Stay on schedule.(practice of gynecology)(EDITORIAL)(Report)

No practice can run on schedule everyday. There are simply too many uncontrollable variables inherent in the practice of medicine. And no single scheduling system is perfect for every practice.

The most traditional and probably the most popular scheduling system is continuous scheduling. Patients are booked at regular intervals throughout the hour; for example, the first at 9 a.m., the next at 9:15, the next at 9:30, and so on.

Continuous scheduling is popular with patients, but it is far less than ideal for most physicians running high-volume practices. If the 9-a.m. patient arrives late, your entire half-day is delayed before you even start. Similarly, a single visit that takes longer than anticipated, or one unplanned patient who needs urgent care, will throw off the entire schedule. Even without late patients or work-ins, continuous scheduling can be inefficient in high-volume offices because the workload tends to pile up toward the end of each hour as new patients arrive and you struggle to keep up.

For many offices, a better system is wave scheduling. Instead of one patient per 15 minutes, you would schedule two or three per half-hour, or three on the hour, two at 20 minutes past, and one at 40 minutes past, so that patients arrive in waves, rather than continuously. In that way, variations in time needed per patient, as well as problems created by the inevitable disruptions, will average out over each hour during the day. Also, those end-of-hour pile-ups ...