Wait times are a top complaint among patients when scheduling a medical appointment and an issue many physician practices are working to address, according to a recent survey.
A March 27 poll by the Medical Group Management Association (MGMA) found that among 1,100 medical practice leaders, 49% said their practice has changed its processes in the past year to reduce patient wait times. Another 22% of respondents said they are currently working on new processes to help cut the time patients must wait for appointments.
That compares to 27% who said they have not made efforts to reduce wait times in the last year and a final 2% who were unsure if processes were changed.
The fact that almost 50% of respondents said they had taken steps to reduce wait times wasn’t a surprise to Kenneth T. Hertz, a principal in MGMA’s healthcare consulting group. Wait time has been a perennial issue that practices face, he says.
Between the number of practices that have changed processes and those working on new processes to cut wait times, that's nearly three-fourths of respondents acknowledging the problem, he says. “It’s about respect for the patients, respect for the patients’ time and trying to improve the patient experience and run a practice that is patient-centric,” he says.
The problem is related to another big patient complaint, that of wait times to actually see the doctor or other clinician once the patient has come into the office for their appointment, he says. And some of the solutions for one, help with the other. Long wait times often result in backups and problems getting people in to see the doctor, which often translates into long wait times to schedule an appointment.
At a time when practices are seeing increased competition from retail clinics and urgent care clinics, which can promise patients quick, same-day appointments, practices have to be even more attuned to patient needs, he says. “Patients have a choice and they tend to vote with their feet.”
A recent study found that wait times are costly for physicians, with 1 in 5 patients saying they have switched doctors because of long wait times and 30% of patients reporting they have left a doctor appointment because of a long wait.
So, what can practices do to address the problem of wait times? Here are some tips from Hertz:
Expand office hours. Consider, for instance, a practice that is open 8:30 a.m. to 5 p.m., and closes for an hour at lunchtime. The practice decides to expand its hours to start seeing patients at 7 a.m. and stays open until 6 or 7 p.m. That provides an expanded number of hours to see patients and also makes it easier for working patients who might prefer early morning or evening appointments so they don’t have to take time off from their job to see the doctor, Hertz says. The practice has added more appointment slots and doesn’t have to double- and triple-book appointments. “That’s not the ultimate and total solution, but it helps with both problems,” he says, both the wait time to get an appointment and time in the reception room.
Of course, it’s easier to add office hours in a practice with multiple doctors who can split up covering the additional hours. A one-physician practice can consider adding hours one day a week, for instance staying open until 7 p.m. on Thursdays or opening on Saturday morning. Relying on nurse practitioners or physician assistants to help staff the office can also allow practices to expand hours.
Create a pleasant environment. Having a nice reception area won’t reduce the time patients have to wait to get in to see the doctor, but it makes the time more pleasant, Hertz says. Considering providing wi-fi access. Patients can occupy themselves and even get work done while they wait. Be sure the furniture is comfortable and updated. Use incandescent lights rather than harsh fluorescents. Decorate with plants and even the old favorite, a fish tank. Make sure your magazine selection is current. Consider providing bottled water or coffee while patients wait.
Invest in technology. Technology can shorten the time it takes to get a patient registered. It can take more than 5 minutes to get a patient checked in. They may need to update personal information, make a co-payment and wait for a receipt. When going to an appointment with his endocrinologist last week, Hertz said he got an email confirming his appointment. It asked him to review his personal information, make any changes and indicate he had reviewed the information. It reminded him of an appointment to get lab work done and allowed him to make his co-pay online. When he showed up at the doctor’s office, he gave his name and took a seat. Instead of taking minutes, his check-in took about eight seconds. For staff checking in 20 patients a day, it can be a major time-saver.
Investing in such an automated system is an expense. “I would look at it as an investment. A physician practice is a business, and a business has to continually re-invest in itself,” Hertz says. Each practice needs to look at technology solutions and measure the cost against what they can save in employee costs, patient time and employee time. “The return on investment makes it well worth it,” he says.
Make good use of practice personnel. Practices might want to take a lesson from other industries and have a manager whose job it is to keep operations running smoothly. In the restaurant business, for instance, there’s often a person who makes sure everything is going well in the dining room, troubleshooting any problems, he says. There’s often a person who does the same in the busy kitchen. Practices can incorporate this approach. They can perhaps have a nurse or certified medical assistant keep an eye on things both at the front desk and the clinical area to make sure bottlenecks don’t occur and operations keep moving.
Another idea is to hold huddles with your clinical team to identify problems. Some practices begin the day with a huddle, then also regroup at the start of the afternoon. Staff can identify potential bottlenecks. For instance, if a doctor is supposed to see his or her first patient at 8 a.m. and doesn’t get into the office until 8:30 a.m., the practice is already a half an hour behind. Also, if a doctor begins seeing patients at 8:30 a.m., schedule the first patient of the day to come in earlier so he or she is ready and in the exam room when the doctor arrives.
And remember that along with the care they receive from their doctor or other clinicians, patients place a high priority on how they are treated by office staff.
While you want to create a better patient experience, you will also create a better work environment for your staff, team members and doctors, Hertz says. When a practice is not running smoothly, it is stressful for those who work there, as well as patients.
A combination of better using people and technology to reconfigure processes can improve patient wait times, Hertz says.
While practices may not want to spend additional money, that’s not always smart, he says. “I think we have to be careful. There’s a tendency by some practices of thinking that by saving money and cutting things their practice is more successful and more profitable. But that’s not always the case,” he says. If you have a 15- or 20-year-old telephone system and you get complaints from patients that they cannot get through to your office or their calls get dropped, then your practice is losing patients, he says.
And keep in mind that that making changes is not a one-time fix, he says. You need to continue to look at procedures and processes and evaluate how they are working. Periodically review your operations and when you redesign processes, involve the people who are stakeholders. Don’t rework how your front desk operates without involving those workers from the start and letting them help come up solutions that really work, he says.