DIFFICULT PROBLEMS...POSITIVE SOLUTIONS (part3) by Susan Hoy THE CHICKEN OR THE EGG Q: What do you do when patients don't respect your schedule, and that indifference results in your office having scheduling problems, patients waiting, and patient conflicts? A: "A great patient experience" is the result of proper scheduling. That feat is no easy task, especially if your patients do not respect your schedule. The ultimate result is scheduling chaos, stress, and lost patients. You could ask yourself this question: "Which came first . . . the chicken or the egg?" In other words, do patients not respect your schedule because you don't respect theirs, or vice versa? Whatever the case, an unkempt schedule creates stress, both for the office staff and for your patients. Besides, if your goal is to treat and help as many patients as possible, an "on time" schedule is extremely important. So, how do you get control? First, let me admit that we've been having scheduling problems over the last few months. So much so, that we had been devoting the major portions of many staff meetings discussing solutions. We know that our practice can't grow until we solve these problems. Our goal is to help as many patients as possible and if the schedule is bogged down, we won't have room for any more patients! In fact, it's just the opposite. Our existing patients will go away. I believe that most patients will start respecting our schedules as soon as we start respecting theirs. When we keep patients waiting for 10 or 15 minutes on a regular basis, our patients will begin to be 10 or 15 minutes late. Therefore, the first solution is to stay on time. It isn't always possible, but it is possible most of the time. In order for us to schedule properly, we must know how long our doctors routinely spend with patients. I find that the staff usually answers the question differently than the doctor. That's because the doctor often loses track of time while treating patients. A time study ultimately must be done to remedy this situation. It should be done without the knowledge of the doctor. Otherwise, the doctor will be sure to work perfectly during the study. Try to conduct it at different times of the day, taking into consideration different types of patients, i.e., maintenance patients usually take less time than more intensive care patients. If you want to be completely accurate, and have your doctor be involved also, do what our office did: The problem we were having was that our doctor had little or no concept of time. On a busy day, or even on a not so busy day, he would spend unproductive time with his patients. In fact, it was worse on a "not so busy" day when he could have the opportunity to spend extra time with patients. Suddenly, we'd get very busy, but our doctor was in the "slow mode". It was creating a lot of stress for our staff and for our patients. Unfortunately, he never realized how much time he was spending with patients. Since he couldn't adjust with his watch on, he had to depend on his staff to let him know when he was running behind schedule. When we told him how long he had spent with a patient, he would literally not believe us, usually citing a reason why we were at fault, not him. Needless to say, this was quite frustrating for us, to the point that resentment would start building. Pent-up resentment is negative and negativity is not something we want in our practice. Now don't get me wrong, when our doctor needs to spend time with a patient because the patient needs his help, we don't resent that. But, when we're running behind schedule and the doctor is chatting about his children, or cars, we get hot under the collar, and so do our patients! Ultimately, WE take their abuse, not the doctor. Additionally, from personal experience, when we keep our patients waiting too long, the patient-base begins to dwindle. I know this is an industry-wide problem. I recently spoke to an exasperated CA who explained that her doctor wants patients scheduled every 15 minutes, however, the doctor spends at least a half hour with each patient. Now, that is a horrendous problem, especially for the staff. The Solution: Recently, I was consulting with a chiropractic office in our area when the doctor pulled a little gadget out of his pocket. "Does your doctor have this, Susan? It's a timer, and if I don't have it in my pocket while treating my patients, I always get behind." My ears perked up l He went on to explain that the timer can be set to vibrate quietly when a certain time period is up. The time can be set up to go off at three different intervals as a warning that you are spending too much time. The timer counts down, vibrates, and then counts up. So if the timer is set to go off at ten minutes, with vibration warnings at five and seven minutes, at the end of ten minutes, it begins counting up. Thus, when the doctor emerges from the treatment room, if the timer says plus ten minutes, then the doctor knows that he has spent twenty minutes with the patient. It allows for NO excuses. I immediately bought two timers, one for each of our doctors. I didn't even care if I had to pay for them myself. It was my gift for the staff. If these little gadgets would eliminate staff frustrations, and ultimately patient frustration, they would be the best investment I had ever made. Using them would result in less stress for everyone, and more room for patients. The timers arrived and I showed them to our doctors. They were very enthusiastic. Being the open- minded doctors that they are, they could see how this would help us get through a busy day and help them keep track of time. Besides, they love gadgets. The timer was a hit right away. My doctor began challenging himself to treat the patient in the allotted amount of time. Now, that doesn't mean he short-changes his patient, it just means that he keeps to chiropractic! No longer do we hear him discussing his children or getting off the subject with his patients. He focuses on the problem the patient is having, gives the proper treatment and moves on. In other words, he's now focused and on purpose. I have recommended the use of timers for chiropractors who are building a practice, too. Even though they do not have a reception room full of patients, they must prepare themselves and their patients for when they do. The chiropractor must decide how much time it takes to treat a patient, and then be consistent with that time. If patients get used to a doctor spending lots of time with them, then when the practice gets busier, those patients will feel short-changed. It is extremely important to spend approximately the same amount of time with every patient whether he is are helping 20 a day or 120! These days, when my doctor spends too much time with a patient, I simply ask him, "What does your timer say?" He looks at it, gets a guilty look on his face and says, "Too long!" Our staff only gets blamed when scheduling problems are actually our fault. Our staff is happier, our patients are happier, and our doctors are staying to the subject of chiropractic, and having fun, too. The truth is, I would have spent twice as much for those timers, considering the results they have given us.