Optometric Management Tip # 10   -   Wednesday, March 27, 2002
Active Appointment Management

A well-trained front office staff can do wonders for maintaining good patient flow in the office. As leaders and managers, optometrists must first decide the proper way to handle the little details, then communicate this to their receptionists.

The goal in my office is to keep the waiting time for patients at an absolute minimum. I am proud to say we are quite successful at this. Consistently being on time for appointments is a major practice builder. We also take a caring approach that leads to high levels of patient satisfaction. Here is how we handle the little details.

Late patients. The key here is to tell the patient he or she is late immediately upon check-in. I would say “Hi, Mr Smith. I see your appointment was for 3:00, and it’s now 3:25. There may be a short wait as we adjust our schedule, but we will call you as soon as possible.” This may be a little awkward at first for the receptionist – but it’s best to let the patient know that we know he’s late. We try hard to not turn late patients away, but we also want to let the patient know that if their wait is longer than usual, or if they see someone called in ahead of them, it’s because they were late.

Early Patients. Extremely early patients can also be a problem. If we start their exams early – patients who then show up on time may have to wait because our staff and exam rooms are tied up. We manage this by acknowledging to the early arriver that we know she is early, and advising her that we may not be able to start until near the appointment time. We still make her feel welcome and indicate that we will start as soon as possible. Now the pressure to call that person in quickly is removed and we can look at our schedule and use some judgment. If we have some time before the next patient, we will start the early bird. But if we are very busy and running on time, we will stick to the schedule.

On time patients. Unexpected events can disrupt any schedule, causing us to run late. We still try to start on time by being flexible and having adequate staff to begin pre-testing. Any available technician can start an exam in one of two pre-test rooms, or in an open exam room. If techs and pre-test rooms are all tied up, but the doctor is available, the doctor may start an exam without pre-testing, and we’ll do those tests after the exam. We may even leap frog an early patient over one that is on time. If we are really backed up, the most important thing is for the receptionist to alert the waiting person – and apologize for the delay. It is rare these days for a doctor or staff to show any concern for a patient’s time, so it is much appreciated. Sometimes these patients like to browse for frames before the exam, which saves them time at the end of the visit.

An active office manager or chief receptionist should analyze patient flow on the fly – and coordinate all resources to keep things running smoothly. If you are almost always running late, I would fine-tune the appointment book with key block-outs to allow you to catch up. Or evaluate how the time is being consumed and what you could delegate to gain efficiency.
Best wishes for continued success,

Neil B. Gailmard, OD, MBA, FAAO
Chief Optometric Editor, Optometric Management