practice management

Maximize Your Schedule's Profit Potential

By structuring your schedule based on the type of eye care patients require, you'll provide efficient clinical care and increase your bottom line.

JOHN R. SCIBAL, O.D., MOREHEAD CITY, N.C.

Years ago, owning a business that booked appointments months in advance was a common goal. Today's reality is that consumers expect businesses to cater to their schedules rather than the business's schedule. In other words, they demand fast and easy access to the products and services they desire, and if the business can't do this, they'll find one that can. The same is true for optometric practices, according to the "AOA 2008 Consumer Survey."

Specifically, when the AOA asked consumers how long they'd wait for an eye doctor appointment after having lost or broken eyeglasses, 40% said they would wait one day before seeking an appointment from another eye doctor, 24% said one week, 5% said two weeks, 3% said one month, and 27% set no time limit. In the case of having lost or run out of contact lenses, 28% said they would wait one day before seeking an appointment from another eye doctor, 25% said one week, 7% said two weeks, 2% said one month, and 39% set no time limit. (Note: The statistics quoted in this excerpt are correct. The math doesn't add up to 100% due to the rounding of numbers.) This means that more than 50% of our patients who need glasses or contact lenses — the most profitable patients — will seek these products from another eyecare practitioner if they can't get an appointment with us within a week or less. This is something that can have an enormous negative impact on our practice's bottom line, considering half the revenue from the typical optometric practice comes from the optical dispensary, and we are currently practicing during tough economic times.

To avoid this outcome, it's essential we design an appointment schedule that enables our routine eyecare patients (e.g., spectacle and contact lens wearers) to obtain appointments within a few days without alienating our other patients. Here's how my practice achieved this.

Template scheduling

Unfortunately, the appointment schedule for many practices is filled to capacity for six weeks or more, and, typically, with patients who are less profitable than our routine eyecare patients. These patients may have poor-paying managed-care plans or present for routine maintenance exams. I discovered this was the case in my practice several years ago.

My schedule was filled with visits ranging from red eyes to intraocular pressure measurements, leaving very little room for those patients who needed new spectacles or contact lenses. This random approach to scheduling was threatening the financial growth of my practice. To solve this problem, I implemented template scheduling.

Through this type of scheduling, we (my staff and I) categorize and reserve specific time slots for each appointment type. The result: We're able to hold enough slots for our routine eyecare patients — ensuring we can see them within a few days rather than a few weeks or months — due to grouping our "short" visit patients (e.g., red eye, intraocular pressure checks, etc.) into specific schedule blocks. (See "Sample Template Schedule" below.)

Key to Sample Schedule: VA = Visual Analysis (full exam), CLE = Contact Lens Exam, OV = Office Visit (i.e., short).

Note from the sample schedule that we've blocked "short" visits in four distinct groups throughout the day. Whereas we allow 15 minutes for full exams, we schedule two "short" visits per fifteen minutes. Thus, we see two patients between 8:00 a.m. and 8:15 a.m. and four between 1:15 p.m. and 1:45 p.m.

We give "shortvisit" patients the same appointment times in our "short" blocks because these visits rarely exceed a certain amount of time each, and our well-trained and well-delegated staff is able to efficiently manage and treat all patients scheduled within the given block of time. Translation: Our "short-visit" visit patients remain satisfied with the times we see them.

To determine how many "short" visits your practice should designate on your schedule, count the number of patients that required such visits through the past year. Double that number, and group these short visits in blocks as discussed. (By doubling the number of slots for short visits than you had for the prior year, you're assured of having enough.) Spreading these slots throughout the day provides enough slots to avoid having to work patients into the schedule; you almost always have one available for the emergency patient within 24 hours. The remaining blocks of time are for your "long" visits, or routine eyecare patients.

To further maximize your schedule's profit potential, consider restricting the number of slots for "no show" patients and those who belong to the poorest-paying managed care plans.

A work in progress

Realize that your first "template" schedule is not set in stone, but rather a work in progress. In other words, take the time to monitor its success, so you can make changes as needed.

For instance, if you discover that the slots you've designated for certain appointment types are inadequate, change your template schedule to allow more time for these visits.

Similarly, if you're sure the template schedule can't possibly get any better than it is, yet it's not allowing for the amount of routine eyecare visits it should, it's time to reassess it and you and your staff's ability to adhere to it. In some cases, for instance, the computer program you use to create the template schedule may be the culprit, as it may not preclude the person who takes the appointments from assigning the wrong appointment type in a given slot. If this is the case, you obviously want to invest in a program that prevents this problem.

Remember: Just as various airline companies seek to fill their flights to capacity with high-paying business flyers, you want to have your schedule as filled as possible with your most profitable patients.

Break the cycle

In most cases, we can modify the appointment schedule. The problem is most of us simply accept our existing schedule, seeing patients for any appointment type at regular intervals from first thing in the morning until closing because that's the way we've always done it.

By using the eyecare services your patients need as your guide, however, you can structure a schedule that not only provides efficient clinical care for all your patients — increasing patient satisfaction and thus, referrals — but also enables you to see more patients in the same amount of time. The result: an increase in the financial strength of your practice. OM

Dr. Scibal is a practice management consultant in Moorehead City, N.C. E-mail him at jscibal@scibalconsulting.com