Nothing messes up a day like a steady string of interruptions.
As we know, interruptions such as an incessantly ringing telephone, multiple walk-ins, emergencies, unending staff questions
all cause the day to be longer, stressful and tiring.
The question is: How do we manage these interruptions?
The answer: appointments. Most workers are believed to accomplish two hours of uninterrupted work in a normal eight-hour workday. American workers are
reportedly hit with 300 incoming and out-going messages each day. The reality is that while it might seem busy internally,
interruptions aren't helping you complete more surgeries.
When we track our veterinary work week, important patterns emerge. Those patterns can be relegated to an appointment system.
With a structured and complex appointment system, interruptions (mostly) disappear, thereby creating more value each day,
which can work to improve profits and your medical delivery.
By scheduling appointments, the value of the day increases. Your work day seems to slowdown, and you suddenly have time to
enjoy your casework, read, look up a complex case, or just have a nice chat with a long-time client.
In business, the management buzz continues to be focused on productivity. In veterinary practices, productivity improves by
taking a thoughtful, conscientious look at your appointment systems.
Contributors to veterinary productivity include:
- a medical records-based practice,
- excellence in training staff personnel,
- effective delegation of duties,
- outsourcing and living with appointments.
Some clinics can live without appointments by making specific adjustments to staff the clinic during peak times of client
activity.
Such practices tend to think that control of the Saturday-morning rush without appointments is the best way to go. Yet when
we study these issues, certainly one result is a lower average client charge and all of its negative implications.
By solving interruptions with discipline, we can control the clinic activities most of the time, and that is all it takes
to restore peace to a chaotic environment. In addition, efficient processing of patients and clients are essential to good
medicine and good business (profits).
In the veterinary workplace, all duties can fit into slots.
In my last column, we discussed scheduling appointments for life. This column will deal with setting appointments to achieve
a balanced clinic life.
A concept of peak time management is a central theme within business circles because failure to deliver goods or services
during these times can destroy goodwill as well as undermine morale. Remember this tenet: We rise to our own incompetence.
Different practices have different needs for client appointments, and these issues must be incorporated into the appointment
template.
Specialty practices and "spay clinics" have very different types of peak-time management issues.
Go to a dentist and be prepared to wait for an appointment. One is going to wait even longer for an in-depth procedure appointment
as dentists may only set up a couple of two-hour procedure slots per week. So, in the case of a bone graft, for example, one
might wait six weeks to get the appointment. Other than emergencies, the same issues seem prevalent for human specialists.
Some businesses thrive without appointments, while other businesses would likely die. Personnel needs also vary.
Some of us can work 7 a.m. to 7 p.m. without breaks. But most of us work well in 90-minute time slots. An example might be
to work on outpatient cases for 90 minutes, then switch off to, say, inpatient procedures.
In real medical practices where oncology is on the table, where cardiology is happening and where pancreatitis patients are
in oxygen and on fluid pumps, mental breaks are needed.
High-volume practices roll through patients at a quick clip because the tasks are simple and the mental stress low.
But in typical veterinary practices, at least 19 different appointment types are needed.
Anatomy of an appointment system
- Brief: This appointment should take five minutes, e.g. suture removal.
- Limited: Set these slots for 20 or 30 minutes (annual checkups).
- Extended: Set these for 30 to 45 minutes (oncology cases).
- Release: Another five-minute appointment category.
- Conferences: 10 minutes in a specific conference room.
- White time: Nothing is set or scheduled (my favorite). Schedule two hours of white time for Monday mornings, a couple of hours anytime
during the week, and late in the day on Fridays.
- Study hall: Reading is the lifeblood of the practice as well as keeping burnout at bay. Set up seven hours per week, but remember that
one might only get five of those hours.
- Meetings: All kinds of meetings are needed, so set up three, 30-minute slots per week (one hour is way too long).
- Surgical point systems: Figure out a point system that works for you. A surgical point system can be created based on the complexity of the surgery.
For example, a surgical spay might be 2 points while only 1 is assigned to a routine dental. Cruciate repairs might be worth
6 points.
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