Fitting in Well Visits

January 1, 2009

I am having trouble keeping up with my well checkups even though I do at least eight to 10 of them a day. I don’t have an opening for another three months. How can I see more well-checks?

Question: I am having trouble keeping up with my well checkups even though I do at least eight to 10 of them a day. I don’t have an opening for another three months. How can I see more well-checks?

Answer: Eight to 10 well visits a day does seem pretty productive already, but you can look at ways to be even more efficient. For example, have your nurse handle more aspects of the intake, educating about vaccines or discussing asthma, for example, so you can get on to the next appointment.

You can also consider doing a “well check Saturday” to catch up on the backlog. It may take a couple Saturdays. The idea is that by grouping them, you can work faster. You bring in several staffers to process patients through, checking weight, hearing, vision, etc., while you stay on task moving through pieces of the exam only you can do. You can also be simultaneously holding (nurse-led) group educational sessions on asthma, ADHD, childhood obesity, and other topics, so you don’t have to educate patients/parents one by one. If you take this approach, be sure you have measured demand for well visits so you know you’ll be able to keep up in the future. There are a few spikes each year (camps, back to school) but otherwise demand should be pretty steady.

How many sick visits are you turning away? You’ll need to know how many times a parent calls and is either triaged without a visit, told to try again tomorrow, etc. It doesn’t do you much good to do a bunch of well checks only to have the parents get frustrated when they can’t see you for other visits.

Certainly, many physicians these days rely on NPs for follow-ups, which would open more slots.

Or if demand for sick and well checks is sufficient, your group can even look at adding a physician.