A day in the life of a typical physician can often be fraught with practice workflow challenges. Patient no-shows, practice inefficiencies, navigating EHR systems and falling behind schedule were just a few of the hurdles cited in Medscape’s Practice Workflow Report 2017, which includes responses from more than 1,150 physicians across 25+ specialties.
About three-quarters of physicians (76%) see between 11 and 30 patients each day, and 40% see between 11 and 20 on a daily basis. But it’s the patients you don’t see that can be most problematic. No matter how many reminders you send out, whether by phone, text, or email, some patients are going to stand you up. In a typical week, 72% of physicians’ appointments include up to 10% of no-shows. And almost a quarter (24%) of physicians say that 11% to 20% of their patients fail to show as scheduled. When reminders don’t work, charging for no-shows seems to be the most common solution.
When it comes to practice efficiency, just over half of physicians they’re either very satisfied or somewhat satisfied. A meaningful percentage of providers think there is room for improvement, including:
- Better technology (43%)
- More non-physician clinical staff (38%)
- Fewer patients scheduled (29%)
- More administrative staff (19%)
- More physicians (18%)
As you likely know from your own experience, that efficiency loss isn’t happening because physicians are out for leisurely lunch breaks. Almost half (44%) of employed physicians take less than 30 minutes for lunch, and 27% say they typically don’t break for lunch at all. Some use that time to squeeze in patient phone calls: 61% of physicians do phone patients during the day, but they don’t have a scheduled time to do so. The phone remains the preferred method of communicating with patients outside the office, according to a whopping 93% of physicians. Email is the choice for 34% and texting for only 8%.
Electronic Health Records
EHRs also play a big part in the day of most physicians. In addition to documenting visits, half of physicians use EHR to identify patients who need a follow-up visit, 42% use it to identify patients who need additional treatments, and 38% use it to send patient reminders. Even though many physicians find EHR burdensome, they did cite several features they feel improve efficiency, including:
- Electronic prescribing
- Ease of capturing notes
- Remote access
- Ease of finding results and reports
- Dictation of patient information
- Sharing of medical records among physicians and referring physicians
Falling Behind Schedule
Regardless of what improvements are put in place, more than one-third (36%) of physicians generally fall behind schedule several times per week. 28% of physicians run late on a daily basis, and 13% are in the weeds once per week. These lags often lead to wait times of 16 to 30 minutes (for 45% of respondents), or 15 minutes or less (for 37% of respondents). But 12% say they get backed up for as long as 45 minutes. Only 6% of respondents say they are never behind schedule.
The reasons for these wait times vary. The most common for more than three-quarters (79%) of physicians is their commitment to spending as much time per patients as required, even if it throws off the schedule. Nearly two-thirds (66%) say it’s because patients arrive late and hold things up while they fill out necessary paperwork. Less than half (49%) say it’s due to time spent recording patient notes in between appointments.
Some physicians were able to offer advice to help stay on schedule. Their words of wisdom include:
- “Be sure your office doesn’t overbook”
- “Become more adept with your EHR”
- “Develop and communicate a policy of charging for no-shows”
- “See less complicated patients”
- “Take fewer breaks (if you currently take breaks)”
Lessening the Burden
Focusing on patient care while managing an efficient practice can sometimes feel like walking a tightrope. It’s important to find ways to reduce stress and avoid burnout. The suggestions above are a starting point, but “take fewer breaks” is probably not the practice management advice you’re looking for – especially if you don’t get any breaks to start with. Many physicians have been pleased with the freedom and flexibility associated with locum tenens opportunities, which allow them to focus on patient care and free themselves from most administrative burdens. For more on this potential practice alternative, check out our past blog post, What is Locum Tenens? and read the story of Dr. William Gruss, in Fed Up with the Business of Medicine?
*Image Source: Medscape 2017 Practice Workflow Report