hats off to you! If, however, you recognize any of the aforementioned symptoms of schedule neglect, there are things you can do to improve. A bunion, hammertoe or plantar fasciitis is fixed, in part, with patient adherence, right? Certainly, you can fix your schedule. 

It is not always one single thing that causes a schedule to explode. I can share at least two dozen fixes. (E-mail me at lynn@soshms.comfor a copy of “A Working Schedule: Strategies that manage patient flow and help you stay on time.”)

 To jump-start this discussion, let us focus on these three items.

1. Arrive on time! In my experience, a doctor’s late arrival is the number one reason that a day runs behind schedule. Arriving on time means 15 minutes before the first patient to allow for preparation.If 15 minutes is good, 30 minutes is twice as good. Review the schedule with staff, plan the day, grab a cup of coffee, sign paperwork, make phone calls, read e-mails and, most importantly, see your first patient on time! My motto is, “If you can’t be on time, be early.”
2. Create a time-aligned schedule. In other words, assign an estimated amount of time it takes to treat your top 10 conditions. For example, maybe a heel pain patient takes you 45 minutes, and treatment for an ingrown nail takes 30 minutes, etc. Write them down! It is a flexible and ongoing exercise. It may not be exact at first but is still better than winging it, and gives the staff a leg up on how toproperlyplace patients in the schedule. The key word in this statement is “properly.”
3. It is not feasible (from a timely schedule standpoint) to treat secondary, complicated patient complaints that are not scheduled. Unless you have a block of time to spare, hear their concern, assess the urgency, offer temporary relief and reschedule the patient for comprehensive evaluation and treatment.

Ms. Homisak is the President of SOS Healthcare Management Solutions, based in Federal Way, WA.

Reference

1. Finnegan J. Report outlines the business perils of long patient wait times. Fierce Health Care.com. Available at:  https://www.fiercehealthcare.com/practices/ppatients-switched-doctors-long-wait-times-vitals. Published March 22, 2018. Accessed June 10, 2019.