5 proactive strategies to make more time for patients

Dr. CavaleOur practice has made its reputation by focusing on making time for patients, whether during office visits, on the phone or via email. Physicians, their staff and patients must understand that time with patients is hardly ever paid for under the current third-party-based payment system. But every physician practice must understand also that time with patients brings the best value for patients and professional satisfaction for themselves. This has been our principle for 14 years and should work for almost all private practices.

Efforts at making time for patients start with contracting with payers that pay better for our services and demand less from our staff (so-called hassle factors). So we have essentially ended contracts with payers that don’t understand this value-based concept. A significant minority of our patients covered by such plans continue to seek our care outside of their network by paying us directly, and we make it affordable for them.

Second, every staff member and I prepare for patient visits ahead of the appointment time. Our staff confirms every appointment one week prior to the appointment to avoid no-shows and to make sure patients have had the needed tests (this makes every visit more productive.)

In the background, our outsourced billing crew verifies insurance and other details such as deductibles, copays, etc., so our office staff is aware what to collect when the patient arrives. Another basic principle of our practice is to keep only those staff that need to interact directly with our patients. All other functions are outsourced.

Third, we have designed our electronic health record (EHR) system such that the staff can input all demographic data prior to the patient arriving for the visit and visit-related lab data while checking the patient in for the visit. I usually review and enter lab/investigation data before bringing the patient into the exam room. So when the patient is with me, I am able to spend about 80% to 90% of the visit time with the patient.

Fourth, our staff is trained to utilize our EHR to its full extent. This allows us to message each other ahead of or after a patient visit, which makes each visit more patient-focused. Since we have many patients on insulin pumps, these patients are encouraged to upload their pump data just before their visit. Pump data saved ahead of the visit helps me analyze it before I see the patient. However, I do not participate in worthless activities such as the physician quality reporting system (PQRS) or Meaningful Use, so I am not worried about, nor do I care about checking boxes to satisfy such data collection efforts. I accept the reimbursement penalty and explain this to patients. I cannot overstate the value of not participating in these programs when it comes to spending time with my patients.

Finally, everyone from our team educates our patients on how to maximize their visit time with me. We believe that an educated patient gets the most of out of every interaction with the physician. We also educate patients about their insurance plans–whether they have a deductible or cost-sharing–so they know, as best as possible, what they owe us for each visit/service. This prevents wasting time arguing over payments, and permits more face-face time to discuss medical issues.

In summary, in order to maximize time spent with patients, it is essential that everybody involved in the process understand the preparation necessary and make efforts to keep fine-tuning the processes. It is equally important that physicians avoid contracts with payers who are unable or unwilling to reduce useless administrative burdens (paperwork).

If we believe that time spent with patients is the most important piece of our patient care, we must have the conviction and courage to do what is right and say no when we need to say no, whether it is to payers who don’t value our time, or government data collection mandates that take time away from our patients. In return, I ask my patients to appreciate our efforts to dedicate our time for them.