The Patient Scheduling Conundrum

Join Our Mailing List

Efficient New Patient-Scheduling Models

[By Staff Writers]biz-book15

Most doctors follow a linear (series-singular) time allocation strategy for scheduling patients (i.e., every 15 or 20 minutes).  This can create bottlenecks because of emergencies, late patients, traffic jams, absent office personal, paperwork delays, etc.  

Therefore, as first proposed by Dr. Neal Baum, a practicing urologist in New Orleans, one of these three newer scheduling approaches might prove more useful. 

Customized Scheduling 

The bottleneck problem may be reduced by trying to customize, estimate or project the time needed for the patient’s next office visit.  

For example:  CPT #99211 (15 minutes), #99212 (25 minutes), #99213 (35 minutes), or #99214 (45 minutes). Occasionally, extra time is need, and can be accommodated, if the allocated times are not too tightly scheduled.   

Wave Scheduling

Most patients do not mind a brief 20-30 minute wait prior to seeing the doctor.  Wave scheduling assumes that no patient will wait longer than this time period, and that for every three patients; two will be on time and one will be late.

This model begins by scheduling the three patients on the hour; and works like this. The first patient is seen on schedule, while the second and third wait for a few minutes.  The later two patients are booked at 20 minutes past the hour and one or both may wait a brief time. One patient is scheduled for 40 minutes past the hour. The doctor then has 20 minutes to finish with the last three patients and may then get back on schedule before the end of the hour. 

Bundle Scheduling  

Bundling involves scheduling like-patient activities in blocks of time to increase efficiency.  

For example, schedule minor surgical checkups on Monday morning, immunizations on Tuesday afternoon, and routine physical examinations on Wednesday evening, or make Thursday kid’s day and Friday senior citizens day. Do not be too rigid, but by scheduling similar activities together, assembly-line efficiency is achieved without assembly line mentality, and allows you to develop the most economically profitable operational flow process possible for the office. 

Patient Self Scheduling (Internet Based Access Management) 

New software programs allow patients to schedule their own appointments over the internet. The software allows solo or individual group physicians with a practice to set their own parameters of time, availability and even insurance plans.  Through a series of interrogatories, the program confirms each appointment. When the patient arrives, a software tracker communicates with office staff and follows the patients from check-in, to procedures, to checkout. 

Today, many hospitals have even abandoned the check-in or admissions, department. It has been replaced by Access Management.


The traditional inear patient scheduling system is slowly being abandoned by modern medical practitioners; an all venues (medical practices, clinics, hospitals and various other healthcare entireties).


Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.


Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact:


Product DetailsProduct Details

Product Details


3 Responses

  1. Unusual Appointments?

    Dr. Dennis M. Dimitri, a family physician, runs an unusual office. Few appointments are accepted in advance.

    Instead, patients call in the morning and are assigned a time slot later that day. Some patients even walk in without calling ahead. The counterintuitive outcome of this lack of advance planning means that no one has to spend weeks trying to get an appointment; and once patients arrive, they rarely wait more than a few minutes!



  2. Use a Good Scheduling System

    Many practices assign a relatively low-paid employee to schedule appointments manually. Yet the schedule has an enormous impact on productivity and efficiency.

    Dedicate resources to developing a good scheduling system, hire a top-notch person to run it, and ensure that the entire staff understands it. This is especially important for solo practices that are growing into groups. Good scheduling can increase patient flow by two or more patients per day, which is net income to the practice.

    So, if you use a manual system, consider computerizing it. Your billing system may have a scheduling module that is adequate for solo and small-group practices. You can buy a more sophisticated system, but don’t upgrade until you have established scheduling guidelines and policies.

    Source: Rod Aymond, Family Practice Management


Leave a Reply

Please log in using one of these methods to post your comment: Logo

You are commenting using your account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: