I work in a large(ish) main campus academic department. I have noticed that, as a whole, our patient volume is quite cyclical. I am in clinic 3 days/week and there are weeks that I will only have 3 consults, and then others that I have 8+. I noticed that the weeks I have few consults, colleagues in other sites are also pretty quiet. I wonder if there isn't some psychology at play in what makes patients decide to come certain times of the year... perhaps something to do with insurance deductibles and limits.
Even though I am usually too busy and hoping for things to cool off, I can't help but feel anxious on those weeks when things are quiet. I guess the grass is always greener....
I STRONGLY believe in various outside forces driving the cyclical nature of consults. I have three main theories:
1) If you're in certain areas of the country, the weather. I have noticed decreased consults and problem visits in the Spring, for example, when the weather first starts to get nice. My hypothesis is that people are trying to get outdoors and enjoy it, and are less likely to sit inside perseverating on issues, or will intentionally delay activities (especially unpleasant activities, like going to the doctor) which will take them outdoors. I suspect this is less prevalent in like, Florida and SoCal.
2) I agree, I think some people will delay healthcare depending on insurance deductibles, and try to time visits to when it is potentially least expensive.
3) Major holidays. Almost invariably, from Thanksgiving to a week or so after New Years, volume is down. Similar to the weather, people are either otherwise occupied and not perseverating on issues, or are delaying presenting for care in order to spend time with friends and family. I also think the entire system slows, as people employed in healthcare take vacations and we don't run at 100% capacity.
I actually designed some projects to study this, but never pulled the trigger because I had more pressing obligations. Literally for my own interest I will probably still try to study and quantify these hypotheses...perhaps I'll just publish them on SDN, as the publication fees are low and the Impact Factor is out of this world.
