RE: appointment scheduling

From: [mailto: ] On Behalf Of

Sent: Wednesday, December 22, 2010

10:17 AM

To:

Subject: Re:

appointment scheduling

oh god no They always say it will just take 5minutes.

no no no

On Wed, Dec 22, 2010 at 9:24 AM,

wrote:

Also- the rules about making all the appointments the same length is very

helpful.

I believe asking the patient how much time they

require also works - some evidence somewhere ....

--

Graham Chiu

Synapse - the use from anywhere EMR.

--

PATIENTS-please remember that email may not be entirely secure, and that

Email is part of the medical record and is placed into your chart (

be careful what you say!)

Email is best used for appointment making and brief questions

Email replies can be expected within 24 hours-Please CALL if the

matter is more urgent .

MD

115 Mt Blue

Circle

Farmington

ME 04938

ph fax

impcenter.org

December 23, 2010

Agreed….the most long-winded patients

always are the ones over the phone who say “it will only take a few minutes of

the doctor’s time” and then they’re here for 30+ minutes J

Pratt

Office Manager

Oak Tree Internal Medicine P.C

From: [mailto: ] On Behalf Of

Sent: Wednesday, December 22, 2010

10:17 AM

To:

Subject: Re:

appointment scheduling

oh god no They always say it will just take 5minutes.

no no no

On Wed, Dec 22, 2010 at 9:24 AM,

wrote:

Also- the rules about making all the appointments the same length is very

helpful.

I believe asking the patient how much time they

require also works - some evidence somewhere ....

--

Graham Chiu

Synapse - the use from anywhere EMR.

--

PATIENTS-please remember that email may not be entirely secure, and that

Email is part of the medical record and is placed into your chart (

be careful what you say!)

Email is best used for appointment making and brief questions

Email replies can be expected within 24 hours-Please CALL if the

matter is more urgent .

MD

115 Mt Blue

Circle

Farmington

ME 04938

ph fax

impcenter.org

December 23, 2010

Agreed….the most long-winded patients

always are the ones over the phone who say “it will only take a few minutes of

the doctor’s time” and then they’re here for 30+ minutes J

Pratt

Office Manager

Oak Tree Internal Medicine P.C

From: [mailto: ] On Behalf Of

Sent: Wednesday, December 22, 2010

10:17 AM

To:

Subject: Re:

appointment scheduling

oh god no They always say it will just take 5minutes.

no no no

On Wed, Dec 22, 2010 at 9:24 AM,

wrote:

Also- the rules about making all the appointments the same length is very

helpful.

I believe asking the patient how much time they

require also works - some evidence somewhere ....

--

Graham Chiu

Synapse - the use from anywhere EMR.

--

PATIENTS-please remember that email may not be entirely secure, and that

Email is part of the medical record and is placed into your chart (

be careful what you say!)

Email is best used for appointment making and brief questions

Email replies can be expected within 24 hours-Please CALL if the

matter is more urgent .

MD

115 Mt Blue

Circle

Farmington

ME 04938

ph fax

impcenter.org

December 23, 2010

your times up

Agreed….the most long-winded patients

always are the ones over the phone who say “it will only take a few minutes of

the doctor’s time” and then they’re here for 30+ minutes J

Pratt

Office Manager

Oak Tree Internal Medicine P.C

From: [mailto: ] On Behalf Of

Sent: Wednesday, December 22, 2010

10:17 AM

To:

Subject: Re:

appointment scheduling

oh god no They always say it will just take 5minutes.

no no no

On Wed, Dec 22, 2010 at 9:24 AM,

wrote:

Also- the rules about making all the appointments the same length is very

helpful.

I believe asking the patient how much time they

require also works - some evidence somewhere ....

--

Graham Chiu

Synapse - the use from anywhere EMR.

--

PATIENTS-please remember that email may not be entirely secure, and that

Email is part of the medical record and is placed into your chart (

be careful what you say!)

Email is best used for appointment making and brief questions

Email replies can be expected within 24 hours-Please CALL if the

matter is more urgent .

MD

115 Mt Blue

Circle

Farmington

ME 04938

ph fax

impcenter.org

-- Graham Chiuhttp://www.compkarori.co.nz:8090/Synapse - the use from anywhere EMR.

December 23, 2010

your times up

Agreed….the most long-winded patients

always are the ones over the phone who say “it will only take a few minutes of

the doctor’s time” and then they’re here for 30+ minutes J

Pratt

Office Manager

Oak Tree Internal Medicine P.C

From: [mailto: ] On Behalf Of

Sent: Wednesday, December 22, 2010

10:17 AM

To:

Subject: Re:

appointment scheduling

oh god no They always say it will just take 5minutes.

no no no

On Wed, Dec 22, 2010 at 9:24 AM,

wrote:

Also- the rules about making all the appointments the same length is very

helpful.

I believe asking the patient how much time they

require also works - some evidence somewhere ....

--

Graham Chiu

Synapse - the use from anywhere EMR.

--

PATIENTS-please remember that email may not be entirely secure, and that

Email is part of the medical record and is placed into your chart (

be careful what you say!)

Email is best used for appointment making and brief questions

Email replies can be expected within 24 hours-Please CALL if the

matter is more urgent .

MD

115 Mt Blue

Circle

Farmington

ME 04938

ph fax

impcenter.org

-- Graham Chiuhttp://www.compkarori.co.nz:8090/Synapse - the use from anywhere EMR.

December 23, 2010

your times up

Agreed….the most long-winded patients

always are the ones over the phone who say “it will only take a few minutes of

the doctor’s time” and then they’re here for 30+ minutes J

Pratt

Office Manager

Oak Tree Internal Medicine P.C

From: [mailto: ] On Behalf Of

Sent: Wednesday, December 22, 2010

10:17 AM

To:

Subject: Re:

appointment scheduling

oh god no They always say it will just take 5minutes.

no no no

On Wed, Dec 22, 2010 at 9:24 AM,

wrote:

Also- the rules about making all the appointments the same length is very

helpful.

I believe asking the patient how much time they

require also works - some evidence somewhere ....

--

Graham Chiu

Synapse - the use from anywhere EMR.

--

PATIENTS-please remember that email may not be entirely secure, and that

Email is part of the medical record and is placed into your chart (

be careful what you say!)

Email is best used for appointment making and brief questions

Email replies can be expected within 24 hours-Please CALL if the

matter is more urgent .

MD

115 Mt Blue

Circle

Farmington

ME 04938

ph fax

impcenter.org

-- Graham Chiuhttp://www.compkarori.co.nz:8090/Synapse - the use from anywhere EMR.

December 23, 2010

I think there are times when being too " patient centered " can become

detrimental:

1) to your own health and family time/commitments (what to do when already

fully booked, need to leave " ON TIME " to pick up kids or be at their

Christmas concerts and patients walk in, asking for same day apts... Pts.

who fail to come in for over one year, despite multiple reminders, by phone,

e-mail and snail mail!)

2) to patient's ability to become " self-managed " . If we send multiple

reminders, it seems to enable a " dependence " on the practice, and encouraged

patients to demand MORE of our time so they have to plan LESS around their

medical needs...

When the provider begins to feel like a " doormat " , my opinion is that is too

" patient-centered " !!!

R

Ramona G. Seidel, MD

www.roscoevillagefamilymedicine.com<http://www.roscoevillagefamilymedicine.c

Arnold, MD

410 518-9808

Re: appointment scheduling

I am a firm believer in empowering your staff so I would first start with a

staff meeting to problem solve. Always consider if you are the problem and

not the staff.

We have totally simplified our schedule and make no distinction between

" miscellaneous things and truly sick patients " . All our appointments are the

same length. I figure that some patients will be quick and some will be

longer and it will average out. It is often impossible to know from a phone

call how much time a person will take. A " check up " can be a ppd placement

or a major illness. I don't want my staff asking anyone why they are coming

in but rather when they want to come in.

You can block certain times for same day appointments that open up the

night before to help you with same day appointments. On Mondays more than

half our appointments are blocked until Friday night. If you can't see every

patient the same day they call on more than 1 day a week then you probably

have too many patients for your situation

Larry Lindeman MD

Roscoe Village Family Medicine

2255 W. Roscoe

Chicago, Illinois 60618

om/>

We are a family practice with one provider and our patient flow never seems

to go smoothly. I have tried different strategies but it seems we always end

up with too many appointments for miscellanous things, such as back aches,

depression ect.. to the exclusion of truly sick patients and an overloaded

afternoon schedule. I do not seem to be able to get the front office to

understand how things should flow. Any ideas on how to make them understand

just how important scheduling is?

Scheduling continues to be a problem for our office. Any suggestions?

--

PATIENTS-please remember that email may not be entirely secure, and that

Email is part of the medical record and is placed into your chart ( be

careful what you say!) Email is best used for appointment making and brief

questions Email replies can be expected within 24 hours-Please CALL if the

matter is more urgent .

MD

ph fax

impcenter.org<http://impcenter.org/>

------------------------------------

December 23, 2010

I think there are times when being too " patient centered " can become

detrimental:

1) to your own health and family time/commitments (what to do when already

fully booked, need to leave " ON TIME " to pick up kids or be at their

Christmas concerts and patients walk in, asking for same day apts... Pts.

who fail to come in for over one year, despite multiple reminders, by phone,

e-mail and snail mail!)

2) to patient's ability to become " self-managed " . If we send multiple

reminders, it seems to enable a " dependence " on the practice, and encouraged

patients to demand MORE of our time so they have to plan LESS around their

medical needs...

When the provider begins to feel like a " doormat " , my opinion is that is too

" patient-centered " !!!

R

Ramona G. Seidel, MD

www.roscoevillagefamilymedicine.com<http://www.roscoevillagefamilymedicine.c

Arnold, MD

410 518-9808

Re: appointment scheduling

I am a firm believer in empowering your staff so I would first start with a

staff meeting to problem solve. Always consider if you are the problem and

not the staff.

We have totally simplified our schedule and make no distinction between

" miscellaneous things and truly sick patients " . All our appointments are the

same length. I figure that some patients will be quick and some will be

longer and it will average out. It is often impossible to know from a phone

call how much time a person will take. A " check up " can be a ppd placement

or a major illness. I don't want my staff asking anyone why they are coming

in but rather when they want to come in.

You can block certain times for same day appointments that open up the

night before to help you with same day appointments. On Mondays more than

half our appointments are blocked until Friday night. If you can't see every

patient the same day they call on more than 1 day a week then you probably

have too many patients for your situation

Larry Lindeman MD

Roscoe Village Family Medicine

2255 W. Roscoe

Chicago, Illinois 60618

om/>

We are a family practice with one provider and our patient flow never seems

to go smoothly. I have tried different strategies but it seems we always end

up with too many appointments for miscellanous things, such as back aches,

depression ect.. to the exclusion of truly sick patients and an overloaded

afternoon schedule. I do not seem to be able to get the front office to

understand how things should flow. Any ideas on how to make them understand

just how important scheduling is?

Scheduling continues to be a problem for our office. Any suggestions?

--

PATIENTS-please remember that email may not be entirely secure, and that

Email is part of the medical record and is placed into your chart ( be

careful what you say!) Email is best used for appointment making and brief

questions Email replies can be expected within 24 hours-Please CALL if the

matter is more urgent .

MD

ph fax

impcenter.org<http://impcenter.org/>

------------------------------------

December 23, 2010

I think there are times when being too " patient centered " can become

detrimental:

1) to your own health and family time/commitments (what to do when already

fully booked, need to leave " ON TIME " to pick up kids or be at their

Christmas concerts and patients walk in, asking for same day apts... Pts.

who fail to come in for over one year, despite multiple reminders, by phone,

e-mail and snail mail!)

2) to patient's ability to become " self-managed " . If we send multiple

reminders, it seems to enable a " dependence " on the practice, and encouraged

patients to demand MORE of our time so they have to plan LESS around their

medical needs...

When the provider begins to feel like a " doormat " , my opinion is that is too

" patient-centered " !!!

R

Ramona G. Seidel, MD

www.roscoevillagefamilymedicine.com<http://www.roscoevillagefamilymedicine.c

Arnold, MD

410 518-9808

Re: appointment scheduling

I am a firm believer in empowering your staff so I would first start with a

staff meeting to problem solve. Always consider if you are the problem and

not the staff.

We have totally simplified our schedule and make no distinction between

" miscellaneous things and truly sick patients " . All our appointments are the

same length. I figure that some patients will be quick and some will be

longer and it will average out. It is often impossible to know from a phone

call how much time a person will take. A " check up " can be a ppd placement

or a major illness. I don't want my staff asking anyone why they are coming

in but rather when they want to come in.

You can block certain times for same day appointments that open up the

night before to help you with same day appointments. On Mondays more than

half our appointments are blocked until Friday night. If you can't see every

patient the same day they call on more than 1 day a week then you probably

have too many patients for your situation

Larry Lindeman MD

Roscoe Village Family Medicine

2255 W. Roscoe

Chicago, Illinois 60618

om/>

We are a family practice with one provider and our patient flow never seems

to go smoothly. I have tried different strategies but it seems we always end

up with too many appointments for miscellanous things, such as back aches,

depression ect.. to the exclusion of truly sick patients and an overloaded

afternoon schedule. I do not seem to be able to get the front office to

understand how things should flow. Any ideas on how to make them understand

just how important scheduling is?

Scheduling continues to be a problem for our office. Any suggestions?

--

PATIENTS-please remember that email may not be entirely secure, and that

Email is part of the medical record and is placed into your chart ( be

careful what you say!) Email is best used for appointment making and brief

questions Email replies can be expected within 24 hours-Please CALL if the

matter is more urgent .

MD

ph fax

impcenter.org<http://impcenter.org/>

------------------------------------

December 23, 2010

That is what they say on the phone in my practice and 30 minutes later....My appointment quest is set up with 15, 30, 45 and 60 minute appointments with some written guidelines. Overall, most patients select appropriately. I think the most common problem is someone in a big hurry who does not read the guidelines who then chooses a LONGER time. But these are patients who have been with me some time... I do think newer patients will underestimate the time (likely since they've probably never had a visit elsewhere that was longer than 15 minutes?)My appointment quest set up gives the patient total choice. If their need is urgent and all appointments are taken for the day, it directs them to email me or call and then I fit

them in- which is a rare occurrence. CarlaTo: Sent: Wed, December 22, 2010 11:16:54 AMSubject: Re: appointment scheduling

oh god no They always say it will just take 5minutes. no no no:)

Also- the rules about making all the appointments the same length is very helpful.I believe asking the patient how much time they require also works - some evidence somewhere ....

-- Graham Chiuhttp://www.compkarori.co.nz:8090/Synapse - the use from anywhere EMR.

-- PATIENTS-please remember that email may not be entirely secure, and that Email is part of the medical record and is placed into your chart ( be careful what you say!)

Email is best used for appointment making and brief questionsEmail replies can be expected within 24 hours-Please CALL if the matter is more urgent . MD

ph fax impcenter.org

December 23, 2010

That is what they say on the phone in my practice and 30 minutes later....My appointment quest is set up with 15, 30, 45 and 60 minute appointments with some written guidelines. Overall, most patients select appropriately. I think the most common problem is someone in a big hurry who does not read the guidelines who then chooses a LONGER time. But these are patients who have been with me some time... I do think newer patients will underestimate the time (likely since they've probably never had a visit elsewhere that was longer than 15 minutes?)My appointment quest set up gives the patient total choice. If their need is urgent and all appointments are taken for the day, it directs them to email me or call and then I fit

them in- which is a rare occurrence. CarlaTo: Sent: Wed, December 22, 2010 11:16:54 AMSubject: Re: appointment scheduling

oh god no They always say it will just take 5minutes. no no no:)

Also- the rules about making all the appointments the same length is very helpful.I believe asking the patient how much time they require also works - some evidence somewhere ....

-- Graham Chiuhttp://www.compkarori.co.nz:8090/Synapse - the use from anywhere EMR.

-- PATIENTS-please remember that email may not be entirely secure, and that Email is part of the medical record and is placed into your chart ( be careful what you say!)

Email is best used for appointment making and brief questionsEmail replies can be expected within 24 hours-Please CALL if the matter is more urgent . MD

ph fax impcenter.org

December 23, 2010

That is what they say on the phone in my practice and 30 minutes later....My appointment quest is set up with 15, 30, 45 and 60 minute appointments with some written guidelines. Overall, most patients select appropriately. I think the most common problem is someone in a big hurry who does not read the guidelines who then chooses a LONGER time. But these are patients who have been with me some time... I do think newer patients will underestimate the time (likely since they've probably never had a visit elsewhere that was longer than 15 minutes?)My appointment quest set up gives the patient total choice. If their need is urgent and all appointments are taken for the day, it directs them to email me or call and then I fit

them in- which is a rare occurrence. CarlaTo: Sent: Wed, December 22, 2010 11:16:54 AMSubject: Re: appointment scheduling

oh god no They always say it will just take 5minutes. no no no:)

Also- the rules about making all the appointments the same length is very helpful.I believe asking the patient how much time they require also works - some evidence somewhere ....

-- Graham Chiuhttp://www.compkarori.co.nz:8090/Synapse - the use from anywhere EMR.

-- PATIENTS-please remember that email may not be entirely secure, and that Email is part of the medical record and is placed into your chart ( be careful what you say!)

Email is best used for appointment making and brief questionsEmail replies can be expected within 24 hours-Please CALL if the matter is more urgent . MD

ph fax impcenter.org

December 23, 2010

I've really struggled with some of these issues over the years and still don't have them all figured out but I just keep chanting "boundaries" when I find myself feeling like a doormat. As Jim said, the relationship is not a one-sided responsibility- the patient has responsibility also and there are consequences when those responsibilities are not met. Rewarding some behaviors is detrimental and similar to refilling those opioids because they "lost" their prescription again. Yet being patient centered may mean that you are appropriately flexible, not rigid. The times I think I'm finding that perfect balance are quite liberating.I think this would be a great topic for Camp.CarlaTo: Sent: Thu, December 23, 2010 6:00:38 AMSubject: RE: appointment scheduling

I think there are times when being too "patient centered" can become

detrimental:

1) to your own health and family time/commitments (what to do when already

fully booked, need to leave "ON TIME" to pick up kids or be at their

Christmas concerts and patients walk in, asking for same day apts... Pts.

who fail to come in for over one year, despite multiple reminders, by phone,

e-mail and snail mail!)

2) to patient's ability to become "self-managed". If we send multiple

reminders, it seems to enable a "dependence" on the practice, and encouraged

patients to demand MORE of our time so they have to plan LESS around their

medical needs...

When the provider begins to feel like a "doormat", my opinion is that is too

"patient-centered"!!!

R

Ramona G. Seidel, MD

www.roscoevillagefamilymedicine.com<http://www.roscoevillagefamilymedicine.c

Arnold, MD

410 518-9808

Re: appointment scheduling

I am a firm believer in empowering your staff so I would first start with a

staff meeting to problem solve. Always consider if you are the problem and

not the staff.

We have totally simplified our schedule and make no distinction between

"miscellaneous things and truly sick patients". All our appointments are the

same length. I figure that some patients will be quick and some will be

longer and it will average out. It is often impossible to know from a phone

call how much time a person will take. A "check up" can be a ppd placement

or a major illness. I don't want my staff asking anyone why they are coming

in but rather when they want to come in.

You can block certain times for same day appointments that open up the

night before to help you with same day appointments. On Mondays more than

half our appointments are blocked until Friday night. If you can't see every

patient the same day they call on more than 1 day a week then you probably

have too many patients for your situation

Larry Lindeman MD

Roscoe Village Family Medicine

2255 W. Roscoe

Chicago, Illinois 60618

om/>

We are a family practice with one provider and our patient flow never seems

to go smoothly. I have tried different strategies but it seems we always end

up with too many appointments for miscellanous things, such as back aches,

depression ect.. to the exclusion of truly sick patients and an overloaded

afternoon schedule. I do not seem to be able to get the front office to

understand how things should flow. Any ideas on how to make them understand

just how important scheduling is?

Scheduling continues to be a problem for our office. Any suggestions?

--

PATIENTS-please remember that email may not be entirely secure, and that

Email is part of the medical record and is placed into your chart ( be

careful what you say!) Email is best used for appointment making and brief

questions Email replies can be expected within 24 hours-Please CALL if the

matter is more urgent .

MD

ph fax

impcenter.org<http://impcenter.org/>

------------------------------------

December 23, 2010

I've really struggled with some of these issues over the years and still don't have them all figured out but I just keep chanting "boundaries" when I find myself feeling like a doormat. As Jim said, the relationship is not a one-sided responsibility- the patient has responsibility also and there are consequences when those responsibilities are not met. Rewarding some behaviors is detrimental and similar to refilling those opioids because they "lost" their prescription again. Yet being patient centered may mean that you are appropriately flexible, not rigid. The times I think I'm finding that perfect balance are quite liberating.I think this would be a great topic for Camp.CarlaTo: Sent: Thu, December 23, 2010 6:00:38 AMSubject: RE: appointment scheduling

I think there are times when being too "patient centered" can become

detrimental:

1) to your own health and family time/commitments (what to do when already

fully booked, need to leave "ON TIME" to pick up kids or be at their

Christmas concerts and patients walk in, asking for same day apts... Pts.

who fail to come in for over one year, despite multiple reminders, by phone,

e-mail and snail mail!)

2) to patient's ability to become "self-managed". If we send multiple

reminders, it seems to enable a "dependence" on the practice, and encouraged

patients to demand MORE of our time so they have to plan LESS around their

medical needs...

When the provider begins to feel like a "doormat", my opinion is that is too

"patient-centered"!!!

R

Ramona G. Seidel, MD

www.roscoevillagefamilymedicine.com<http://www.roscoevillagefamilymedicine.c

Arnold, MD

410 518-9808

Re: appointment scheduling

I am a firm believer in empowering your staff so I would first start with a

staff meeting to problem solve. Always consider if you are the problem and

not the staff.

We have totally simplified our schedule and make no distinction between

"miscellaneous things and truly sick patients". All our appointments are the

same length. I figure that some patients will be quick and some will be

longer and it will average out. It is often impossible to know from a phone

call how much time a person will take. A "check up" can be a ppd placement

or a major illness. I don't want my staff asking anyone why they are coming

in but rather when they want to come in.

You can block certain times for same day appointments that open up the

night before to help you with same day appointments. On Mondays more than

half our appointments are blocked until Friday night. If you can't see every

patient the same day they call on more than 1 day a week then you probably

have too many patients for your situation

Larry Lindeman MD

Roscoe Village Family Medicine

2255 W. Roscoe

Chicago, Illinois 60618

om/>

We are a family practice with one provider and our patient flow never seems

to go smoothly. I have tried different strategies but it seems we always end

up with too many appointments for miscellanous things, such as back aches,

depression ect.. to the exclusion of truly sick patients and an overloaded

afternoon schedule. I do not seem to be able to get the front office to

understand how things should flow. Any ideas on how to make them understand

just how important scheduling is?

Scheduling continues to be a problem for our office. Any suggestions?

--

PATIENTS-please remember that email may not be entirely secure, and that

Email is part of the medical record and is placed into your chart ( be

careful what you say!) Email is best used for appointment making and brief

questions Email replies can be expected within 24 hours-Please CALL if the

matter is more urgent .

MD

ph fax

impcenter.org<http://impcenter.org/>

------------------------------------

December 23, 2010

I've really struggled with some of these issues over the years and still don't have them all figured out but I just keep chanting "boundaries" when I find myself feeling like a doormat. As Jim said, the relationship is not a one-sided responsibility- the patient has responsibility also and there are consequences when those responsibilities are not met. Rewarding some behaviors is detrimental and similar to refilling those opioids because they "lost" their prescription again. Yet being patient centered may mean that you are appropriately flexible, not rigid. The times I think I'm finding that perfect balance are quite liberating.I think this would be a great topic for Camp.CarlaTo: Sent: Thu, December 23, 2010 6:00:38 AMSubject: RE: appointment scheduling

I think there are times when being too "patient centered" can become

detrimental:

1) to your own health and family time/commitments (what to do when already

fully booked, need to leave "ON TIME" to pick up kids or be at their

Christmas concerts and patients walk in, asking for same day apts... Pts.

who fail to come in for over one year, despite multiple reminders, by phone,

e-mail and snail mail!)

2) to patient's ability to become "self-managed". If we send multiple

reminders, it seems to enable a "dependence" on the practice, and encouraged

patients to demand MORE of our time so they have to plan LESS around their

medical needs...

When the provider begins to feel like a "doormat", my opinion is that is too

"patient-centered"!!!

R

Ramona G. Seidel, MD