Medical practice creates 'bump list' to get sick patients in to see a doctor

Medical practices are commonly faced with two problems: trying to squeeze sick patients in to see a doctor right away and no-shows who never make it to their scheduled appointments.

Now a New York City medical practice is hoping to take those two problems and create a solution for patients who need to be seen for illnesses that might send them to a retail or urgent care clinic instead of the primary care doctor's office for treatment.

His practice, Weill Cornell Internal Medicine Associates, is experimenting with a "bump list," writes Fred N. Pelzman, M.D., on MedPageToday. Because schedules at the practice are usually booked solid for several weeks out, patients sometimes end up being seen in freestanding urgent care centers or going to the emergency room for conditions that should be handled in the office, Pelzman says. At the same time, the practice battles with a 30 percent or higher no-show rate, which leaves times throughout the day when providers could see patients for brief, focused visits to take of urgent complaints.

The bump list works like this: patients who call for a same- or next-day appointment, who are willing to see an available practitioner, agree that the visit will focus only on the single issue and understand they will need to wait to be seen, are put on the list.

Instead of overbooking patients on the schedule and hoping for no-shows, patients on the bump list are given appointments. Half of the patients on the list are told that if they arrive by 8:45 in the morning they will be seen during the morning practice session. The other half are told to arrive by 12:45 p.m. and a provider will see them by the end of the afternoon.

The other restriction is that patients must leave the office with an appointment scheduled for the future to see their primary care providers.

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