Connections for Success



How To Choose the Right Scheduling Approach
Kelly H. Buchheit

Among the top patient complaints is waiting too long to see a doctor. And all too often, it is with good reason — practices simply do not implement good scheduling practices. Many practices randomly fill in appointments where there is a slot, regardless of what the patient is there for. As a result, the daily schedule can turn into a chaotic mess long before noon.

Related Read: Mastering Your Patient’s Appointment Scheduling

Three common schemes

There are three broad types of scheduling schemes:

  1. Traditional, or Standardized, Method
    Using this approach, a physician’s schedule is split into consistent blocks, often consisting of 15 minutes each, with four per hour (or 10 minutes, six per hour). Patients are simply slotted into the blocks.

    This method is simple and straightforward, but it does not consider emergencies, late patients or no-shows. It also does not account for the variability of patient visits, where some procedures might take five minutes while others might take 30 minutes or more. Another name for this method is “cramming,” which is not a compliment.

  2. Wave, or Steady Stream, Approach
    This can be implemented in several ways, but the most common is to schedule several patients, often six, at the top of the hour. While the staff is collecting data, information and vitals from several patients, the doctor is seeing others. A modification is to spread the six patients over an hour, with two scheduled on the hour, two at the 20-minute mark and the remaining two 40 minutes after the hour.
  3. Modified Wave Approach
    As the name suggests, this is similar to the wave method. However, this method leaves the last 15 minutes of the hour open to allow the physician to finish with patients or deal with any unexpected problems that arise. The benefit of this approach is having time built in to deal with the unexpected.

Specific considerations

Weigh various factors when deciding which type of scheduling works best for your practice. First, assess what type of practice you have. If you run an operation that handles many routine care situations that can be triaged by ancillary staff, that may require one type of scheduling. However, if most of your care situations involve extended examinations and treatments, that may call for a completely different scheduling method.

Second, be honest with yourself about how you approach your day. Are you able to stay on a strict schedule or do you feel that spending more time with each patient is important? Do you tend to get behind, despite your best intentions? Do you schedule time throughout your week to deal with business-related issues, continuing medical education and correspondence? These factors all play a role in what system would work best.

Third, how much staff do you have? Are there enough employees to take vitals and triage some patients while you see others? Is this the case for all patients or just for specific types of cases?

Your best scheduling approach might turn out to be a blend of all three approaches. Finding the right balance will require insight into your medical practice’s purpose, culture and your own personality.

For example, you may want to schedule specific types of patients in blocks. New-patient visits might take 30 to 45 minutes compared with a typical 15-minute appointment for an existing patient. Some physicians set aside one day a week for longer appointments, whether new-patient visits or annual physicals. That way, for the remainder of the week, they can focus on shorter appointments, such as treatment of acute illnesses or surgical follow-ups.

The necessity of buy-in

Occasional conflicts will likely happen no matter what scheduling approach you use. And we have not even mentioned software. It is possible your scheduling software is not adequate or flexible enough for your needs, but that is a matter for another day.

Ultimately, whatever approach you choose, obtaining buy-in from your fellow physicians and staff is essential. An effective, widely embraced scheduling policy can lead to a less stressful work environment that maximizes efficiency, good patient care and profitability.

For more information, contact Kelly Buchheit at [email protected]. Visit to learn more about our Health Care Group.

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