Optometric Management Tip # 227   -   Wednesday, May 24, 2006
Appointment Scheduling Strategies

I’m often asked about the appointment scheduling procedure I use in my practice. Not that my way is the only way or the right way, but it works well for me. Each of the doctors in my practice (usually three on any given day) sees about 25 patients per day and we generally run on time. There are many clever appointment templates in use today, but I just prefer to keep things simple. Here are my covenants for appointments.

Keeping it simple

• All slots are 15 minutes long.
• It doesn’t matter if the appointment is for a new patient, established patient, comprehensive exam, contact lens follow-up, medical office visit or whatever – they are all 15 minutes long (specialty exams like low vision are an obvious exception to this rule, however).
• The 15 minute slot is time with the doctor, but the technician will spend 20 to 30 minutes with the patient before the doctor sees him or her. We don’t schedule technician time.
• Any day of the week and any time of day may be used for any type of visit. We do not reserve certain times for vision plan patients or follow-up exams, etc.
• Block out slots are inserted before lunch and before quitting time so we stay on time for staff.
• Additional block outs are inserted as needed to stay on schedule for patients and to accommodate emergency squeeze-ins. Depending on how many block out slots you insert, you may actually be seeing patients on an every 20 minute basis, rather than 15 minutes.
• We record the type of visit in the appointment slot (on our software system) so the tech and doctor know what to expect and what pretesting protocol to use.

By randomly filling the schedule with various types of visits, we see a good mix of patients – some taking longer and some being quicker. Some visits produce high gross revenue, some are low or even no charge (like contact lens follow-ups that are prepaid). It all comes out in the wash. Since patients don’t always show up exactly on time, I feel there’s no advantage in trying to perfectly control everything – doing so doesn’t work any better anyway. We are efficient and flexible, and we can adjust our protocol if needed to handle unusual chance occurrences.

The advantage of this system is great ease of scheduling for front office staff. It’s simple and quick. Patients are easily accommodated for the appointment time of their choice. Caring about patient’s wants and needs should never be underestimated.

Other thoughts

• Appointments should be scheduled on an office management software program. I know many offices still prefer the old paper appointment book, but I have to think they don’t know what they are missing. Staff may resist change, but the computer offers many benefits that are too great to pass up.
• Forms and questionnaires for patients to complete are kept simple and quick. Not only do patients dislike filling out forms, but I don’t want them to delay the start time. Many practitioners mail forms in advance, and we make ours available on our website, but it’s easy to keep forms simple and have them filled out in person.
• Contact lens fitting procedures should be streamlined and delegated so that a patient can be fit and dispensed during an exam appointment, even if the office was not informed in advance.
• We tell patients the actual appointment time – not an early made up time. That seems too confusing to me.
• Develop a good track record for being on time for staff at lunch and end of day. These factors are important to employees and respecting that makes your practice a better place to work.
• Start patient appointments on time. As a rule, you should be able to start appointments within 5 minutes of the correct time at greater than 90% of the time. In health care today, just being on schedule is enough to give you a true competitive advantage.

Our doctors stay flexible by wearing a silent pager that lets him or her know when the next patient is ready and waiting in another exam room. We just do what we can to stay on time; that might mean doing tests in a different order or delegating a task and moving on. We also stay on time by leap-frogging patients out of order and seeing patients without a scribe, if necessary.


Best wishes for continued success,

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