Appointment time

[Perrotfish]

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Just out of curiosity, what do you guys think a reasonable appointment time is for a:

1) Well child visit/checkup for a healthy patient

2) Acute visit for a healthy patient

3) Well child visit/checkup for a patient with multiple medical problems

4) Acute appointment for a patient with multiple medical problems

This is assuming that the clinic runs 8-5 (i.e. no note writing time built into the normal working day)

 

[Cuthbert]

Here is how my schedule is divided:


1) Well child visit/checkup for a healthy patient

Our well child nurse (separate from my personal nurse) sees the patient and family and has 20 minutes with the patient to obtain PMHx, concerns, developmental screening, vitals, etc. She also goes over anticipatory guidance for the child's particular age. I have 10 minutes for each well child which comes directly after the child is seen by the nurse. I answer left over questions and do my exam. Works great!

2) Acute visit for a healthy patient

10 minutes for easy issues - ears, sore throat, etc. 20 minutes for more complex issues - knee pain, ankle pain, etc. 30 minutes for very complex issues - abdominal pain, migraine HAs. 40 minutes for new ADHD.

3) Well child visit/checkup for a patient with multiple medical problems

Same as 1) but with an additional 10 minutes added to my encounter.

4) Acute appointment for a patient with multiple medical problems

At least 20 minutes, more pending the issue.


I rarely get behind. It happens sometimes - can't always be prevented in medicine. I average between 25-30 patients daily.

 

[deleted311769]

Just out of curiosity, what do you guys think a reasonable appointment time is for a:

1) Well child visit/checkup for a healthy patient

2) Acute visit for a healthy patient

3) Well child visit/checkup for a patient with multiple medical problems

4) Acute appointment for a patient with multiple medical problems

This is assuming that the clinic runs 8-5 (i.e. no note writing time built into the normal working day)

Is this for a resident clinic? And how medically complex do you mean for multiple medical problems?

A complex care/special needs clinic where kids are on vents or have other equipment, are followed by multiple specialists, etc are often 90 min for well child and 45 min for any other type of appointment.

 

[Perrotfish]

Is this for a resident clinic? And how medically complex do you mean for multiple medical problems?

A complex care/special needs clinic where kids are on vents or have other equipment, are followed by multiple specialists, etc are often 90 min for well child and 45 min for any other type of appointment.

Yes its a resident clinic. By medically complex I mean at least three medical problems which each require subspecialist follow up at least quarterly, as well as at least one piece of indwelling hardware (G/tube, port, etc). NICU surviviors, congenital heart disease kids, genetic disorders, etc.

Wow, 90 minutes? That's just for the PCM?

 

[deleted311769]

Yes its a resident clinic. By medically complex I mean at least three medical problems which each require subspecialist follow up at least quarterly, as well as at least one piece of indwelling hardware (G/tube, port, etc). NICU surviviors, congenital heart disease kids, genetic disorders, etc.

Wow, 90 minutes? That's just for the PCM?

I only have personal experience with one place where the appointment slot lengths are 90 minutes for any new patient and 45 min for any return patient, and then the "well" can be any length between. I'm told its pretty common for primary care clinics that are medical homes for kids who are technology dependent (not just g-tubes, those don't really count in isolation, these are kids who have HICUs - home ICUs) or have very complex medical needs and/or social situations. For a new patient they are actually told they will likely be there for up to 3 hours including social work, the dietitian, etc, etc.

These are not the resident clinic, though. I'm sure other's can address what their programs do for that. Mine doesn't change appointment lengths depending on the kind of kid coming in. Which means the a kid with a fresh liver transplant with severe oral aversion and the well kindergartener have the same appointment length.