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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,
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
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
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.
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
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
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
Best wishes for continued success,
Neil B. Gailmard, OD, MBA, FAAO
Editor, Optometric Management Tip of the Week
Dr. Gailmard's new book, Practice Management in Optometry: A Blueprint for Success Based on the Optometric Management Tip of the Week, is now available on Amazon.