Staff Management

Compressed Doctor Schedule=Improved Profitability

By Gina Wesley, OD, MS, FAAO

Compress your schedule to put you and your staff in “patient exam mode” for shorter, more profitable periods of time.

To beaprofitablepracticeintoday’s managed care environment, an OD must work with the entire practice staff to manage time and tasks. Effectively managing your schedule is one of the most important tasks a practice needs to stay on top of. If you are inefficiently seeing patients, you are not managing the most productive revenue-generator of the staff: the doctor. If you assume average revenues of $300 per patient, and you can delegate to your staff and find a way to see two more patients per doctor day, that can add up to $12,000 per month assuming a five-doctor day per week schedule, according to Essilor and Alcon-sponsored Management and Business Academy research.

Compress Versus Uncompressed Schedule

Uncompressed

Patient Exam
Every 30 minutes

Average Revenue per Exam
$300

8 Hours/Day, 5 Days/Week, 50 Weeks per Year
4,000 exams annually

= $1.2 million annually

Compressed

Patient Exam
Every 20 minutes

Average Fee
$300

8 Hours/Day, 5 Days/Week, 50 Weeks per Year
6,000 exams annually

=$1.8 million

The key to using time well is to compress the doctor/patient schedule. Compressing your schedule means limiting the time you are in the office, but making that time more productive by seeing a greater number of patients in those fewer hours than you currently see every week. You can do that by delegating tasks such as contact lens training and other patient education such as discussion of pre-testing results, and also, by training staff to focus solely on patients, rather than administrative tasks, during the hours when the doctor is in. The hours when you as doctor are not in the office can be spent on administrative work such as billing and coding, payroll and correspondence with frame and contact lens vendors.

Compress Doctor Schedule
I recently opened a second office, and in my newer office I see patientstwo and ahalf to three days per week. During those times, we are very busy with patient flow, but it’s much more effective for my staff to be in “patient mode” with all of our office processes than to see patients over a spread-out schedule. Because my time in the office is compressed, my staff and I are forced to get down to serving patients rather than going back and forth between seeing patients and doing administrative tasks. My staff knows that when I am in the office our priority is seeing and interacting with patients. They can do administrative work when I am not present.

Bouncing back and forth between my exam lanes is a much better use of my time than seeing a patient, going back to my office to work on office administration, then seeing another patient 20 minutes later. Compressing my schedule has actually increased my production per patient because my staff and I are solely focused on patient care during that time.

Analyze Schedule Efficiency Gaps
The first step to improving schedule management is to sit down and examine your office schedule to see where efficiencies can be boosted. To do this, we relied on the practice management scheduler that comeswith our electronic health record system. If you do not have an EHR system, your practice management software may have a practice management scheduler. These automated systems automatically update your electronic books whenever an appointment is made and can allow you to enter in the number of hours you plan to devote to patient visits and then allow you to book only the number of appointments that fill that set number of hours.

ThreeSteps to Compress Your Schedule

Compress.Compress your schedule into fewer days and hours if you can. Having the office staff and yourself in “patient mode” versus scattered scheduling will make everyone more efficient. Use the now free time to market and manage your practice.

Evaluate.Ask for patient feedback with post-visit surveys. If you don’t ask you won’t know how many patients feel rushed, or conversely, feel like their appointments are dragging. This information will guide you in creating schedules that improve patient experience.

Reviseand improve. Schedule management is dynamic. I’ve changed how I schedule and see patients several times in the four years my practice has been open. It’s important to review to see what is most efficient.

Hire a Technician
Secondly, in my practice, I greatly improved my efficiencies by hiring a technician who could do all of the initial tests, data gathering and data input that I had been handling before. While I was seeing one patient, she was testing the next patient, saving me at least 10 to 15 minutes per patient. This has allowed me to add several patients per doctor day. Again, because I only see patientstwo and ahalf to threedays per week, I was able to maintain that schedule while still growing my practice because of improved schedule management. At the time I hired the technician, I also needed her to assist in the optical and help manage my contact lens research, so non-doctor days were still busy for her. I encourage offices to look at all the areas of delegation you could potentially fit that new employee into. The increase in office revenues will far justify the costs of hiring and training.

As I continue to grow my practice, I look forward to potential refraction delegation with the purchase of additional equipment that will allow me to do so. I also hope to add more associate doctor time once my regular patient days fill up.

Improved Doctor Schedules = Improved Patient Experience
We regularly receive patient feedback that our customer service is very good, and that they find all interactions with staff to be positive. I received more of these comments once I started delegating more efficiently and managing our schedule differently. I believe that having more employees allows staff to spend more time with each patient, instead of feeling rushed. Ironically, this hasn’t increased the time patients spend in our office, but it changes the perception for the patient in that they feel they were well taken care of. Additionally, patients like to see other patients in your office and see that you are busy and successful. By compressing my schedule, I have done just that, all the while not compromising the care provided.

Gina M. Wesley, OD, MS, FAAO, is the owner of Complete Eye Care of Medina in Medina, Minn. To contact her: drwesley@cecofmedina.com

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