How to Solve Your Medical Practice's Toughest Challenges

Kathy I. Moghadas, RN, CLRM, CHBC


October 11, 2017

In This Article

What Makes Physicians' Days So Tough?

The results are in for Medscape's Practice Workflow Report 2017.  More than 1150 physicians responded and talked about the challenges of running a medical practice. The survey aimed to find out how efficient physicians are throughout their day; what they're doing that makes their practice more successful; how they're dealing with daily bottlenecks; and what the main staffing and patient issues are.

Even in today's insurance-driven selection environment, it was interesting to see that almost three quarters (72%) of physicians still get their new patients through referrals from patients or other providers. As long as this trend continues, physicians can still distinguish themselves from their peers and competitors by providing quality services—such as being on time, with competent, caring staff and an attitude of cooperation. Regardless of their insurance, patients will still make a choice as to who they will consider for providing their care if given the opportunity.

No-shows and Running Late

How does the day's patient flow go for most physicians? Aided by the ability to schedule appointments via a secure practice portal, automated patient recall systems, and smoother operations, thankfully the trend for no-shows appears to be dropping, with almost three quarters (72%) of physicians reporting a no-show rate of less than 10%.

However, despite all of the administrative technology that most practices use, we are still seeing a trend for physicians to fall behind schedule. Over one third (36%) of the respondents reported falling behind schedule several times a week, and more than one quarter (28%) of physicians fall behind daily. The most common reason for running late is that a patient comes in with multiple issues or worsening symptoms, and requires more complex counseling than was allotted for a normal visit.

Drilling a little deeper, we see that physicians are not just a couple of minutes behind, but that the largest percentage (45%) will get almost a half-hour behind. That constant daily or weekly failure to meet their own performance expectations can contribute to low practice satisfaction from all facets of the practice.

On the other hand, for some physicians, running behind may occur so frequently that it no longer bothers them and no longer seems like a problem to solve. However, it's good to keep in mind that today's patients are getting less complacent about wait times. If you worry about potentially getting less-than-complimentary online reviews or losing patients, reducing wait time may be an area to look at for improvement.

Over three quarters (79%) of physicians report that the major reason for falling behind is that they will spend the amount of time needed with their patients, even if that throws a monkey wrench into schedule. And that is as it should be, if you want to see the highest practice satisfaction. But clearly, such factors as patient acuity, worsening patient condition, and physician relationship with the patient, as well as unforeseeable complications, are not being considered when scheduling patients.

In my experience, this practice bottleneck arises owing to the use of scheduling templates, which are created on the basis of the number of patient dollars needing to be generated per day versus consideration of the patient acuity rating or the other factors mentioned above.


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