Types and telephone scheduling
Different types of appointment scheduling are used to meet the various needs of the medical facility, the providers, and the patients. Some offices use a combination of methods to create the right mix of activity during the day and to ensure that the day runs smoothly and efficiently. The medical assistant should become proficient at managing appointments. The following section presents several methods of appointment scheduling.
Time-specified (stream) scheduling
When each patient is given a specific time for their appointment, this is referred to as time-specified or stream scheduling, as it keeps a steady flow of patients moving through the office. This is the most common type of scheduling used in healthcare facilities. Studies have shown that providers can see more patients with less pressure when patient appointments are scheduled for a specific time slot. The medical assistant who is scheduling patients using this method should know the amount of time needed for each appointment type and keep time slots available for urgent visits.
Wave scheduling
Wave scheduling is an attempt to create short-term flexibility within each hour. Wave scheduling assumes that the actual time needed for all the patients seen will average out over the course of the day. Instead of scheduling patients at each 15-minute interval, wave scheduling places three patients in the office at the same time, and they are seen in the order of their arrival. This way, one person’s late arrival does not disrupt the entire schedule.
Modified wave scheduling
The wave schedule can be modified in several ways. For example, one method is to have two patients scheduled to come in at 10 AM and a third at 10:30 AM. This hourly cycle is repeated throughout the day. In another version, patients are scheduled to arrive at given intervals during the first half of the hour, and none are scheduled to arrive during the second half of the hour. This would allow time for urgent or walk-in patients to be seen.
Double-booking
Booking two patients to come in at the same time is sometimes used to work in a patient with an acute illness or injury when there are no open appointments. This works out best if one of the patients needs laboratory work or another procedure done before seeing the provider. The provider can see one of the patients while the other one is being prepared.
Open office hours
With the open office hours method, the facility is open at given hours of the day or evening, and the patients are told that they can come in at any time. This type of system is often used in an urgent care setting. Patients are then seen in the order in which they arrive, although a patient with an urgent condition may be seen ahead of those who arrived before them.
The open office hours system can have many disadvantages. The office may already be crowded when the provider arrives, resulting in an extremely long wait for some patients. Patients may arrive in waves throughout the day, which causes parts of the day to be very busy and other parts to be slow. This makes accomplishing other office duties difficult. Without planning, the facilities and staff can be overburdened.
Grouping procedures
Grouping or categorizing procedures is another method of scheduling that appeals to many practitioners. For instance, an internist might reserve all morning appointments for complete physical examinations, or a pediatrician might keep that time for well-baby visits. A surgeon might devote 1 day each week to seeing only referral patients. Obstetricians often schedule pregnant patients on different days from gynecology patients. The providers and staff can experiment with different groupings until the plan that works best for the practice eventually becomes evident. In applying a grouping system of appointments, the medical assistant may find it helpful to color-code the sections of the appointment book reserved for designated procedures.
Advanced booking
Often, appointments are made months in advance. When any appointment is made, an appointment card should be completed and given to the patient. All appointment cards should mention that patients must give 24 hours’ notice if they are unable to keep the time reserved. Most offices have some type of confirmation procedure by which patients are notified the day before to verify that they intend to keep the appointment. E-mail and text messages are becoming common methods of reminding patients of upcoming appointments. The medical assistant should be aware of the policies for his or her facility regarding patient reminders.
Time patterns
When booking appointments, the medical assistant should make it a policy to leave some open time during each day’s schedule so that if a patient calls with a special problem that is not an immediate emergency, time will be available to book the patient for at least a brief visit. Mondays and Fridays generally are the most hectic days of the week. Keeping one time slot available in the morning and the afternoon specifically for emergencies is a wise practice. A busy provider always fills these open slots, and having them in the schedule causes the least disruption during the day. If possible, set aside time in the morning and afternoon for a break. Even 15 minutes can give the provider time to return calls from patients, verify prescription calls, or answer questions.
Telephone scheduling
A pleasant manner and expressing a willingness to help are just as important on the telephone as when meeting patients face to face. This is especially true when making appointments, because the telephone contact may be the patient’s first impression of the facility. Often, the manner in which the booking is made makes more of an effect than the convenience of the appointment time.
Be especially considerate if the time requested for an appointment must be refused: briefly explain why the time is not available and offer a substitute date and time.
Many offices offer the patient a choice when scheduling the appointment and let the patient decide which option is best for him or her.
These small courtesies give patients the feeling that they control their time. Always repeat the time to reinforce the appointment, and do not hesitate to ask the patient if he or she has a pen ready to jot down the time and date. While repeating the information to the patient, check the appointment book or computer screen to ensure that it was posted correctly. When scheduling appointments over the telephone, it is not possible to give the patient a reminder card for the appointment. Be sure to ask if they would like a telephone, e-mail, or text message reminder of the appointment.
Write legibly when using an appointment book. These records could be called into court, and the medical assistant must be able to read his or her own writing if asked to testify. Form the habit of entering the patient’s daytime telephone number after every entry. The appointment may need to be canceled or the schedule rearranged in a hurry, and many precious minutes can be saved if the telephone number is handy. Cell phone numbers are quite useful for tracking down a patient quickly.