How many patients do you see daily on average?

[perox123]

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I would like to hear from other colleagues about average number of patients you see daily?
I have been following all these recent posts about psychiatrist salaries but there is never any discussion about required clinical hours and patients numbers and how that translates into salary value.
For me personally seeing >12 patients (majority being follow ups) per day is too much. I see some of my colleagues cranking high numbers with regards to pts numbers, but I also see great deficiencies in many aspects of their care.

 

[Merovinge]

I would like to hear from other colleagues about average number of patients you see daily?
I have been following all these recent posts about psychiatrist salaries but there is never any discussion about required clinical hours and patients numbers and how that translates into salary value.
For me personally seeing >12 patients (majority being follow ups) per day is too much. I see some of my colleagues cranking high numbers with regards to pts numbers, but I also see great deficiencies in many aspects of their care.

I think if you are expecting more than 30 minutes for an MD visit that isn't explicitly for therapy you just are not being honest with yourself about the realities of medicine.

I completely get that for some providers the best care is to provide in 45-60 minute blocks, which I can't argue with, but if that's your plan, you can make that happen in PP. For everyone else, and the rest of medicine, there just are not enough providers and we are forgetting about justice if we demand f/u longer than 30 minutes. As is, the system is missing lots and bursting at the seams. I happen to sleep better knowing that more folks are getting very good care even if it could ratchet up to superior care with 1/2 as many patients seen, I would take that as a net loss.

Now at some point my argument clearly breaks down, because most people would agree 10 min med checks are criminal in psychiatry. I think the line right now is 30 min f/u and I hope the field can keep that, but it certainly remains to see.

 

[wolfvgang22]

Setting, organizational and patient expectations, and patient population matters a lot.

I think about 12 a day in my clinic is a good limit, it is what I'm able to do at the VA. I'll see 10 thirty minute follow ups and 2 one hour new evals per day. I have to do a LOT of paperwork.

If I were in a less bureaucratic environment, and in an outpatient clinic without much severe mental illness, or if I had a very strict limit that I provide ONLY medication management, I could see 20 a day.

 

[Shikima]

I am in a relatively easy walking wounded clinic and can plug along quite easily if uninterrupted.
Slow day is 18. Busy is 30.

 

[hamstergang]

I'm doing child/adolescent. For me, a full day is 2 new patients and either 5 or 7 follow ups depending on the day (some days have meetings). I find the full days to be too much, and leave no wiggle room for extra paper work or phone calls. I don't know how people manage much more than this, but I'm pretty sure I'm just not efficient enough.

 

[nexus73]

I am in a relatively easy walking wounded clinic and can plug along quite easily if uninterrupted.
Slow day is 18. Busy is 30.

Do you mean a worried well clinic?

 

[wolfvgang22]

I'm doing child/adolescent. For me, a full day is 2 new patients and either 5 or 7 follow ups depending on the day (some days have meetings). I find the full days to be too much, and leave no wiggle room for extra paper work or phone calls. I don't know how people manage much more than this, but I'm pretty sure I'm just not efficient enough.

Child takes a little longer with the parents and school involvement. More interactive complexity billing.

 

[Merovinge]

I'm doing child/adolescent. For me, a full day is 2 new patients and either 5 or 7 follow ups depending on the day (some days have meetings). I find the full days to be too much, and leave no wiggle room for extra paper work or phone calls. I don't know how people manage much more than this, but I'm pretty sure I'm just not efficient enough.

I think it also depends how well known to you your f/us are. For ones that are well known, you are likely coping forward a last note and should be able to edit that note in the session (unless there's some major problem). The school calls, IEP plans, and collaboration take time, it depends how much of that can be done by other staff (say a psychologist if the pt is also getting therapy).

If you can dictate the new patients, that should be sub 30 minutes for 2 new evals; some folks Ive known do this with a handsfree phone device in their car, although that is a bit rich for my blood. If not, gotta find some time for those notes assuming you are only taking light notes in the intake. Hopefully you have software that is autopopulating parts of the intake either done by a PCP in your system or by your front desk staff in a more private psychiatry model. If you are a one-man-show then hopefully pay is good enough to make the documentation time worth it .

 

[wolfvgang22]

Comment removed due to my poor reading comprehension.

 

[hamstergang]

Less than 30 minute new evaluations is a recipe for poor evaluations, especially for complex cases.
Evaluating anybody over the telephone while driving is malpractice.

He's talking about the documentation, not the evaluation itself.

 

[hamstergang]

I think it also depends how well known to you your f/us are. For ones that are well known, you are likely coping forward a last note and should be able to edit that note in the session (unless there's some major problem). The school calls, IEP plans, and collaboration take time, it depends how much of that can be done by other staff (say a psychologist if the pt is also getting therapy).

If you can dictate the new patients, that should be sub 30 minutes for 2 new evals; some folks Ive known do this with a handsfree phone device in their car, although that is a bit rich for my blood. If not, gotta find some time for those notes assuming you are only taking light notes in the intake. Hopefully you have software that is autopopulating parts of the intake either done by a PCP in your system or by your front desk staff in a more private psychiatry model. If you are a one-man-show then hopefully pay is good enough to make the documentation time worth it .

Well, it's complicated. I'm at one hospital but in a mix of 3 settings with differences in staff and patients and all sorts of things. One place is still using paper charts but the others have a great EMR.

The pay is good enough for NJ, but surely pales in comparison to what this work would be worth elsewhere.

 

[wolfvgang22]

He's talking about the documentation, not the evaluation itself.

sorry! I retract my comment.