Running a Practice Means Running Behind, Survey Shows

September 13, 2017

Six percent of physicians claim that they never fall behind on their appointment schedule.

These are same physicians, no doubt, who fill in a New York Times crossword puzzle in 15 minutes and never get coffee stains on their white coat.

For most physicians, however, running late is a way of professional life, according to the Medscape Practice Workflow Report 2017: Physicians' Bottlenecks, Challenges, and Time. Thirty-six percent said they fall behind schedule several times a week. For 28%, it happens every day.

Despite frequent losses to the clock, a majority of physicians said they are very satisfied (15%) or somewhat satisfied (40%) with their office's overall efficiency, Medscape found. In contrast, 8% said they were very dissatisfied with their efficiency, while 23% were somewhat dissatisfied.

Another 14% were in the middle.

When physicians can't keep up with their appointment schedules, most aren't terribly off the pace — 15 minutes or less for 37%, and 16 to 30 minutes for 45%. The most cited reason for falling behind, by the way, is a Hippocratic one. Seventy-nine percent of physicians said they spend as much time with a patient as required, even if it means making the next patient wait.

Physicians don't harbor an efficiency-be-damned attitude, however. Sixty-six percent complained that patients arrive late to appointments, with insufficient time to complete the necessary forms. Forty-seven percent said appointment slots aren't long enough to address their patients' needs. And 49% said they fall behind because they're recording patient notes between visits.

Physicians completing the Medscape survey offered some tips on staying on schedule:

  • Be sure the front desk doesn't overbook.

  • Remind patients the day before to bring in their paperwork.

  • Create a more efficient rooming strategy.

  • Take fewer breaks.

It's not as if physicians are lolly-gagging through the day. Close to 30% don't take time off for lunch, and another 40% or so shrink lunch hours to less than 30 minutes. And 36% of physicians are seeing 21 to 30 patients per day, while 31 or more is the norm for 14%.

Technology to the Rescue?

When physicians were asked what would improve practice efficiency, better technology (43%) topped the list of recommendations, followed by more nonphysician clinical staff (38%). Only 18% of physicians recommended hiring more physicians.

However, technology didn't exactly shine in the Medscape survey in other respects:

  • Nine percent of physicians said patients are frequently frustrated with their use of an electronic health record (EHR) system, and another 36% said patients are occasionally miffed. That's not surprising, in light of the common patient complaint that physicians give more face time to their computer screen.

  • Online patient portals, where patients can request a prescription refill or view their test results, have yet to catch on big time. Seventy percent of physicians reported that only 25% or less of their patients use the portals. This finding corroborates results of a recent study by the Government Accountability Office about the importance of portals to patients.

  • The go-to technology for communicating with patients outside the office is still the one invented in 1876 — the telephone, named by 93% of physicians. Thirty-four percent of them said they used email (physicians could choose more than one method), with text messages (8%) and videoconferencing (2%) at the end of the list.

The Medscape Physicians' Practice Challenge Report 2017 is based on a survey completed this summer by almost 1200 physicians in more than 25 specialties. The full results are available here.

Follow Robert Lowes on Twitter @LowesRobert


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