outpatient attendings: do you block off lunch? how do you design your patient schedule?

[fleshwound]

I'm starting in a new outpatient position soon and need to decide on how much time to set for new vs follow up visits as well as whether to block off time for lunch. I was wondering how you tailor your day... 45/15 min visits? do you block certain afternoons/days for procedures (e.g. botox, emg)? Basically what works for you and why? What kind of practice setting are you in (private practice vs academic)?

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[Thama]

I'm in academics so I have a little more flexibility, especially since I'm movement and thus mostly see complex neurodegenerative patients that have been deemed too complex for their private practice neurologist. My regular visits are 60 minutes for a new and 30 for a return. For botox, I schedule 40 for a new and 20 for a return, though others in my practice that are more efficient with more experience do 30/15 for BTX. It works vastly better having BTX occur in a half-day block (if you have sufficient volume) - that way you can train a nurse/MA to mix, draw and inventory it. I would imagine similar efficiencies of scale would occur with things like EMG.

Definitely block off lunch. Whether you have time to eat or just have to catch up from your morning is highly variable, but you should absolutely block it off if at all possible.

 

[GuillainMollaret]

I have an hour blocked for lunch each day. Good way to finish notes from the morning and pre-chart for the afternoon. My group also has a meeting once per week during this time.

Botox is scheduled in regular return visit slots. No specific block for this and our MAs are not trained to mix unfortunately. I do EMGs as well and these are specifically blocked (4 per half day, no tech. May try to increase to 5 per half day).

News 60 / returns 30. Community hospital employed.

 

[xenotype]

I have an hour blocked for lunch each day. Good way to finish notes from the morning and pre-chart for the afternoon. My group also has a meeting once per week during this time.

Botox is scheduled in regular return visit slots. No specific block for this and our MAs are not trained to mix unfortunately. I do EMGs as well and these are specifically blocked (4 per half day, no tech. May try to increase to 5 per half day).

News 60 / returns 30. Community hospital employed.

Salary if you don't mind? That is a pretty sweet arrangement for a community job, usually have to be academic to have a reasonable pace like that.

 

[Thama]

Salary if you don't mind? That is a pretty sweet arrangement for a community job, usually have to be academic to have a reasonable pace like that.

Seriously. Like, damn.

 

[GuillainMollaret]

Salary if you don't mind? That is a pretty sweet arrangement for a community job, usually have to be academic to have a reasonable pace like that.

300k. 4.5 days / week of clinic. No call or weekends.

A sweet gig indeed.

 

[sharkbaitwhohaha]

300k. 4.5 days / week of clinic. No call or weekends.

A sweet gig indeed.

the kicker.....city with pop. <20K?

 

[GuillainMollaret]

the kicker.....city with pop. <20K?

Suburb of a major coastal city

Very high cost of living is the kicker

 

[Neurogeneral]

I get 1 hour break at noon. 15 minutes of it though is spent driving from my hospital to the clinic. The rest I use for lunch and catch up on charting.

Your schedule seems nice. I get to do 4 EMGS in half a day but I also see consults and read EEGs in the same block of time. In clinic I spend 45 minutes for new’s and 30 minutes for follow ups.

 

[deathmerchant]

I'm starting in a new outpatient position soon and need to decide on how much time to set for new vs follow up visits as well as whether to block off time for lunch. I was wondering how you tailor your day... 45/15 min visits? do you block certain afternoons/days for procedures (e.g. botox, emg)? Basically what works for you and why? What kind of practice setting are you in (private practice vs academic)?

I do half days of clinic. Started with 1 new and 1 follow up per hour (40 min and 20 min respect). But now my staff has become very efficient in taking orders, checking tasks etc so started scheduling 1 new and 2 follow ups per hour. So I schedule about 12 patients (4-6 new, 6-8 f/u) from 12.30-430. Usually only 8-10 show up.

If you are doing a full day, taking a 45 min lunch break will be very important to make sure you are not staying in long after 5 finishing notes/tasks.