Unproductive NP

April 1, 2004

I have a nurse practitioner (NP) who is always 45 minutes to an hour behind his patient schedule. Our family practice has 15-minute appointment slots that management will not change. None of the other physicians or physician assistants have this problem. He is very thorough and documents visits very well, which is why he is so slow. He's dragging his support staff down with him, often working them through lunch, and patients will complain about the wait. What do we do?

Question: I have a nurse practitioner (NP) who is always 45 minutes to an hour behind his patient schedule. Our family practice has 15-minute appointment slots that management will not change. None of the other physicians or physician assistants have this problem. He is very thorough and documents visits very well, which is why he is so slow. He's dragging his support staff down with him, often working them through lunch, and patients will complain about the wait. What do we do?

Answer: Try offering specific performance goals as a means of benchmarking improvement. Make sure the NP knows what you are expecting.

You also should help the NP figure out how to meet the goals. Not everyone understands how to be thorough and fast. He needs examples. I've seen some people make great gains if they follow a more productive provider around for a day. If specific productivity goals aren't subsequently met, then it's time to discuss dismissal.