Article Date: 3/1/2004

view from the top
Staying on Schedule
Consider this advice the next time waiting patients have you stressed out.
By Gary Gerber, O.D.

It never fails. No matter how hard you try, you can't seem to stay on schedule. Only now, the stress is starting to get to you. As you're attempting to examine the patient in room one, you can hear your staffer leading the next patient into room two. You also overhear another patient entering the office. Make it stop! Make them go away!

Many of us suffer from the stress of getting backed up in our schedules. Add to that emergencies and other unexpected patient visits and it's enough to give even the calmest of us reason to worry about how we'll ever get through our day.

Don't be rude

I counsel clients to force themselves to clear their heads of any administrative tasks and "on deck" patients when they're working with a patient. This conscious effort will help you provide better patient care because patients notice any inattention and distractive behavior. While seemingly insignificant and (unfortunately) sometimes routine, patients perceive sticking your head out of the exam room door and answering non-emergency phone calls or talking on the intercom as intrusions on their time. Yet many of us politely tell patients, "Excuse me. I'll be right back." Unless it's an emergency, don't do it!

Get to the root of the problem

Numerous patient surveys and exit interviews have shown that the number-one request patients have is for an obvious and clear addressing of their chief complaints. Yet, it's not uncommon for me to see doctors chatting about non-essential personal eye care topics for an amount of time that eclipses the actual exam! Be friendly to your patients, but respect their time. They generally won't tell you what's often on their minds: "Hey doc, enough with the small talk, take care of my eyes!" Exhibiting this prompt and succinct cordialness will not only help you to stay on time with waiting patients, but it'll help you stay focused on the problems of the patient in front of you.

Work with your staff

As with most practice-building issues, your staff can help here too. Alert your staff that the patient's time with you is "golden" and that they should only disturb you in the case of absolute emergencies. (Sometimes it's helpful to define "non-emergencies," e.g., if a pharmacy calls and asks if it can substitute a drug). In this case, don't interrupt the patient. Not only will you get behind schedule, but you'll also get more stressed and you'll have a harder time concentrating on the patient in front of you. Instead, have your staff tell the pharmacy that you'll call back.

Set a goal

I was in a client's office during game seven of the Yankees/Red Sox playoff series. The client, a devout Yankee fan, had every intention of being at home and in front of his TV for the first pitch of the game. And he did -- not by cutting clinical corners -- but by forcing himself to stay on schedule and keeping his non-clinical chatter to a minimum. Setting these short-term goals is often an effective way to keep your concentration level up and your exam pace on target.

Keep the experience positive

Remember, for the most part, your patients don't want to be in your office and certainly don't want to devote any more time than is necessary. Keeping them there too long will have the same negative effect on building your practice as rushing through their exam.

Dr. Gerber is the president of the Power Practice, a company specializing in making optometrists more profitable.  Learn more at or call Dr. Gerber at (800) 867-9303.


Optometric Management, Issue: March 2004