How to See More Patients
By Wendy S. Myers, CVJ, President, Communication Solutions for Veterinarians
Seeing patients every 30 minutes doesn’t work. If Dr. Smith has outpatient exams from 8 a.m. to 5 p.m. with an hour for lunch, he will see 16 patients. His daily production will be $3,072 to $3,360 based on a $60 exam fee and average doctor transaction of 3.2 to 3.5 times the exam fee. (*1) Tweaking scheduling techniques will let Dr. Smith see eight more patients each day, increasing income $4,608 to $5,040. Let’s start making more money:
Step 1: Schedule exam time based on the reason for the visit.
Don’t put every appointment in a 30-minute slot because a progress exam will take less time while a sick-patient visit may take longer.
Veterinarians and receptionists will work together to create scheduling guidelines. Don’t force this significant change on employees without their input—or it’s guaranteed to fail. Talk about what works and doesn’t work with your current schedule, how nurses support doctors in exams, and which scheduling tweaks will have the greatest impact. When making any change in your hospital, answer:
- How will this change improve client experiences?
- How will this change improve patient care?
- How will this change grow revenue?
Teamwork will help everyone understand the “why” behind scheduling renovations and get buy-in to follow guidelines consistently. Receptionists and doctors will need to define appointment lengths such as:
- 10 minutes: Booster vaccines without exams, Level 1 progress exams for minor problems such as ear infections, and surgical discharges when a doctor needs to provide instructions.
- 20 minutes: Adult preventive checkups, complicated medical/surgical discharges, Level 2 progress exams for complex problems, disease-management exams for chronic conditions, and second, third, and fourth puppy/kitten exams.
- 30 minutes: Sick and urgent care exams, senior preventive exams, new clients, limping or symptoms that may require radiographs, skin cases, ophthalmic exams, second opinions, quality of life consults, and unattended euthanasia.
- 40 minutes: Patients with vomiting and/or diarrhea, first puppy/kitten exams, attended euthanasia, and exotic pets.
Expand this list based on the types of appointments you see. Keep the quick-reference chart of scheduling guidelines on reception computers or laminated cards so tips become habit-forming. Your practice-management software also lets you designate appointment types, which would automatically block the correct length based on the exam type.
Step 2: Think in 60-minute blocks.
Your goal is to book every minute of each hour, avoiding gaps in the schedule. A 60-minute block could include a 10-minute progress exam, a 20-minute preventive checkup, and a 30-minute sick-patient exam. The next 60 minutes might consist of a new client appointment followed by a disease-management exam. Both choices had you successfully fill each hour.
Step 3: Book sick-patient exams next to checkups.
If you schedule three sick patients in a row, you risk running behind and creating an avalanche of late exams. Preventive checkups are more predictable and likely to stay on time. If you sandwich a sick-patient exam between two checkups, your schedule could stay on track.
Step 4: Leverage nurses.
Evaluate which appointments could shift from the schedule of veterinarians to nurses, such as giving booster vaccines that don’t require an exam, expressing anal glands, changing bandages, administering fluids, trimming nails, collecting samples for drug monitoring, and more.
Step 5: Evaluate as you go.
You’ll need two to four weeks to transition to the new scheduling system because you may have forward-booked appointments for progress exams. Everyone will need training on how the new scheduling system will work and what their roles are in executing it. Set a transition date to switch from the old to new scheduling method. The transition is best made quickly and completely.
During the first 90 days of implementation, have a doctor and receptionist supervisor meet weekly to see what worked well in the schedule’s flow and identify tweaks to make. Fine-tuning during the first 90 days will help you define your perfect exam flow.
Step 6: Track results.
Measure before-and-after progress. Create a spreadsheet on the number of appointments and revenue for 30 days before changes were implemented, and then 30, 60, and 90 days after the new schedule began. You should see up to 33 percent growth.
During staff meetings and invite employees to share feedback. When employees see results and know they were part of making it happen, your practice will thrive.
*1 – Tumblin D. Problem: Your Average Doctor Transition Is Low. Veterinary Team Brief, January/February 2018. Available at: www.veterinaryteambrief.com/article/problem-your-average-doctor-transaction-low. Accessed on March 10, 2019.