Guest guest Posted May 16, 2004 Report Share Posted May 16, 2004 We don’t reserve slots for anything – they are all available at any time – pt gets to choose their appt time/date. We still have a lot of people who like to book their appt in advance – sometimes weeks in advance. Yes, we sometimes have to see someone at the end of the day, but that is for acute stuff, not follow-ups. That happens maybe once a month. I’ve met someone at the office once when I was not planning on being there to avoid an ER visit – once in 9 months. A. Eads, M.D. Pinnacle Family Medicine, PLLC phone fax P.O. Box 7275 Woodland Park, CO 80863 Open Access How is everyone doing with open access. What percentage of your day do you schedule for physicals and follow ups? I was guessing 30-40%. Do you try to schedule these in the morning as much as possible? Do you ever have days that end up significantly overbooked with follow ups? THanks, Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 21, 2004 Report Share Posted August 21, 2004 Open access is founded on matching capacity to demand. In the scenario you describe below, it is only a matter of time before your practice will start to look like the kind you've been trying to avoid. There are a number of variables you can (and ultimately MUST) control to make this work: 1: Don't take on too many patients. If you see that the schedule starts getting booked with more patients per week (or your " average visits per week " ) than you are comfortable seeing, you've reached the point of closing to new patients. Believe me, it is ALWAYS easier to accept patients in spite of being closed than it is to manage a practice with too many patients. They will come, don't worry about people wanting you as a doc. 2: Don't take on work that you can avoid. " Dr. Scaggs, can you call me when your schedule opens up in four months? Can you put me on a list of folks who would like an appointment with you for April of 2005? " I turn this around. " I'd be delighted to see you in April of '05. Give me a call and I'll offer to see you that same day. If that day doesn't work for you, well, why don't you call me on a day that is convenient? " The onus is on folks calling you, not on you keeping track. 3: Don't lose track of folks who need care We have a legitimate burden of not dropping the ball for those who need care in the future (planned care for well child check, OB re-check, chronic disease, etc). Don't use the schedule as a tickler system. Rather, use a registry for those with chronic disease. Registries allow you to manage chronic disease in a population and track critical process and outcome metrics. For instance, we run a list each month for those who have not come in or called and are due to have something checked on their chronic disease. Example: We run our chronic disease list and find that Mr. S is due for lipid testing. We then contact Mr. S and suggest it is time to check lipids. Open access works 'cause I have appointment availability. It is not all that complex one you understand how it works, but it is remarkably counterintuitive for any who have practiced in the past. I recommend the following link to learn more: http://ihi.org/IHI/Topics/OfficePractices/Access/ Don't just add more hours or you'll find yourself working too hard. Do add hours if you're doing it only as a temporary measure to reduce backlog. If you have backlog, you should close to new patients. Gordon At 01:01 PM 8/21/2004, you wrote: Thanks for the open access article Gordon. I like to hear that it is working for you. I have been trying to do open access since I started 2 years ago. Many patients are thrilled when we say " can you get here in 20 minutes? " or " We're booked, but that shouldn't wait, so I'll stay late to get you in today. " The issue that has suprised me is how many people don't want to come today. Fully 2/3 to 3/4 of the patients I see prefer to schedule in advance. Some of them want to schedule 6 to 12 monts ahead. So far I have held the line at 3 months, but then I get the ones that want to be called as soon as the schedule opens for three months lead time. I have tried very hard to make sure people get in when they call for acute visits, so they will have confidence that they don't have to schedule a year in advance, but have met lots of resistance. As it stands now, my schedule is booked solid 3 weeks out, except for the spots I hold for " Same Day " , but now my receptionist is starting to use " Same Day " spots for tomorrow because even the sick folks who call and are told to " come now " say " I can't leave work " or for some other reason can't come the day they call. I'm beginning to think that what I should do is just let the schedule get booked, and plan on seeing the " same day " folks in the evening. If nobody can come the same day, then I get to go home early, and I still had a full schedule instead of holding those " same day " spots and have some of them never get used. Anybody with similar experience, or ideas on converting patients to the open accesss mentality? Annie Skaggs, MD KY Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 22, 2004 Report Share Posted August 22, 2004 Gordon, We are interested in your registry idea for patients with chronic disease. What are the logistics? Is it set up within Alteer or do you keep a registry database in Excel, for example? Please forgive me if you have already explained this in a previous listserve email. For followup on patients with specific one-time problems, Rian will put an "event" phonecall into the Alteer schedule (in the lunch time or before work time slots) right after he sees the patient, for 10 days out (or whatever timeframe he asked them to contact him), to call a patient if we have not heard from him/her. He puts the responsibility on them and mostly they do call him back about how they are doing but occasionally it doesn't happen and then these easy reminders in the schedule help Rian to not lose track of someone's outcome. It only takes five seconds to create the phonecall reminder in the schedule and it takes two seconds to delete it later if it's not needed. Some examples of problems where he uses the schedule in this way include: unusually severe shoulder problem, atypical chest pain, social crisis, etc. - problems where the patient doesn't want to commit to a scheduled followup appointment. a Mintek for Rian Mintek, M.D. Allegan, MI office phone: email: mintek@... Re: OPEN ACCESS Open access is founded on matching capacity to demand.In the scenario you describe below, it is only a matter of time before your practice will start to look like the kind you've been trying to avoid.There are a number of variables you can (and ultimately MUST) control to make this work:1: Don't take on too many patients.If you see that the schedule starts getting booked with more patients per week (or your "average visits per week") than you are comfortable seeing, you've reached the point of closing to new patients. Believe me, it is ALWAYS easier to accept patients in spite of being closed than it is to manage a practice with too many patients. They will come, don't worry about people wanting you as a doc.2: Don't take on work that you can avoid."Dr. Scaggs, can you call me when your schedule opens up in four months? Can you put me on a list of folks who would like an appointment with you for April of 2005?"I turn this around. "I'd be delighted to see you in April of '05. Give me a call and I'll offer to see you that same day. If that day doesn't work for you, well, why don't you call me on a day that is convenient?"The onus is on folks calling you, not on you keeping track.3: Don't lose track of folks who need careWe have a legitimate burden of not dropping the ball for those who need care in the future (planned care for well child check, OB re-check, chronic disease, etc).Don't use the schedule as a tickler system.Rather, use a registry for those with chronic disease. Registries allow you to manage chronic disease in a population and track critical process and outcome metrics. For instance, we run a list each month for those who have not come in or called and are due to have something checked on their chronic disease. Example: We run our chronic disease list and find that Mr. S is due for lipid testing. We then contact Mr. S and suggest it is time to check lipids.Open access works 'cause I have appointment availability.It is not all that complex one you understand how it works, but it is remarkably counterintuitive for any who have practiced in the past.I recommend the following link to learn more:http://ihi.org/IHI/Topics/OfficePractices/Access/Don't just add more hours or you'll find yourself working too hard. Do add hours if you're doing it only as a temporary measure to reduce backlog. If you have backlog, you should close to new patients.GordonAt 01:01 PM 8/21/2004, you wrote: Thanks for the open access article Gordon. I like to hear that it is working for you.I have been trying to do open access since I started 2 years ago. Many patients are thrilled when we say "can you get here in 20 minutes?" or "We're booked, but that shouldn't wait, so I'll stay late to get you in today." The issue that has suprised me is how many people don't want to come today. Fully 2/3 to 3/4 of the patients I see prefer to schedule in advance. Some of them want to schedule 6 to 12 monts ahead. So far I have held the line at 3 months, but then I get the ones that want to be called as soon as the schedule opens for three months lead time. I have tried very hard to make sure people get in when they call for acute visits, so they will have confidence that they don't have to schedule a year in advance, but have met lots of resistance. As it stands now, my schedule is booked solid 3 weeks out, except for the spots I hold for "Same Day", but now my receptionist is starting to use "Same Day" spots for tomorrow because even the sick folks who call and are told to "come now" say "I can't leave work" or for some other reason can't come the day they call. I'm beginning to think that what I should do is just let the schedule get booked, and plan on seeing the "same day" folks in the evening. If nobody can come the same day, then I get to go home early, and I still had a full schedule instead of holding those "same day" spots and have some of them never get used. Anybody with similar experience, or ideas on converting patients to the open accesss mentality?Annie Skaggs, MDKY Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 22, 2004 Report Share Posted August 22, 2004 a, We looked at Docsite which I am sure Gordon will explain. It looked good, but was just too difficult for us to ever get it set up and it requires double entry. Although this is my last week with Alteer, we did have a work around that served us. We created a ficticious doctor named reminders. Reminders has its own schedule. We book a reminder phone call a week or two before lipids or A1C or whatever is due. We check the reminder calender daily and call. We let the patient know that they are due to come in for whatever reason. They still pick date/time according to open access, but we remind them when it is coming up. AbbyMintek Family wrote: Gordon, We are interested in your registry idea for patients with chronic disease. What are the logistics? Is it set up within Alteer or do you keep a registry database in Excel, for example? Please forgive me if you have already explained this in a previous listserve email. For followup on patients with specific one-time problems, Rian will put an "event" phonecall into the Alteer schedule (in the lunch time or before work time slots) right after he sees the patient, for 10 days out (or whatever timeframe he asked them to contact him), to call a patient if we have not heard from him/her. He puts the responsibility on them and mostly they do call him back about how they are doing but occasionally it doesn't happen and then these easy reminders in the schedule help Rian to not lose track of someone's outcome. It only takes five seconds to create the phonecall reminder in the schedule and it takes two seconds to delete it later if it's not needed. Some examples of problems where he uses the schedule in this way include: unusually severe shoulder problem, atypical chest pain, social crisis, etc. - problems where the patient doesn't want to commit to a scheduled followup appointment. a Mintek for Rian Mintek, M.D. Allegan, MI office phone: email: mintek@... Re: OPEN ACCESS Open access is founded on matching capacity to demand.In the scenario you describe below, it is only a matter of time before your practice will start to look like the kind you've been trying to avoid.There are a number of variables you can (and ultimately MUST) control to make this work:1: Don't take on too many patients.If you see that the schedule starts getting booked with more patients per week (or your "average visits per week") than you are comfortable seeing, you've reached the point of closing to new patients. Believe me, it is ALWAYS easier to accept patients in spite of being closed than it is to manage a practice with too many patients. They will come, don't worry about people wanting you as a doc.2: Don't take on work that you can avoid."Dr. Scaggs, can you call me when your schedule opens up in four months? Can you put me on a list of folks who would like an appointment with you for April of 2005?"I turn this around. "I'd be delighted to see you in April of '05. Give me a call and I'll offer to see you that same day. If that day doesn't work for you, well, why don't you call me on a day that is convenient?"The onus is on folks calling you, not on you keeping track.3: Don't lose track of folks who need careWe have a legitimate burden of not dropping the ball for those who need care in the future (planned care for well child check, OB re-check, chronic disease, etc).Don't use the schedule as a tickler system.Rather, use a registry for those with chronic disease. Registries allow you to manage chronic disease in a population and track critical process and outcome metrics. For instance, we run a list each month for those who have not come in or called and are due to have something checked on their chronic disease. Example: We run our chronic disease list and find that Mr. S is due for lipid testing. We then contact Mr. S and suggest it is time to check lipids.Open access works 'cause I have appointment availability.It is not all that complex one you understand how it works, but it is remarkably counterintuitive for any who have practiced in the past.I recommend the following link to learn more:http://ihi.org/IHI/Topics/OfficePractices/Access/Don't just add more hours or you'll find yourself working too hard. Do add hours if you're doing it only as a temporary measure to reduce backlog. If you have backlog, you should close to new patients.GordonAt 01:01 PM 8/21/2004, you wrote: Thanks for the open access article Gordon. I like to hear that it is working for you.I have been trying to do open access since I started 2 years ago. Many patients are thrilled when we say "can you get here in 20 minutes?" or "We're booked, but that shouldn't wait, so I'll stay late to get you in today." The issue that has suprised me is how many people don't want to come today. Fully 2/3 to 3/4 of the patients I see prefer to schedule in advance. Some of them want to schedule 6 to 12 monts ahead. So far I have held the line at 3 months, but then I get the ones that want to be called as soon as the schedule opens for three months lead time. I have tried very hard to make sure people get in when they call for acute visits, so they will have confidence that they don't have to schedule a year in advance, but have met lots of resistance. As it stands now, my schedule is booked solid 3 weeks out, except for the spots I hold for "Same Day", but now my receptionist is starting to use "Same Day" spots for tomorrow because even the sick folks who call and are told to "come now" say "I can't leave work" or for some other reason can't come the day they call. I'm beginning to think that what I should do is just let the schedule get booked, and plan on seeing the "same day" folks in the evening. If nobody can come the same day, then I get to go home early, and I still had a full schedule instead of holding those "same day" spots and have some of them never get used. Anybody with similar experience, or ideas on converting patients to the open accesss mentality?Annie Skaggs, MDKY Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.