What's the most number of patients you've seen in a day?

[F0nzie]

I have 26 patients scheduled at the CMHC today. Please tell me that I'm not alone.

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[Extralong]

1 bizzzillion, give or take about 3

 

[heyjack70]

89 Rvu's worth?

 

[Shikima]

I have 26 patients scheduled at the CMHC today. Please tell me that I'm not alone.

I wish you had that in PP instead

 

[F0nzie]

89 Rvu's worth?

Not sure. I don't understand RVU. I am salaried and I get paid $900 per day.

 

[nitemagi]

42 in cross covering a private hospital.

 

[Doctor Bagel]

Ugh, I'm doing some community MH next year, and I'm hoping that doesn't happen. It wasn't with the people I talked with, but I wouldn't be too surprised if my schedule starts to get busier and busier, which I guess is when it's time to move on.

How many new evals versus follow ups?

 

[Shikima]

Not sure. I don't understand RVU. I am salaried and I get paid $900 per day.

Need to renegotiate that rate bud...

 

[Doctor Bagel]

42 in cross covering a private hospital.

Actually rounding on that many or just carrying the pager for that many? If the latter, me too and doable. If it's the former, jeez!

 

[nitemagi]

Actually rounding on that many or just carrying the pager for that many? If the latter, me too and doable. If it's the former, jeez!

Rounding, unfortunately.

 

[F0nzie]

Need to renegotiate that rate bud...

Denied

 

[F0nzie]

Rounding, unfortunately.

Ouch!

 

[heyjack70]

If you line up every patient on the inpatient unit and run by high fiving each one, you could see like hundreds of patients a day.

 

[daru1]

31. But that was outpatient.

 

[psych md jd]

If you line up every patient on the inpatient unit and run by high fiving each one, you could see like hundreds of patients a day.

I knew a guy like that. He ran a nursing home practice. 500+ patients every weekend. Last I saw of him, he was on TV, in cuffs, being taken away by the FBI.

 

[nitemagi]

Ouch!

Yeah. It was supposed to be 10 minute med checks, and basically "babysitting" inpatients over the weekend. Included a detox unit, so just following to make sure vitals were stable, things like that. Still, add in a handful of crises and it usually was a 10-12 hour day, without breaks.

 

[Doctor Bagel]

Yeah. It was supposed to be 10 minute med checks, and basically "babysitting" inpatients over the weekend. Included a detox unit, so just following to make sure vitals were stable, things like that. Still, add in a handful of crises and it usually was a 10-12 hour day, without breaks.

Did you have to write progress notes on everyone? So 10 minutes for 42 patients is 7 hours. 5 minutes for talking, 5 minutes for note writing. Of course things always go slower/wrong. Any admissions? I hope they paid you well.

 

[nitemagi]

Yes, minimal progress notes. Tack on 5 minutes a patient the first day to read the chart and get a sense of what's going on. Plus up to 6+ admissions (I think my record was 8 or 10). You learn to get very efficient very fast, and to avoid the major problems. Always was compromising the level of care I could have offered.

The pay was "meh" considering the workload. But I was a resident

I've gone the other way, now. 30 minute med follow-ups. Most people prefer to do a full hour and incorporate some therapy, and some see me just for therapy (no meds).

 

[kitsens]

If you line up every patient on the inpatient unit and run by high fiving each one, you could see like hundreds of patients a day.

LOL

 

[heyjack70]

S: Still disorganized and delusional
MSE: check boxes
A: Schizophrenia
P: Continue current meds

99231

 

[F0nzie]

23/26 patients showed for their follow up appointment today....better turn out than I anticipated. Annddd I'm done for the week.

 

[birchswing]

I saw a very controversial psychiatrist who did group psychiatry. I was in a group with about 20 people. He would see all 20 of us in one hour sessions once a week. It was filled with his political rantings and a recounting of the hagiography of himself he had crafted. He did refills for everyone at the same time. I never noticed him changing anyone's meds. Everyone seemed to take what they were already on when they came to him. He has yet to be sanctioned because he has many avid believers, but there are a number of doctors who have tried to report him. I reported him anonymously, which didn't carry as much weight as a regular report, but at the time I was still very afraid of him (when I stopped going he would call repeatedly and tell me I was ruining my life). He didn't believe in patients getting better outside of seeing him. He outright said that people would need him for the rest of their lives, that he was a mother and father to everyone in the room, that they had to renounce their own mothers and fathers, and that life's great paradox is that complete independence requires complete dependence. He was either quite evil or quite ill. If you look at his reviews online, it's either exactly what I've said: that's is a mind-control cult, or very glowing reviews of how he is the only "healthy psychiatrist" in the world (that's one thing he would say about himself).

Anyhow, the point was that he was able to see 20 people in an hour. I would guess he has the world record of seeing the most people in a day, or at least per hour or week, because he had multiple groups. He also made extra money by forcing patients to pay for infractions. You had to bring cash with you. If he didn't like something about you, you had to pay right there. I have Tourette's and would have to pay if I ticced loudly. There was so much worse than that, but people tend not to believe stories about this person so I only outlay the general weirdness.

 

[Ceke2002]

I saw a very controversial psychiatrist who did group psychiatry. I was in a group with about 20 people. He would see all 20 of us in one hour sessions once a week. It was filled with his political rantings and a recounting of the hagiography of himself he had crafted. He did refills for everyone at the same time. I never noticed him changing anyone's meds. Everyone seemed to take what they were already on when they came to him. He has yet to be sanctioned because he has many avid believers, but there are a number of doctors who have tried to report him. I reported him anonymously, which didn't carry as much weight as a regular report, but at the time I was still very afraid of him (when I stopped going he would call repeatedly and tell me I was ruining my life). He didn't believe in patients getting better outside of seeing him. He outright said that people would need him for the rest of their lives, that he was a mother and father to everyone in the room, that they had to renounce their own mothers and fathers, and that life's great paradox is that complete independence requires complete dependence. He was either quite evil or quite ill. If you look at his reviews online, it's either exactly what I've said: that's is a mind-control cult, or very glowing reviews of how he is the only "healthy psychiatrist" in the world (that's one thing he would say about himself).

Anyhow, the point was that he was able to see 20 people in an hour. I would guess he has the world record of seeing the most people in a day, or at least per hour or week, because he had multiple groups. He also made extra money by forcing patients to pay for infractions. You had to bring cash with you. If he didn't like something about you, you had to pay right there. I have Tourette's and would have to pay if I ticced loudly. There was so much worse than that, but people tend not to believe stories about this person so I only outlay the general weirdness.

Whoa, this is eerily similar to that abusive Psych I was seeing back in the 90s. Very similar modus operandi - he was practically a guru, no one knew more about treating addiction than he did; he was the only Doctor who could help, if anyone questioned whether or not you should be seeing him then you were encouraged to break contact with that person (including family members) because they didn't have your bests interests in mind only he did; big pharma, the medical board and drug dealers were all coming to over throw him because they were jealous of his brilliance and wanted to destroy what he created because he was taking money off them with his superior treatment methods; anyone who left treatment was automatically condemned to either die, end up in jail or be an addict forever, and leaving treatment also meant you had joined forces with the ones who were conspiring to bring him down, so, you know, if you left his clinic, and the clinic got shut down, and patients that were still there ended up dying from their addictions then that was your fault. He had an inner circle of patients that he'd groomed as true believers, all very carefully chosen for a) they're level of compliance, and b) they're lack of education, that he used to spy on the rest of us and note down our conversations so he could see who wasn't toeing the line properly, or who might be having doubts, at which point he'd use the information to start breaking patient confidentiality left, right and centre and drive wedges between what he thought of as the disruptive influences (and then of course the true believers could sweep in once certain friendships had been separated and make sure they got people back on the right path, as in conform to the group think or else). He also used his inner circle patients as 'medical' assistants in his overnight detox clinic, where most of the patients were under twilight sedation under going a naltrexone rapid detox - well you know he did need the extra time to himself when he was molesting sedated patients, and the compliant, under educated inner circle patients were less likely to question why a Doctor thought it necessary to perform a breast and pelvic exam in the middle of the night on an unconscious person - and of course sometimes he just needed a break, and I'm sure poorly educated recovering drug addicts, with absolutely zero medical or even first aid training, were a perfectly reasonable alternative to be taking care of patients under heavy sedation going through rapid detox.

So there you go, everyone. If you find yourself with an overload of work just hire a bunch of your patients to take care of things, because I'm sure there's absolutely nothing that could go wrong with that.

 

[birchswing]

Whoa, this is eerily similar to that abusive Psych I was seeing back in the 90s. Very similar modus operandi - he was practically a guru, no one knew more about treating addiction than he did; he was the only Doctor who could help, if anyone questioned whether or not you should be seeing him then you were encouraged to break contact with that person (including family members) because they didn't have your bests interests in mind only he did; big pharma, the medical board and drug dealers were all coming to over throw him because they were jealous of his brilliance and wanted to destroy what he created because he was taking money off them with his superior treatment methods; anyone who left treatment was automatically condemned to either die, end up in jail or be an addict forever, and leaving treatment also meant you had joined forces with the ones who were conspiring to bring him down, so, you know, if you left his clinic, and the clinic got shut down, and patients that were still there ended up dying from their addictions then that was your fault. He had an inner circle of patients that he'd groomed as true believers, all very carefully chosen for a) they're level of compliance, and b) they're lack of education, that he used to spy on the rest of us and note down our conversations so he could see who wasn't toeing the line properly, or who might be having doubts, at which point he'd use the information to start breaking patient confidentiality left, right and centre and drive wedges between what he thought of as the disruptive influences (and then of course the true believers could sweep in once certain friendships had been separated and make sure they got people back on the right path, as in conform to the group think or else). He also used his inner circle patients as 'medical' assistants in his overnight detox clinic, where most of the patients were under twilight sedation under going a naltrexone rapid detox - well you know he did need the extra time to himself when he was molesting sedated patients, and the compliant, under educated inner circle patients were less likely to question why a Doctor thought it necessary to perform a breast and pelvic exam in the middle of the night on an unconscious person - and of course sometimes he just needed a break, and I'm sure poorly educated recovering drug addicts, with absolutely zero medical or even first aid training, were a perfectly reasonable alternative to be taking care of patients under heavy sedation going through rapid detox.

So there you go, everyone. If you find yourself with an overload of work just hire a bunch of your patients to take care of things, because I'm sure there's absolutely nothing that could go wrong with that.

Wow, that's way worse than the operation the guy that I saw is running, most specifically due to the molestation, which is at another level. I was only in it for six weeks so I'm not sure if there was more to it than I saw. I saw him when I moved to the town I currently live in. I called him when I moved there as he was the closest in proximity and he answered the phone after one or two rings. I didn't understand why he didn't have a secretary, and he said he's the only psychiatrist who will answer his own phone and that he remembers everyone's names and if he can't answer will call back in an hour. He was intense, but I was also impressed that he was so hands on. He had me come down to where the group met and showed me the room where we were to meet. After he told me some of the rules, I made a joke that it almost seemed like a cult and he had a blank face response. During the first two weeks you weren't allowed to speak at all and could only observe. There was a rule that you could never talk to anyone outside of the session and he would watch you as you went to your cars to make sure no one talked in the parking lot. He would go around at the end of every session and ask "Do you trust me?" If you didn't answer yes, you had to leave (supposedly forever). If someone vacillated the whole group would start imploring them that they were going to ruin their life. I saw one woman start to leave once and then come back before leaving the door. His most ardent supporter had this delusional belief that if her husband got a job in another town and she had to move, she was going to learn to fly a plane and was going to fly back to come to the weekly group sessions (a view that he supported). He would have people disconnect from family but more often he try to get family members to join his other groups. The content of the sessions was mostly him going on about various political topics, like he was some luminary (the views were very racist and homophobic). People (after the first two weeks) could talk and ask for advice, but it was mainly as a starting off point for him to talk more about his political views and he by far talked more than the patients. His main tenet was that by being in the group you got healthier--it didn't seem to matter what the content was--just that you needed to be there. He didn't like people celebrating holidays (which he said should only be for children), he didn't think people should call their parents mom or dad, and he continually said he was the only healthy psychiatrist. The thing that was weird is that as abusive as some of the things were, nothing had worked well for me, and so when I told my parents about the very unconventional methods, they were not at all dismissive. The last straw for me was that in one session I was wearing a bucket hat and he told me that it made me look like an old Jewish man. He told me to throw it in the trash can, and I did, which is in reflection hard to believe I would do. At the end of the session as people were leaving I took it out of the trash and put it in my pocket. One of the other group members saw me and told him and he said if I didn't throw it away, I was out. So I threw it away again. But after I left I kept thinking about it and I called him and told him I was coming to pick up the hat and that I was out. He had a long, long plea about how I was ruining my life.

The next psychiatrist I saw after this one immediately knew what I was talking about and gave me a form to fill out for the state to report him. He had heard all the stories before and called the patients that came from him "(Doctor's name) survivors." In truth, I haven't gotten much better in terms of mental or physical health since then, and in some ways have deteriorated. My problems are rather refractory; they seem to be very inborn and difficult. So I can't say he was particularly ineffective, but he was particularly bizarre. Still, though, if I could go back and change anything it would be to never have started benzos over anything else. Even more than never having seen him. As odd as he was, I can see why he still exists as a practitioner. I think it's the same reason gangs form. It's a structure and discipline, even if the content is abusive and bizarre.

I actually wrote a fictional story based on him that I have been wanting to find--I know it's on a hard drive somewhere I haven't been able to find. In the story the character is named Mister Mister (because according to him the word Mr. has been so devalued by society he has to use it twice) and he is like a guru who runs a clinic in the remotest part of Iceland for people "finding themselves" for lack of a better term. His premise is that it doesn't matter what people do as long as they have structure. That was never something the crazy psychiatrist I saw said, but it was what I could have seen as valuable in his groups. In this story Mister Mister also becomes abusive and the story follows the escape of one of the participants and his life after leaving. So, if nothing else it was a good place to get writing material.

 

[Ceke2002]

Wow, that's way worse than the operation the guy that I saw is running, most specifically due to the molestation, which is at another level. I was only in it for six weeks so I'm not sure if there was more to it than I saw. I saw him when I moved to the town I currently live in. I called him when I moved there as he was the closest in proximity and he answered the phone after one or two rings. I didn't understand why he didn't have a secretary, and he said he's the only psychiatrist who will answer his own phone and that he remembers everyone's names and if he can't answer will call back in an hour. He was intense, but I was also impressed that he was so hands on. He had me come down to where the group met and showed me the room where we were to meet. After he told me some of the rules, I made a joke that it almost seemed like a cult and he had a blank face response. During the first two weeks you weren't allowed to speak at all and could only observe. There was a rule that you could never talk to anyone outside of the session and he would watch you as you went to your cars to make sure no one talked in the parking lot. He would go around at the end of every session and ask "Do you trust me?" If you didn't answer yes, you had to leave (supposedly forever). If someone vacillated the whole group would start imploring them that they were going to ruin their life. I saw one woman start to leave once and then come back before leaving the door. His most ardent supporter had this delusional belief that if her husband got a job in another town and she had to move, she was going to learn to fly a plane and was going to fly back to come to the weekly group sessions (a view that he supported). He would have people disconnect from family but more often he try to get family members to join his other groups. The content of the sessions was mostly him going on about various political topics, like he was some luminary (the views were very racist and homophobic). People (after the first two weeks) could talk and ask for advice, but it was mainly as a starting off point for him to talk more about his political views and he by far talked more than the patients. His main tenet was that by being in the group you got healthier--it didn't seem to matter what the content was--just that you needed to be there. He didn't like people celebrating holidays (which he said should only be for children), he didn't think people should call their parents mom or dad, and he continually said he was the only healthy psychiatrist. The thing that was weird is that as abusive as some of the things were, nothing had worked well for me, and so when I told my parents about the very unconventional methods, they were not at all dismissive. The last straw for me was that in one session I was wearing a bucket hat and he told me that it made me look like an old Jewish man. He told me to throw it in the trash can, and I did, which is in reflection hard to believe I would do. At the end of the session as people were leaving I took it out of the trash and put it in my pocket. One of the other group members saw me and told him and he said if I didn't throw it away, I was out. So I threw it away again. But after I left I kept thinking about it and I called him and told him I was coming to pick up the hat and that I was out. He had a long, long plea about how I was ruining my life.

The next psychiatrist I saw after this one immediately knew what I was talking about and gave me a form to fill out for the state to report him. He had heard all the stories before and called the patients that came from him "(Doctor's name) survivors." In truth, I haven't gotten much better in terms of mental or physical health since then, and in some ways have deteriorated. My problems are rather refractory; they seem to be very inborn and difficult. So I can't say he was particularly ineffective, but he was particularly bizarre. Still, though, if I could go back and change anything it would be to never have started benzos over anything else. Even more than never having seen him. As odd as he was, I can see why he still exists as a practitioner. I think it's the same reason gangs form. It's a structure and discipline, even if the content is abusive and bizarre.

I actually wrote a fictional story based on him that I have been wanting to find--I know it's on a hard drive somewhere I haven't been able to find. In the story the character is named Mister Mister (because according to him the word Mr. has been so devalued by society he has to use it twice) and he is like a guru who runs a clinic in the remotest part of Iceland for people "finding themselves" for lack of a better term. His premise is that it doesn't matter what people do as long as they have structure. That was never something the crazy psychiatrist I saw said, but it was what I could have seen as valuable in his groups. In this story Mister Mister also becomes abusive and the story follows the escape of one of the participants and his life after leaving. So, if nothing else it was a good place to get writing material.

Should we perhaps start another discussion topic for this? I'd actually be interested in hearing how some of the Doctors on here approach cases where a patient has been formerly abused by a Psychiarist/Therapist, and I kind of feel like we're derailing this topic. I am really glad you got away from that nut job though, but yeah I know the damage that can be done with situations like this.

 

[PikminOC]

23/26 patients showed for their follow up appointment today....better turn out than I anticipated. Annddd I'm done for the week.

What else is covered with that 900 a day? Are you a w2 or 1099?
And when do you have time for PP? !!

 

[PsyDr]

I hold an prescribing license, although I have never used it and never plan on using it.

A recruiter called and offered me an interview for a position which required 40 pts per half day (i.e., 4 hrs). Outpatient. Some of those were intakes. $150/hr. No malpractice stipend. No benefits.

Nope.

 

[splik]

I saw a very controversial psychiatrist who did group psychiatry. I was in a group with about 20 people.

was this through insurance? because unless he was billing 90853 (group therapy) he was committing fraud. You cannot bill for individual med management services when seen patients in groups it has to be individual. its becoming increasingly common for cmhcs to run medication groups where all the patients are seen at once, but you cannot bill E&M codes legitimately unless you see pts 1:1

 

[birchswing]

was this through insurance? because unless he was billing 90853 (group therapy) he was committing fraud. You cannot bill for individual med management services when seen patients in groups it has to be individual. its becoming increasingly common for cmhcs to run medication groups where all the patients are seen at once, but you cannot bill E&M codes legitimately unless you see pts 1:1

I have a poor memory for a lot of things and this was probably about 10 years ago. The things I remember best are those that have some sort of emotional impact, which unfortunately means I tend to remember more negative things. My recollection is that he charged what the insurance copayment would have been but not charging insurance--at least at first. I do remember there being something odd about it because I remember asking him why he didn't want to bill my insurance and something about the fact that he would do it later on but that at first he would just take co-pays. I don't know how accurate all of that is--but I am quite sure that he never charged my insurance. I can't say with certainty what he did for other people. I was definitely paying, though. I think he asked me what my copay would be and just charged that, but I can't say with absolute certainty. I can much more vividly remember having to pay for getting out of my seat once or a time that I spilled a bottle of water. There were $5 and $10 infraction charges. The first time he charged me for an infraction I went and got cash from my dad who was waiting for me in the parking lot, and thereafter brought cash in with me.

 

[digitlnoize]

was this through insurance? because unless he was billing 90853 (group therapy) he was committing fraud. You cannot bill for individual med management services when seen patients in groups it has to be individual. its becoming increasingly common for cmhcs to run medication groups where all the patients are seen at once, but you cannot bill E&M codes legitimately unless you see pts 1:1

We do med mgt groups at my residency program (not this big, maybe 6-10 patients in an hour) and the lawyers assure my program they can code for E&M with these and we've done it for decades without problems.

I think it could actually be done well, if you had all stable patients grouped by dx: ADHD group, Depression group, etc. If you need a med change you need an individual appointment to sort it out. That's not what we do. It's just random people, usually with Medicare/Medicaid (but not always). They're not particularly stable (some are). It's not an ideal situation.

Edit: I found this PDF guide from MHG about group visits. Even they say that as long as certain documentation requirements are met (that individual evaluation occurred in the context of a group visit, Pg 15), then you can bill E&M codes.

http://www.massgeneral.org/stoecklecenter/assets/pdf/group_visit_guide.pdf

 

[psyxh]

In residency, I regularly moonlighted at a facility with 2 units: one "straight" psych with some teenagers but mostly adults, and another unit with all eating disordered adolescents and adults. Combined, I needed to round on as many as 47 patients. I mostly worked weekend days, when they'd largely be full, so admissions were minimal. The 24hr rate was around $1300. This was outside of Boston.

My first shift had me working non-stop for 20hrs. After a few times at this, I'd be done within 6-8hrs, which included a lunch break.

Edit: I should add that, after finishing the work, I had to remain on-site (or very close by) to complete the 24hr shift. Mostly just a few calls for telephone orders.

 

[Indodo]

26 patients in a half day is not bad for med checks.
If you are seeing patients every 15 minutes you can see 32 patients if you are totally full. More if you are double booked and even more if you work 10 days. I have had 40 patients in a day.

The fact that 23 actually showed up is quite impressive and unfortunate for you because I generally have a 50% show rate.

 

[Information Underload]

I just don't get the need to see so many outpatients--inpatients, I get. There really is a lot of work that can go on in outpatients sessions. I'm seeing 2-3 new outpatients per days and 7-8 follow-ups with psychotherapy add-ons. Revenue is the same as churning. Satisfaction is way up. Care provided is way up. Patients aren't missing appointments like the churning MHCs. I've rounded on 36 inpatients per day on the weekends, which is doable, though I tend to spend more time with them than some I've seen. Most admissions in a 12-hour shift was 11. A huge reason for me not seeing so many patients is the documentation. Can't stand the stuff, and it eats into my day when I'm at my least productive.

 

[Thewonderer]

Not sure. I don't understand RVU. I am salaried and I get paid $900 per day.

$900 for 23 patients is not a lot. You are better off taking insurance contracts. 99213 could pay $50. 99214 could pay $65.

 

[birchswing]

26 patients in a half day is not bad for med checks.
If you are seeing patients every 15 minutes you can see 32 patients if you are totally full. More if you are double booked and even more if you work 10 days. I have had 40 patients in a day.

The fact that 23 actually showed up is quite impressive and unfortunate for you because I generally have a 50% show rate.

Why such a low show rate?

 

[smalltownpsych]

I just don't get the need to see so many outpatients--inpatients, I get. There really is a lot of work that can go on in outpatients sessions. I'm seeing 2-3 new outpatients per days and 7-8 follow-ups with psychotherapy add-ons. Revenue is the same as churning. Satisfaction is way up. Care provided is way up. Patients aren't missing appointments like the churning MHCs. I've rounded on 36 inpatients per day on the weekends, which is doable, though I tend to spend more time with them than some I've seen. Most admissions in a 12-hour shift was 11. A huge reason for me not seeing so many patients is the documentation. Can't stand the stuff, and it eats into my day when I'm at my least productive.

I think the churn method has to do with agencies where other providers do therapy so they want one psychiatrist to see all the patients for medication. I think it is a horribly flawed system and perspective. Especially when they start running it all with midlevels. We need to advocate and explain that there is a lot more to psychiatry than writing a script and a lot more to psychotherapy than empathic listening.

 

[heyjack70]

I think the churn method has to do with agencies where other providers do therapy so they want one psychiatrist to see all the patients for medication. I think it is a horribly flawed system and perspective. Especially when they start running it all with midlevels. We need to advocate and explain that there is a lot more to psychiatry than writing a script and a lot more to psychotherapy than empathic listening.

Get back in line prescriber

 

[F0nzie]

26 patients in a half day is not bad for med checks.
If you are seeing patients every 15 minutes you can see 32 patients if you are totally full. More if you are double booked and even more if you work 10 days. I have had 40 patients in a day.

The fact that 23 actually showed up is quite impressive and unfortunate for you because I generally have a 50% show rate.

All 26 were court ordered meaning case management call the police to send them to the hospital if they no-show.

 

[F0nzie]

Why such a low show rate?

A 50% no-show rate is pretty common IMO and one of the biggest income hits we take in Psychiatry. Even parity cannot save us here unless we get compensated for our higher than average no-show rate. If anybody has actual data it would be interesting to compare.

The issue we face regarding scheduling is 1. We need more time blocked for patients and 2. We have a higher no show rate. I have already limited the number of therapy patients I accept because a no-show or cancellation means I sit in my office for an entire hour and earn no income. I have had days where 100% or more have no-showed.

I try to keep my no-show rate at 25% via appointment reminders and by charging missed visits in full (which believe it or not does not necessarily mean I will get paid). I still continue have some really bad days that make me think I should just do contract work.

 

[Frazier]

A 50% no-show rate is pretty common IMO and one of the biggest income hits we take in Psychiatry. Even parity cannot save us here unless we get compensated for our higher than average no-show rate. If anybody has actual data it would be interesting to compare.

The issue we face regarding scheduling is 1. We need more time blocked for patients and 2. We have a higher no show rate. I have already limited the number of therapy patients I accept because a no-show or cancellation means I sit in my office for an entire hour and earn no income. I have had days where 100% or more have no-showed.

I try to keep my no-show rate at 25% via appointment reminders and by charging missed visits in full (which believe it or not does not necessarily mean I will get paid). I still continue have some really bad days that make me think I should just do contract work.

How does a day get more than a 100% no-show rate? You filled some gaps same day and they no-showed too?

Regarding not collecting for no-shows... does your PP accept cc's? If so, do you auto-charge for no shows? (I've seen quite a few with this set up.)

 

[smalltownpsych]

100% or more no show rate. I love it. Those are the days when I have the anti-Midas touch where everything I touch turns to crap! Patients are cancelling and not showing up before they even schedule. Ugh! I hate my life. Actually last week I had a few days with a few too many empty blocks of time and since I have a week off next week, I was getting a little worried about my money. Nothing starts me catastrophizing more than financial stressors. getting slammed this week so feeling tired but relieved that people still need help and I will still be able to pay my bills.

 

[medium rare]

I see patients for either 30 or 60 minute appointments; my maximum is 16/day.

I absolutely charge for no-shows and late cancellations.

 

[Indodo]

A 50% no-show rate is pretty common IMO and one of the biggest income hits we take in Psychiatry. Even parity cannot save us here unless we get compensated for our higher than average no-show rate. If anybody has actual data it would be interesting to compare.

The issue we face regarding scheduling is 1. We need more time blocked for patients and 2. We have a higher no show rate. I have already limited the number of therapy patients I accept because a no-show or cancellation means I sit in my office for an entire hour and earn no income. I have had days where 100% or more have no-showed.

I try to keep my no-show rate at 25% via appointment reminders and by charging missed visits in full (which believe it or not does not necessarily mean I will get paid). I still continue have some really bad days that make me think I should just do contract work.

The 50% no show rate is at a CMHC and this is pretty standard. I don't think I could handle it if everyone showed up. We don't charge for no-shows at the CMHC, I don't think we are allowed.