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Your “Patients Per Day” Stat is Lower Than You Think

November 11, 2015

A very important metric in optometric practice is the number of patients examined per day. In my consulting work, I ask doctors for this data all the time. The problem is that most doctors do not know this statistic and it is usually vastly overestimated. Doctors generally give me a number per day that they believe is pretty accurate, but if we examine the actual data retrospectively, I get a much lower number.
Let’s look deeper at this issue and I’ll provide some advice on how to measure this data point and why. As a test, I’d like you to first estimate the number of patients you think you see per day and then go back in your records and calculate the actual number. I’ll bet the actual number is lower.
Understanding the metric
The basic question of “How many patients does the doctor see per day” has some variability around it, which may explain why we often accept estimates instead of hard data. Most doctors estimate based on the number of appointment slots they have in each day or maybe by counting the number of patients on an appointment list. Unfortunately, these methods do not account for no shows, last minute rescheduling, and appointment slots that were simply not filled. We tend to round up in a big way, perhaps to make ourselves feel like we are busier than we really are.
We need to make some assumptions if we are to standardize this metric. Here is what I do.

What type of exams? In this metric, I prefer to count all kinds of exam encounters: brief, comprehensive, followup, no charge, etc. It is a general mix of exam types. If the doctor sees the patient in the exam room, I would count it. It is interesting to pull comprehensive exams out of the total as a subset, but use all exam types for the metric.

How long is a day? We should recognize that doctors work various office hours, some start early, some work into the evening. We will have to accept some variability if we want to express it per day, but I’m looking to average it for an eight hour day.

Count patient care days only. Do not include days that are primarily administrative.

Be sure to calculate this metric separately for each doctor in the practice.
Running a report
If you were to generate a report for this metric in your office management software, you would need to include several different exam types or CPT codes. These would include new and established patient codes and also routine, comprehensive, intermediate, brief and emergency exams which could have 99 codes, 92 codes or S codes.
Here are the usual steps to take to retrieve this metric:

Choose the time period you want to cover. Monthly works well because you should already have production reports every month and you can pull the number of exams from those.

Add up the number of full days or half days the doctor saw patients that month. It is best to review the appointment scheduler for this because there could be days off for various reasons and this needs to be accurate. If you know the total hours worked in patient care you can divide that figure by eight hours to obtain your number of days worked. I find expressing the number of exams per day to be more illustrative than exams per hour, but they are very similar.

Divide the total number of exams per month by the number of days the doctor worked (in patient care; do not count management days here). Example: 259 exams performed in October / 18.5 work days in October = 14 patients per day.

An interesting side data point is to calculate the percentage of comprehensive exams compared to all exams. I’d like comprehensive exams to be at least 75% of all exams.
Why does it matter?
Your basic productivity matters. If you think you are seeing 21 patients per day on average, but it is really 14.4 patients per day, you may begin to understand why your revenue and profit numbers are not as good as you would like. Knowing the real number of patients seen may motivate you to change your appointment template and delegate more procedures to staff in order to increase your patient volume.
If you do the math on how much time you spend with the average patient by taking the number of patients per day divided by the number of hours worked (after deducting your lunch break), you would realize you are spending more time with each patient than you thought. An eight hour day with an hour lunch is seven hours. If you see 21 patients on average, you would spend 7 / 21 = .33 hours or 20 minutes with each patient. But if you really only see 14 patients, it looks like this: 7 / 14 = .5 hours or 30 minutes per patient.

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.

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Dr. Gailmard offers consulting services to eye care professionals through IDOC; information is available at idoc.net.
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