A Busy Medical Practice is a Blessing and a Curse

May 27, 2013

I love having a full schedule each day, but it's starting to affect appointments. How do I relieve a little pressure without too much negative impact?

We have a very full schedule and a long wait for patient appointments; appointments for both new patients and for follow-ups. It is both a blessing and a curse.

A blessing for us, I suppose, because we don’t have to market the practice. We don’t have to worry about not having enough patients. A curse for prospective new patients who are being told they have to wait four months for an appointment. A curse for follow-up patients who want to reschedule appointments they already have, as they are being told that if they don’t keep what they have, they won’t be seen for 2 months to 3 months. A curse for my staff who gets cursed at by said patients for being the bearers of bad news.

So how do we fix it? One suggestion is to see more patients each day. Well, if we do, that either means longer working hours, which will lead to very unhappy families (ours) and very tired, overworked doctors. Or, we could shorten patient visits, which would lead to poorer service and dissatisfied patients.

One solution would be to hire another provider. Yes, I am working on that. It’s hard. Like any practice, we want someone who knows his stuff and is pleasant to work with. I have yet to find a suitable candidate. I am more actively looking for a nurse practitioner, but am open to hiring another physician if one comes along. A physician assistant (PA) would be fine, too, but I’ve never met a PA with a particular interest in diabetes. Most of the PAs I know are in the surgical fields.

I have contemplated not accepting new patients. I know that will upset a lot of referring physicians. We also get a lot of word of mouth referrals from existing patients, and it’s hard to say, "No, I cannot see your daughter/parent/spouse." And I wouldn’t even know where to begin. I assume we must inform all the insurance companies. And what happens if one day we finally hire someone, we’ll need new patients then.

My husband/biller suggests that we stop participating in plans that don’t pay well. Fortunately, we don’t have many patients with those plans, so that will only make a minimal dent in the backlog of patients, and I am sure they will quickly be replaced by patients with other plans, and then I will back to square one.

I think I wouldn’t mind the backlog so much if only the new patient appointments were affected. But when I want to see a patient back in three months, and I can’t, that’s a problem.

I can’t wait to hear from readers in the comments section below. I’m sure there’s a practice manager out there somewhere with helpful advice for me.

[Editor's note: Dr. Young reacted to some of the suggestions below in a follow-up post on what to do regarding her busy medical practice.]