Scheduling patients efficiently and accurately is a widespread challenge in the chiropractic profession. This seems to be the case whether an office is big or small, and whether one CA or several are doing the scheduling.
For example, consider this dilemma presented by one practice: “We have a huge problem in our office. With six chiropractic assistants working the front desk, we are very inefficient at scheduling appointments. Everyone needs access to the appointment book at the same time. Staff will write notes and forget to schedule things. What should we do?”
When I was asked this question by e-mail, I put on my best “thinking cap,” and asked the following questions: “Do you have a network, and how many computers are available on the network? (Perhaps adding one or two computers will solve the problem.) What speeds are the computers? (Maybe the problem is old, antiquated computers, which take too long to load the appointment book program.) What software are you using? (Is the software itself the problem?)”
Did I ever feel silly when I received this response: “We have a paper appointment book. My CAs are tripping all over each other trying to answer phones and get to the book. We routinely schedule 300 visits per day, with three doctors on staff. Although we have a computer system, we are still scheduling appointments on paper — the way we’ve been doing it for years.”
I envisioned CAs with phone cords stretched to the limit and wrapped around them as they squinted at a tattered, cramped appointment book. Obviously, the solution to this office’s problem lay with an easy-to-use software program with strong scheduling capabilities.
I am certain the doctor had no idea how much that inexpensive paper appointment book was actually costing him in the scheme of things. I guesstimated that the practice was wasting at least 20 staff hours per week struggling with scheduling issues related to keeping the scheduling on paper, and that was only part of the overall cost.
It’s impossible, for example, to quantify the dollars lost from patients who missed their appointments and never received a follow-up call. How many dollars are lost when patients slip through the cracks and are not scheduled at all? With these factors in mind, an efficient scheduling system is obviously an important aspect of your bottom line.
A computerized appointment scheduler can play an essential role in directing the flow of the office. It serves as a point of entry for new and returning patients, so it should interface logically and smoothly with other components of your office software, such as transaction entry, billing, reports, and SOAP notes. If the scheduler is weak or inefficient (and/or still on paper), the rest of the office may suffer as the inefficiency trickles down.
What are some of the characteristics you should look for in a computerized scheduler?
- Quick search – Every office has experienced this scenario: A patient calls and knows he or she has an appointment sometime during the upcoming week but can’t remember when it is. With a paper appointment book, you have to shuffle through the book, scanning every column and every page until you get lucky. If this happens 10 times a week, count the wasted minutes. A computerized scheduler should allow a quick search by the patient’s last name, birth date, telephone number or other key information.
- Flexibility – As the costs of maintaining an office continue to rise, more doctors are joining a group and sharing expenses rather than operating as solo practitioners. The computerized scheduler should allow for an unlimited number of providers, and it should also provide ultimate flexibility in scheduling those providers. It is not unusual for each doctor in the clinic to work different hours and set up different appointment durations. After all, each doctor determines the hours he or she wants to work and how many patients can be booked every hour. In addition, the scheduler should allow doctors to block off vacation times and holidays, as well as time off needed during regular work hours.
- Appointment duration – Appointment duration is determined by two factors: the doctor’s particular style of practice, and the type of appointment. Some doctors want to schedule patients every 15 minutes. Other chiropractors want to see six patients every 15 minutes. The computerized scheduler must be capable of accommodating the different styles of practice. In addition, appointment durations should be associated with different types of appointments. A new patient exam, especially if it involves X-rays, takes longer than an established patient visit. A strong appointment scheduler allows you to reserve more time for particular procedures by associating types of visits, such as new patient exams, with CPT codes.
- Room/resource scheduler – Have you ever had two patients who were scheduled for X-rays at the same time? Unless you have two X-ray rooms, it can be an embarrassing situation and may result in unhappy patients, because no one wants to sit around and wait. Whenever resources are limited, such as an X-ray room, a massage table or electrical stimulation equipment, it makes sense to schedule the resources at the same time you are scheduling a doctor’s time.
- Multiple appointments – Many chiropractors schedule new patients for a series of visits over a specific period of time. An efficient scheduler should allow a CA to schedule these visits with just a few keystrokes and print a list for the patient to take home and put on the refrigerator, on a bulletin board, etc. Unfortunately, once the visits are scheduled, people often change their minds. A strong scheduler will quickly locate future appointments and allow them to be changed.
- Sequential scheduling – Do you have patients who need a massage prior to the adjustment? Maybe a patient needs ultrasound or mechanical traction after an adjustment. If you want to schedule two or three procedures to occur consecutively, you need a sequential scheduling feature. Since the different procedures use different resources or rooms, the scheduler needs the ability to search available times that the appointments could be scheduled in the particular rooms with a specific provider. Sequential scheduling can maximize the use of resources and allow patients to receive nutritional counseling, massage and an adjustment in one visit, with minimal wait time.
- Reminder list – If a patient is coming in three times per week, it’s usually not difficult to remember the next appointment. However, if the patient is coming in on a monthly basis, it is easy to forget an appointment scheduled a month ago. For that reason, hair salons, for example, often make reminder phone calls. In any busy doctor’s practice, there are always patients who need reminder phone calls or postcards. The scheduler should allow a CA to designate the need for a reminder, for all patients or ones they specify.
- Wait list – If the doctor is so busy that patients are waiting for a cancellation to fit in to an opening, a “wait list” feature is important. When an opening becomes available, the wait-listed patient can be moved into the open slot.
- Overbooking – Some of the practice management advice out there recommends that you overbook, to overfill a time slot. If you subscribe to this theory, then your computerized scheduler must allow overbooking.
- Comments – When an existing patient refers a friend to the practice, the doctor has an opportunity to create even more goodwill by thanking the patient personally. This is just one instance where a comments or notes feature comes in handy. If a CA makes a note, “Mary referred her friend Tom Smith,” and the note appears next to Mary’s name on the appointment book print-out, the doctor is reminded to offer personal thanks. The notes feature can also be used to record noteworthy clinical information, such as, “Mary was hurt at work while lifting boxes.”
- Week-at-a-glance – The handy pocket organizers display a week at a time. Likewise, a computerized scheduler should display the open time slots for each provider and each room. It is also interesting to note the popular hours, the time slots that fill up first. If you want to expand the hours you are open, you will know exactly which hours to open up.
- Network operation – If more than one chiropractic assistant will be scheduling appointments, it’s important to know how the scheduler operates over a computer network. In some software programs, one CA cannot see the appointments scheduled by another CA on the network unless the scheduler is closed and reopened. Needless to say, it would be easy to inadvertently book multiple patients for the same appointment slots. It is also a waste of time to exit and re-enter frequently. In order for appointments scheduled on another computer to show up, the database has to be queried and the screen has to be repainted or refreshed. It’s important to ask the software vendor how often the scheduler refreshes, and if the user has control over the refresh rate.
- Color-coding – Color-coding can be an extremely effective scheduling tool. If missed appointments turn red, for example, it provides an immediate alert. Color-coding organizes the scheduler visually, alerting you and your staff to any abnormalities. Color-coding can help make tracking missed appointments, cancellations and reschedules easy. While not essential, color-coding is an added feature that makes daily use a little bit easier.
- Print-outs – For those of you who say, “I’ll never give up my paper appointment book; I like seeing it every morning,” you can simply have your staff print out a paper copy of the computerized schedule. Then you have the best of both worlds — the convenience and efficiency of the computer with the security of the printed word. In addition, print-outs of features such as reminder lists, missed appointment logs, cancellations, etc., can help keep you notified of what’s going on in the clinic. Ask the software vendor for a list of print-outs, and ask whether you can customize the print-outs to match your needs.
Rating Your Priorities
After reviewing the types of features a computerized scheduler may include, decide which features are most important to you. Consider rating the different features on a 1-10 scale, with 10 representing the features most important to you (see chart, this page). Then, shop and compare.
A strong scheduler is just as important as the other components included in your office software. Without a strong point of entry, patients slip through the cracks too easily. A computerized scheduler can control the work flow and make every aspect of the office more efficient.