New trend in appointments — same-day scheduling
New trend in appointments — same-day scheduling
Fears of scheduling gaps discounted
Taking a page out of the customer-driven concept many businesses have adopted to stay competitive, more providers are experimenting with a radical new idea: same-day service. If a patient wants to see his doctor, all he has to do is call in the morning and by the afternoon he is meeting with his physician.
This move to same-day medicine is part of a national movement to reinvent the doctor’s visit based on the idea that if providers better manage their caseload and adopt customer-demand forecasting techniques used by industry, they can eliminate delays that infuriate patients — and ultimately improve both the delivery of care and their bottom line, say experts.
While the idea sounds great to patients, the initial reaction among most providers is it is just not do-able.
"To get past this mentality, you have to be willing to basically blow up the existing system and start over from scratch," says Catherine Tantau, MD, who with her colleague Mark Murray. MD, both of Roseville, CA, are credited with pioneering the same-day philosophy.
"Once you accept the premise, you wonder why it took so long to think of it," notes David Osler, MD, a Somerville, MA, pediatrician. Instead of patients having to book appointments three months in advance, "they can hardly believe all they have to do is call the day before to get in to see me," he says.
The idea seems to be spreading. The HMO HealthPartners plans to convert its 25 clinics in the Minneapolis-St. Paul area to the same-day service system over the next few months, notes Diane Jacobsen, an analyst at the Institute of Clinical Systems Improvement, a Minneapolis-based health care think tank.
In Boston, physicians with Beth Israel Deaconess Medical Center have also adopted the same-day approach.
While some providers question the idea, the Cambridge Health Alliance, a multispecialty practice in the Boston area, says its practice has seen a 14% increase in new patients — while its no-show rate has dropped from 41% to 18% since the conversion to same-day scheduling.
A major worry is if doctors intentionally leave large chunks of their day unscheduled so they can immediately see patients, they’ll lose money. However, most providers who use the system say their schedule is almost always filled by the end of the day. In fact, using a statistical forecasting method, Cambridge Health estimates an average physician in its practice will receive 17 calls a day from patients wanting to come in.
Another advantage is "the office runs more smoothly now," says Cambridge Health physician David Baron, MD. "Before, a receptionist had to juggle a doctor’s schedule if a patient insisted on coming, in which added a lot of stress to the scheduling process."
Patients who did get last-minute appointments under the old process often felt frustrated when they had to see another provider because their personal physician was already over-booked and could not see them.
The old way of looking at the world was, "I am the doctor, this is what you are going to get," notes Peter Lindblad, MD, medical director for the ambulatory service at Cambridge Health Alliance. "Today’s new reality is, You are the patient, what do you want?’"
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