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3 Steps to Battling Scheduling Conflicts


Scheduling patient appointments should not be a battle, but sometimes it is a bit hectic. Use these three simple steps to help your medical office manage scheduling conflicts.

1. Determine the Number of Daily Appointments

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Creating a balance between seeing enough patients that meets the financial needs of the practice but still offers a high level of quality patient care can be challenging. Many practices make the mistake of either over booking appointments or under booking appointments.

The biggest problem with over booking appointments is that the patient suffers. The number one patient complaint is long wait times. Patients should not have to wait longer than 15 minutes for their scheduled appointment. Considering how unpredictable health care can be, it is understandable that there may be times that patients will have a longer wait. Sometimes it may be unavoidable but as a general guide, patient appointments should be scheduled far enough apart that patients are not left waiting for a very long time.

Under booking can also create a number of problems. The major problem is the impact on the financial health of the medical office. All of the office expenses including salaries, supplies and other overhead costs need to be met. The number of daily patient visits should be able to cover the expenses of the office and, of course, make a profit.

2. Determine the Allowed Time for Each Type of Visit

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The types of patient visits vary depending on the practice specialty, the diagnosis of the patient, and procedures being performed during the visit. This means that a different time requirement should be allocated to each visit type. The schedule should be designed to reflect the different time requirements by considering several factors.

  1. Time Increments: Determine which time increments work best for the structure of the practice.
    • Short Visits: 10 or 15 minute increments
    • Medium Visits: 20 or 30 minute increments
    • Long Visits: 30 or 45 minute increments
  2. Types of Appointments: Evaluate how much time is needed for each appointment type.
    • New Patient Visit
    • Annual Physicals
    • Sick Visits
    • Special Procedures
    • Pre-Operative Visits
    • Post-Operative Visits
    • Consults

3. Consider Disruptions to Patient Flow

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When developing the design or structure of your patient scheduling system, it is important to consider any possible events that could cause disruptions to patient flow.

  • Late Arrivals: When one person is late for an appointment, it can throw off the entire schedule for the day especially if other unforeseeable events occur. To assist with this problem set some restrictions on how late a patient can be without having to reschedule, allow a patient that is early for their appointment to move up to the late patients slot, and schedule chronically late patients towards the end of the day.
  • No Shows: Sometimes late arrivals are actually no shows. No shows not only throw off the schedule but also affects the financial goals of the medical office. When a patient fails to show up or cancels an appointment at the last minute, this results in lost revenue for the medical office. When patients don't give notice, their appointment time is now a vacant slot in which no revenue is being generated. Holes in the schedule should be unacceptable. There are three ways to prevent missed appointments.
    1. Reminder calls to patients 24 - 48 prior to their scheduled appointment time.
    2. One way to reduce no shows is by the use of online patient scheduling. Patients can manage, schedule or reschedule their own appointments which makes no shows less likely.
    3. Billing patients a no show fee for missed appointments. No show fees not only make up for some of the lost revenue but also teaches your patients to give a notice if they are going to cancel their appointment. This also allows the opportunity to reschedule the appointment while the patient is on the phone.
  • Walk-ins: Sometimes patients find themselves needing immediate medical care and show up for an unscheduled appointment. It is never a good business practice to turn patients away so the medical office should come up with a way to handle walk-ins. Sometimes walk-ins can be fit into the schedule because of late arrivals or no-shows but this is not always the solution. The patient may be forced to wait or the schedule may be thrown off for several hours. Review the trends on when the medical office tends to see more walk-ins such as on Mondays or during flu season, and make adjustments accordingly.

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