The Dysfunctional Medical Practice – Part I of a Five-Part Series

Several years ago, we were engaged to transform a dysfunctional medical practice. No matter where we turned, there were issues, the largest of which was that the last patient appointment was set at 4:30 p.m. but the staff rarely left the office before 7:30 each night. Lunch was a juggling exercise because the morning patients were walking out as the afternoon patients were walking in. Understandably, patient frustration ran high and employee morale was almost nil. This series will explore four issues that contributed to the chaos and how they were resolved.

Issue #1: The Tardy Physician

Our client was a very affable, likable guy, and an excellent physician. No doubt that is what kept his practice full of patients. However, he was chronically late. The first patient was scheduled at 9:00 a.m. but he rarely walked in before 10:15. Seems like an obvious problem to fix, right? The short-term solution was, of course, to rearrange the patient schedule to better conform to the provider’s actual hours. But a wise man once said, “If you give a mouse a cookie, he’ll want a glass of milk.” Sure enough, once the schedule was revised, he felt less pressure to be on time, and slid further behind.

After a heart-to-heart, some “Tough Love” was in order. The schedule was scaled back by a half-hour, and the Front Desk operations revised to better track and act on patient arrival time. Medical Assistants were made accountable to fill the rooms, perform vitals, note the chief complaint and have patients ready for the clinician. The Office Manager gave the physician a reminder call 20 minutes before the first appointment so he could wrap up any hospital visits. And the physician’s wife was all too happy to help her husband out the door in the morning if it meant he’d be home for dinner with the family.

Read Part II of the series next week.

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