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 By Neil B. Gailmard, OD, MBA, FAAO, Editor November 19, 2003 - Tip #96 
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How long do your patients have to wait?


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Additional Information

When your patients evaluate their experience at your office, the time they spend waiting is a huge factor... and it's one that you actually have control over.

Granted that health care today has become so lax in the "customer service" aspects that waiting in the reception area for 20 minutes is considered normal. And then there is often another 20-minute wait after the patient is called into the exam area! But just because most doctors do this, and patients don't complain much, is no reason to allow it to be the norm in your office. Quite the contrary, if you can stay on time for appointments 90% of the time, you will stand out as a shining example in a sea of mediocrity. Your practice will instantly be elevated as a great place to go for eye care. Becoming an "on time practice" is good for patient relations, and it reduces stress on your staff.

How do we define being "on time"? To me, it depends on when the patient is called in from the reception area (assuming that some testing begins right away). This makes being on time easier for a practice that delegates pre-testing. For my office to be "on time", I don't have to be available at the appointed time, but one of my technicians does.

There are several factors to consider as you analyze your practice scheduling:
  • Do you need more staff? If you routinely don't have a technician or a doctor available to start the patient, this could be the problem.
  • Do you have the exam rooms to go to? It does no good to have more staff if they don't have an open room with the proper equipment. Some practices need more than one pre-test room and more than one set of pre-test instruments. The pre-test area can be a bottleneck. Expensive? Not if you could see more patients per day.
  • Do visits take too long? If you shorten the time it takes to complete a patient, you will free up your resources of staff and exam rooms. There may not be anything you can do, however, to shorten the exam and maintain high quality. Review the number of tests you do, consider if more can be delegated and note if there is excessive chit-chat initiated by the technician or the doctor (some chit-chat is good).
  • For the next week, consider marking each exam form with the time of the appointment, the time the patient actually checked in, the time the pre-testing was started, the time the doctor's exam was started, and the time the exam was finished. This can be enlightening.
  • Are patients scheduled for the right type of visit? Receptionists need guidelines and training on how to determine the type of appointment needed for each patient. For example, a different time allotment is needed for a low vision exam than for a contact lens check-up. Try to keep this simple for the staff as you review your procedures. In my practice we have only two appointment lengths: 15 minutes for all types of visits except low vision exams, which get one hour. Of course, those slots are only for doctor time, so a comprehensive exam patient will be in my office much longer than that. Your practice may require different time slots - but my staff is not confused about how long a slot should be.
  • Do you see a lot of emergency visits? We need to see them, we want to see them, but they can destroy your schedule. Consider placing a block-out in the morning and afternoon schedule to allow time for emergencies. We have 2 block-outs in the morning and afternoon for each doctor, this fine-tuning evolved over time.
  • Are patients often showing up late for appointments? We all have patients who run late, but if it is chronic in your office, find out why. Is parking a problem, or traffic? If so, tell people to try to arrive 5 minutes early.
  • If all of the above factors are operating at the best you can do, then the last resort is to make the appointment slots longer, so you generally reserve the proper amount of time for a patient visit. This forces you to see fewer patients per day, so it would be a last resort to me, but I would do it rather than be constantly late for appointments.
In upcoming issues of this MTOTW, I'll look at how to handle the early or late arriver, and how to handle no shows.

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.

Please Note: The views expressed in Management Tip of the Week do not necessarily reflect those of the sponsor.

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