Time with patients/No shows

[Pain Applicant1]

---

Members don't see this ad.

Anyone willing to share how much time, in general, they spend with:

1. new patients
2. follow up patients
3. and how many patients are typically seen per day
4. also, what the typical no show rate is

I'm trying to set reasonable goals for my new practice and would like to be on par with others in my field.

 

[mille125]

Anyone willing to share how much time, in general, they spend with:

1. new patients
2. follow up patients
3. and how many patients are typically seen per day
4. also, what the typical no show rate is

I'm trying to set reasonable goals for my new practice and would like to be on par with others in my field.

1) 30 min
2) 15 min
3) 20-25
4) 3-4 per day and they are fined

 

[jsaul]

1) 30 min
2) 15 min
3) 20-25
4) 3-4 per day and they are fined

same

 

[knoxdoc]

Same as above, but I don't fine patients (yet). This schedule keeps me plenty busy and i am usually happy when there is an occasional no-show.

 

[specepic]

Anyone willing to share how much time, in general, they spend with:

1. new patients
2. follow up patients
3. and how many patients are typically seen per day
4. also, what the typical no show rate is

I'm trying to set reasonable goals for my new practice and would like to be on par with others in my field.

1. 30-60 (I reserve 60 min slots for the super complex)
2. 15-30
3. 15
4. 1-3/week, 3 no shows or last minute cancels gets you a dismisal from practice ltr

 

[Tenesma]

1) 20-45 mins (rarely up to 60mins) all are booked for 30 min slots though, and I never double-book a NP w/ another NP - only double-book F/Us next to NPs
2) 5-40 mins -- all are booked for 15 mins though - and I never double-book anybody next to my complicated fus (the ones that require a LOT of hand holding/or are talkers/or are just plain complicated)
3) between 30-40 pts (non-proced)/day
4) less than 2-4 no-shows per week, about 3-4 cancellation under 24 hrs per day --- it doesn't bother me because it just gives me more breathing room...

I don't fine/charge no-shows... repeat offenders (no-shows or cancellation in under 24 hrs) get discharged...

 

[drf]

Anyone willing to share how much time, in general, they spend with:

1. new patients
2. follow up patients
3. and how many patients are typically seen per day
4. also, what the typical no show rate is

I'm trying to set reasonable goals for my new practice and would like to be on par with others in my field.

1. 60 min. Everyone.
2. 30 min. Everyone.
3. 4 news and 6-8 f/us when flying solo. Double when supervising.
4. Rarely none. Sometimes 50%. usually 1-2. As I've built my personal practice within the greater clinic, I usually have zero 'own pt' no shows, but news and other people's pts still no-show.

As for the long time. 75% are super-complex and are referred by other pain docs.

 

[Jcm800]

everyone gets 20 minutes slots. news and follow ups and procedures...

its a wash usually. new patient actually takes 30 sometimes, follow ups can take 5 minutes, so its just easier this way for me. procedures probably need only 15 minute slots, but again leaving it 20 minutes just makes things smoother.


when i move to my brand new/shiny completely renovated built to my specs (taking into consideration the existing plumbing and some weird load bearing walls) new office in a few weeks, i am going to try and really stick with PROCEDURE DAY, and NON-PROCEDURE day... but i am a softy and i give in, and a follow up, often gets the E/M for free and the procedure done on that day. thats what screws me up...

i try to see 20-25, 40-50% are procedures (in office) with cancellations its 18-20...

i try to split my mornings for procedures with f/us intermingled, and then afternoons for new and f/u and non-fluoro/U/S Procedures

No shows vary, between 0-5 per day. less than 24 hours get fined, but we dont collect that vigourously. 3 no shows/less than 24 hour cancel and dismissed.

 

[mille125]

Same as above, but I don't fine patients (yet). This schedule keeps me plenty busy and i am usually happy when there is an occasional no-show.

I used to not fine either. But when you get busy and have a 3-4 week wait sometimes and three folks no show, it just isnt fair.

 

[PMR 4 MSK]

30 min new
15 min f/u

#/day depends on what I'm doing. 1/2 day clinic = 4 new and 8 f/u.

I get variably 1 N/S per day on average, I'd guess. We don't charge. Some insurances don't allow it. Medicaid does not allow it. Medicare is questionable. It's a cost of doing business. I used to charge $25 for missed appt, but I never once had someone who did not have an excuse or reason, and did not get PO'd about it. Lost some good patients with that policy. I see it as catch-up time.

I thank the good lord for some patients no-showing.

 

[mille125]

30 min new
15 min f/u

#/day depends on what I'm doing. 1/2 day clinic = 4 new and 8 f/u.

I get variably 1 N/S per day on average, I'd guess. We don't charge. Some insurances don't allow it. Medicaid does not allow it. Medicare is questionable. It's a cost of doing business. I used to charge $25 for missed appt, but I never once had someone who did not have an excuse or reason, and did not get PO'd about it. Lost some good patients with that policy. I see it as catch-up time.

I thank the good lord for some patients no-showing.

I have had the opposite experience. Those with a reason or excuse generally call and tell us. We have questioned the no shows and they say that they forgot or didnt have the number available or some other excuse that makes no sense.

 

[Tenesma]

i agree that there will always be either good or poor excuses for no-shows... you don't have the time to sort through the excuses.... however, the fine will typically just upset patients and you will likely never see the money unless you have their credit card on file...

 

[mille125]

i agree that there will always be either good or poor excuses for no-shows... you don't have the time to sort through the excuses.... however, the fine will typically just upset patients and you will likely never see the money unless you have their credit card on file...

For the most part they have paid without complaint and have not become a repeat offender.

 

[axm397]

1. new patients - 10-15min

2. follow up patients - 10-15 min - no distinction in time slots for new vs FU

3. how many patients are typically seen per day - 30-36 patients for a full day of clinic

4. typical no show rate: - 1-2 per 1/2 day clinic.

I charge for no shows for EMGs and injections because those are expensive slots and the EMG slots are 40 minutes each. ($50) Most of the time, we rarely enforce it but the threat of the charge keeps those no-shows low.

I don't care as much about clinic no shows because they like to overbook my schedule so the no-shows give me breathing room.

I do 6 half day clinics, 2 half day EMGs, and 2 half day procedures per week. Average 20 procedures, 90-120 clinic patients, and 8-10 EMGs per week.

 

[Jitter Bug]

NP 30 minutes
F/u 15 minutes

My schedule has scattered 15 min slots here and there which accomodates the occasional NP who needs an hour or a followup in crisis who needs 30 minutes.

No show rates depend on the economy here. Since it's bad right now, people are afraid to remind their boss they have to leave early for an MD appt and so they no show. They are embarassed to tell us why they aren't coming in so they don't call first. Also if someone laid off gets called back in to work, they will call and cancel everything (MD visit, PT visits etc) becuase they are so needy for work.

 

[PMR 4 MSK]

My wife forgets her appts. I personally called an OB/gyn one time, she made an appt for my wife a few days later, and my wife totally forgot about it, even though I reminded her of it. The OB was nice enough to make another appt for her.

She missed a dentist appt last year and was charged $25. She was upset about it. I told her she was a dumb@$$ because the reminder had been sitting on the fridge for over two weeks and she told me about it a couple days before that.

A couple weeks ago, she was late for another dental appt with her and my daughter, they decided to see my daughter and reschedule my wife. She was late because of construction traffic.

I was late one time for a peds appt for my daughter, just due to I did not think it was going to take me near as long as it did to get there from where I was. I did call to laet them know I would be late, but they were willing to see me.

I guess my point is, things happen. People forget stuff. They're human. The excuses may be made up to try to sound better, or they may have just been stupid. I don't judge. I don't charge. Chronic/repeat offenders get discharged.

Some do get quite irritating. I found out that one pt had been referred to me for EMG had no-showed twice and cancelled within 24 hours six times. She was scheduled for 1 hour each time, so that was an entire day's worth of time she had wasted. I refused to let her reschedule with me, so she rescheduled with my partner and showed up the first time.

Another recently rescheduled twice w/i 24 hours and then no-showed the next two, again for an EMG. We just notified the referring doc so he is aware of the non-compliance.

Forgive once, warn the second time and discharge the third. Less hassle.

 

[drf]

It seems 15-30 minutes is a board standard for FU/NP visits for folks in practice. 15-20 min for procedures. This correlates with what I know about PP in my community as well.

How did people train? What was fellowship like? Did you learn this efficiency then or did it take 6-12 months of building a practice before you could handle this volume and keep patients happy?

 

[PMR 4 MSK]

Efficiency is forced on you for survival. Either your employer pressures you to see more or you need to see more to meet expenses and get a paycheck.

There's also the fact that as you mature as a doctor, you get faster and don't need as much time to see patients as you once did. You learn to ask questions better, get staff to do more for you and get to the heart of the matter quicker.

 

[Ligament]

1. new patients - 10-15min

2. follow up patients - 10-15 min - no distinction in time slots for new vs FU

3. how many patients are typically seen per day - 30-36 patients for a full day of clinic

4. typical no show rate: - 1-2 per 1/2 day clinic.

I charge for no shows for EMGs and injections because those are expensive slots and the EMG slots are 40 minutes each. ($50) Most of the time, we rarely enforce it but the threat of the charge keeps those no-shows low.

I don't care as much about clinic no shows because they like to overbook my schedule so the no-shows give me breathing room.

I do 6 half day clinics, 2 half day EMGs, and 2 half day procedures per week. Average 20 procedures, 90-120 clinic patients, and 8-10 EMGs per week.

How do you see new pain patients in 10 minutes? Are they mostly pre worked up spine cases or full spectrum pain patients? NPs/PAs? 🙂

 

[SSdoc33]

15 min slots for new patients and f/u. about 6 new and 6 f/u per half day clinic session. usually 2-3 no shows per session. injections have a much lower no-show rate.

new patients can be done in 15 minutes. 2-3 minutes organizing paperword, getting patient in the room, finding films, etc. 8 minutes with the patient. 3 minutes dictating. boom! bill a level 3 and move on. more complicated patients get more time and a level 4, but thats only maybe 25% in my practice

 

[drf]

Efficiency is forced on you for survival. Either your employer pressures you to see more or you need to see more to meet expenses and get a paycheck.

There's also the fact that as you mature as a doctor, you get faster and don't need as much time to see patients as you once did. You learn to ask questions better, get staff to do more for you and get to the heart of the matter quicker.

Efficiency or you don't eat makes sense. I'm looking for ways to teach this skill, but likely it simply has to develop with repeated exposure to specific syndromes.

 

[Ducttape]

Are any of you docs doing 15 min NP appointments providing more of a multidisciplinary approach or pure interventional?


heck, with my referral population, it takes me 15 min alone to try to convince them why their chronic {fill in the blank shortacting opioid/APAP taken 10-20 times a day} is dangerous to their health without long term benefit and that I wont prescribe such stuff...