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Schedule Balancing 101

Healthcare Schedule Balancing: Convincing Doctors to Share

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Doctors don’t like sharing patients with other providers, how can you convince them to do so? Healthcare schedule balancing is key to having a well run office with shorter patient wait times and higher schedule utilization. The answer is appealing to their self interest, addressing their fears, and thoughtfully implementing change.

What is Schedule Balancing?

Schedule balancing redistributes patients from busier providers with long appointment wait times to lower utilization providers with appointments much sooner. Here are two examples to illuminate the point. First, using scheduling balancing to make sure an established pulmonologist in one medical office has a very similar schedule utilization and patient wait time to a newer pulmonologist in the same medical office. If not, then utilize schedule balancing to bring the patient in with the less busy provider. that similar providers have similar utilization rates and patient appointment waits. Second, a nurse practitioner who can see new patients should have a similar patient wait time for new patient appointment types as a primary care doctor. If not, use schedule balancing and bring patients booked with the primary care doctor in for an earlier appointment with the nurse practitioner. Remember, for every one day of wait, the probability of a patient no-show increases 1%.

Why Schedule Balancing Exists

The number of nurse practitioners has more than doubled in the last 11 years. Nurse practitioners now have full practice authority in over 22 states with more coming. Why? There aren’t enough doctors to meet the rising demand in the US. This high demand is also burning out doctors at an alarming rate.

Why Health Systems Struggle in Implementing Schedule Balancing

Nurse practitioners and PAs (even MDs) are used to lighten the load in many healthcare systems by taking patient appointments from physicians. However, many medical practices we’ve talked with have struggled with putting this idea into practice.

The most common refrain is “our doctors don’t want anyone else seeing THEIR patients”.

Doctors sharing patients has benefits for patient satisfaction, doctor satisfaction, and staff satisfaction. But, how do you convince a doctor to share?

Schedule Balancing: The Argument for Doctors to Share

Our Guiding Principle: To convince a doctor, one must think like a doctor. Or to quote Caddyshack

I have to laugh because I’ve often asked myself my foe, my enemy, is an animal. In order to conquer him I have to think like an animal and whenever possible to look like one.

1) Show them how many patients they have waiting for them

If I were a doctor, the number one reason I wouldn’t want to give up patients would be fear. Fear that I would lose all my patients. I’d have nothing to do all day and maybe would be rendered obsolete! It’s a bit extreme, but fear is like that.

The first thing to do is show a provider just how far out they are booked for the appointment types you want them to share with other providers. That’s how long the wait for patient appointments are. This lets the provider know that giving up a few patients won’t put them out of work and also boost their ego a bit, who doesn’t love that!

2) Remind them how busy they are every day

Show them a picture of their schedule. The schedule is probably booked back to back to back all day. Let them know that if they gave up 1 or 2 patient appointments they would have an extra 20-30 minutes a day to do paperwork or spend with patients.

3) Make the case for patient satisfaction

Educate providers on the ramifications of patients being booked that far out, something we’ve written about here. Patients booked far out are more likely to no-show, one thing that drives doctors crazy. There are also serious health implications for patients waiting weeks or months for care. Here’s a real-world example of this.

4) Show them the efficacy of the mid-level provider

In addition to making sure they get seen on time, the doctor wants to make sure the patient will be in good hands. Have them talk with the provider who will be taking some of their patients. Make sure the doctor knows the provider’s background. Sell the doctor on the provider!

Implementing Schedule Balancing

1) Start with less desirable appointment types

While being a doctor is a higher calling, it’s also a job. We all have parts of our job we don’t love (blog writing is not one of them :)). Ask the doctor which appointment types they don’t love or take a mental note whenever a doctor complains about a certain appointment type. Start by offloading some of these appointment types.

2) Start with less desirable patients

There may be certain patients that the doctor doesn’t get along with well. Start with these.

3) Start with appointments further out in the future

Don’t try and reschedule patients who have appointments tomorrow to a different provider. This jolts providers who value consistency in their schedule. Start with patients booked weeks out.

4) Train the staff in the call center

If a patient doesn’t care who they are booked with, don’t just use next available appointment. Direct them to specific providers for certain appointment types. The next available appointment could be a result of a cancellation and we don’t want to burn out physicians any more than they are.

5) Do not replace all the patients who are moved to another provider

Put a block in the schedule so the provider sees the extra time they now have in their day. Positive reinforcement is key. Of course, this is a balancing act. You do want to replace some of the patients, but not all.

6) Schedule more desirable appointment types

As you do replace the patients on the schedule, do so with appointment types that the provider likes and finds interesting.

Schedule balancing is key to physician, staff, and patient satisfaction. It’s why QueueDr built a product specifically for Schedule Balancing. Successful implementation can mean the difference between a happy doctor and an angry one.