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 By Neil B. Gailmard, OD, MBA, FAAO, Editor July 7, 2010 - Tip #438 
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The Appointment Manager Concept

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Here is an idea that may help your practice to be more productive and increase gross and net revenue.  Assign a staff member to actively monitor and manage the patient appointment schedule.  Many practice owners may think they already have this in the form of receptionists or front desk personnel, but I often find that many appointment slots still go unfilled due to late cancellations or slightly low demand.  The value of filling the patient schedule every day is huge!  If you filled one last minute cancellation or open appointment slot per day, your practice could generate an additional $91,000 of gross practice revenue per year (based on mean exam revenue of $350).

Job description
The primary goal of the appointment manager is to keep all doctors in the practice fully booked, with special attention given to today and tomorrow.  This staff member actively manages a call list and also contacts any patient who is currently on the schedule in the future and offers the sooner appointment time.  Additionally, the appointment manager would handle all recall efforts and other promotions that result in appointments.  This staff member would call patients who do not respond to standard recall messages or who cancel pre-appointments.  These calls must be made with a great deal of tact and sensitivity to avoid creating a negative image for the practice.

The call list is an important resource for proactively filling empty appointment slots.  This is a list of patients who would like to be called if an appointment opens up that is sooner than the one they currently have reserved.  All staff members who schedule appointments should contribute to the list by asking every patient who schedules an appointment, but indicates that he would have preferred a different date and time or a sooner date in general, if he would like to be placed on the call list.  The concept could even be expanded by asking all patients if they would like to be contacted if an earlier appointment is available, not just those who are unhappy with their time slot.  The call list should contain cell phone numbers or text and email preferences so your office can get in touch with the patient as fast as possible with the fewest voice mail messages.

In an aggressive situation to fill empty time slots that are coming due soon, the appointment manager may call any patients who are booked ahead in the schedule, possibly even with a different doctor, and ask if they are interested in an appointment time that opened up.

Some practice owners may choose to provide some kind of incentive or bonus to the appointment manager (or to all employees) if the goal of a completely full schedule is achieved for a day.  That will work but I'm not convinced it is necessary.  I have a problem with paying staff more to do their basic job.  I believe in monitoring performance on the job and providing lots of feedback and, of course, raises are in order when a job is well done.  But we won't quibble on this point; bonus payments or not, an appointment manager can help your practice.

Depending on the size of your practice and your current staffing needs, you may just assign the appointment manager job as an additional duty to one employee.  It could just be a part time side job that has a special focus.  Or you could create a new position and give the appointment manager a dedicated workspace away from the front desk.  This gives the job the importance it deserves, and it creates an environment that is conducive to making many phone calls without interruption.  The appointment manager could be part of a "call center" in your office, which is an approach that is growing in popularity and offers other advantages.  I'll cover call centers next week.  If you create a new position for appointment manager, consider moving a veteran staff member who knows your procedures and patients into that job and bringing in a new person as a receptionist.

Why can't all staff do it?
To take the concept a step further, consider these points that illustrate why you may be better off dedicating one specialist to managing appointments.

  • Offices get very busy.  With current staff busy answering phones and taking care of patients, time passes and a late cancellation can easily be neglected.  Staff must prioritize their actions and if they are busy with patients, trying to fill tomorrow's vacant slot will go unheeded.  The appointment manager would have the time to do the job well.
  • It is human nature for employees to not really want the appointment schedule full.  A full schedule means more work and more stress.  Of course, staff members understand that it is part of their job and if there is plenty of supervision, they will fill the empty slot, but recognize the tendency to not get around to it, especially as the time grows near.
  • One person is accountable.  In practices with many staff members, it is easy to assume someone else will take care of tasks like calling patients.
  • Special skills and training.  The appointment manager should be very good on the telephone.  We want someone who is friendly, likeable and has good communication skills.
  • Experience is the best teacher.  When one person works repeatedly and frequently on the task of calling people and filling appointment slots, she gets very good at it.
  • A dedicated process.  When the job description is formalized, you will develop a specific protocol for how to handle last minute vacant slots.  Most practices take a simple approach like... if we have any cancellations, we try to fill them.  That could mean wait until someone calls and asks for an appointment and see if he can take the empty slot.  That seems like not enough effort to me.

Best wishes for continued success,

Read Past Tips Neil B. Gailmard, OD, MBA, FAAO
Editor, Optometric Management Tip of the Week

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Send questions and comments to neil@gailmard.com.

Dr. Gailmard offers consulting services to eye care professionals through Prima Eye Group; information is available at www.primaeyegroup.com.

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