Therefore, it might be helpful to step back occasionally; set aside the idealism and heroism associated with practicing medicine; and take a cold, analytical look at “the machine.” How can you repair, redesign, or fine-tune the operation to make your scarce commodity more available to patients who need and want your expertise?
The entire practice revolves around what the physicians do. Therefore, your physicians’ output acts like an engine’s “governor,” regulating the overall speed of your operation. In addition, each stage in the process has its own governing activities.
Input Stage: Appointment Scheduling
Your appointment schedule template governs the initial input by dictating when, what type, and how many patients should come in. When a doctor falls behind, waiting areas overflow, parking lots jam up, and tempers flare. Calculate each physician’s patient-per-hour rate then build your clinic template around that number - high enough to ensure a constant pool of patients for the doctor and light enough to allow for work-ins.
Once the patients arrive, the intake process is governed by at least three more activities:
- Reception: Can your receptionists keep up with the patient flow? What interruptions (like telephones) hamper their efforts? Two ways to smooth the flow include separating check-in from check-out and diverting telephone duty to dedicated staff away from the front desk.
- Exam-room loading: Assign one primary person to keep exam rooms full of patients ready for the physician. An empty room creates a disruption in the doctor’s rhythm - a vacuum that can fill with distractions and halt production.
- Ancillary services: Poorly planned processes like x-ray, suture removal, laboratory tests and other diagnostics, or follow-up treatments can waste time, effort, or resources. Coordinate activities to keep patients flowing, rooms full, and doctors moving from patient to patient. Create “buffer zones,” such as sub-waiting areas associated with ancillary services, to make up for the variations in patient-flow rates.
Analyze each physician activity in the patient exam/treatment area. You will find every activity fits in one of three categories:
- Activities only the physician can/should perform.
- Activities that the physician should delegate to support staff.
- Activities no one should bother with.
- Using medical scribes in the exam room in place of physician dictation or note taking (often effective in transitioning to EMRs);
- Implementing color-light-coded communication systems to alert support staff from within the exam room; and
- Using lower-cost “runners” on staff for moving patients and materials through the clinic.
Finally, in your quest for a finely tuned machine, use sensitivity and care to avoid leaving patients with the impression that you’re running a mill, with patients for grist. Never sacrifice addressing their worries, needs, and comforts in the name of efficiency.
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