How to increase patients (productivity)

[jima]

Hello,

 

I am a newly licensed PA who is working in a family clinic. The clinic I work for is relatively new and patients load is very light. I get paid by hour, so it does not affect to my salary, but I would like to reasonably increase my patients load. I am usually not thinking about my job as a business and not thinking to increase returning patients unless it is medically necessary. For example, I would say F/U if the Sx does not resolve for an adult patient with simple UTI. (I would make child pt to come back to make sure they are doing OK) But are there some ways to increase returning patients and at the same time being medically/ethically sound? This could be silly question, but I have no idea if I am missing something about this. Any advice is greatly appreciated!

[winterallsummer]

From my experience, I have seen clinics schedule technically unnecessary follow up visits (eg follow up for strep throat).  I have seen clinics instate weight loss programs (I am not down with that personally).  

 

Obviously the most ethical thing would be community outreach.  Also networking with non-PCPs to encourage referrals.  There is obviously line between keeping tight control on for example BP or DM and scheduling unneccesary f/u's that don't improve patient outcomes.   

 

Medical home models/community models instate calling pts who need to come in when they don't on their own; eg saw a pt who was HTN and they didn't f/u, so call them and ask to schedule an appt.  Or call pts who need a routine screening test, etc.

[jima]

Thank you, winterallsummer.

I discussed with my SP and he basically said what you suggested. I will review my patient charts some ; some patients needs to be closely monitored their BG or BP as you mentioned... Recently a non-compliant patient passed away, seemingly due to electlytes disturbance and hyperglycemia. I would like to do community outreach and networking with specialists, eventually!

[EMEDPA]

also you can schedule follow ups to chart progress of a disease state at regular intervals:

cholesterol checks

thyroid function checks

BP/glycemic control checks.

medication compliance reviews.

weight loss follow ups

anxiety/depression follow ups after institution of meds or dosage changes

etc, etc

vaccination updates at certain ages (kids obviously but also shingles vacc, pneumovax, etc)

travel vaccinations if available at your clinic

 

these aren't shifty or dishonest, they are staying on top of your pt panel and making sure interventions have an effect.

most pcps I know are overwhelmed and trying to figure out ways to keep their pts out of the clinic by doing email and phone follow ups, etc

[GetMeOuttaThisMess]

A really important one would be your pulmonary patients.  Not so much a peak flow reading but a subjective review of status (I like the "Rules of Two").  IMO this is one of the more important, potentially life-threatening, conditions that is best assessed through history alone (RAD>COPD).  Don't forget your pneumococcal vaccines!

[ventana]

likely just spending some time in established patients charts and you will find a huge amount of patients that need to be seen and you will be helping out the practice

 

HTN - q 6 month follow up

DM  - only on oral agent - 1-2 ---- 6 month follow up

DM that uses insulin - q 3 month follow up

PVD, CAD, Lipids - anywhere from 3-6 month follow up

COPD - q 6 months if stable

 

Annual H+P > 2 years old needs to be updated

 

 

 

 

they are all right there in the practice already

[skyblu]

If you want to increase your new patients, contact your local ED.

 

A brand new practice opened near our hospital. The market is full of PCP's, but they are either full, can't take new patients, no appointments available for a few weeks (sometimes months), and they don't take Medicaid.

 

The new guys asked to meet with our group and told us: "We take Medicaid, and we will guarantee follow up after an ED visit within 1-2 days. We provide in-person interpreters and we have access to all charts and records any time we're on call, so even if the particular PCP on call doesn't know your patient, we can answer your questions about their history at any time."

 

And then they kept their word. I've sent all my patients with no PCP to this practice.

 

I know the "we take them all, and we take them soon" thing won't last, and once their practice is full, appointments won't be so available. But I thought it was a brilliant way of building up a new practice very quickly. They've been fantastic to work with. Not to mention, the patients are thrilled at how easy and fast it is to get their foot in the door of a primary care practice!

 

Make your local ED docs/PAs lives' easy, and your name will be the first one they think of when setting up follow up for a patient who needs a new PCP!

[paproof]

If you want to increase your new patients, contact your local ED. A brand new practice opened near our hospital. The market is full of PCP's, but they are either full, can't take new patients, no appointments available for a few weeks (sometimes months), and they don't take Medicaid. The new guys asked to meet with our group and told us: "We take Medicaid, and we will guarantee follow up after an ED visit within 1-2 days. We provide in-person interpreters and we have access to all charts and records any time we're on call, so even if the particular PCP on call doesn't know your patient, we can answer your questions about their history at any time." And then they kept their word. I've sent all my patients with no PCP to this practice. I know the "we take them all, and we take them soon" thing won't last, and once their practice is full, appointments won't be so available. But I thought it was a brilliant way of building up a new practice very quickly. They've been fantastic to work with. Not to mention, the patients are thrilled at how easy and fast it is to get their foot in the door of a primary care practice! Make your local ED docs/PAs lives' easy, and your name will be the first one they think of when setting up follow up for a patient who needs a new PCP!

Great advice

[jima]

Thank you all for great advice!

[SocialMedicine]

SOCIAL MEDIA!!   esp if in an urban setting.  20% of my practice new patients come from YELP and we are well established with a lot of clinician and patient referrals. Make sure SAME DAY APPOINTMENTS are well known if you can promise them. friendly staff  good medicine  system to remind pts to f/u 

[jmj11]

As a business owner, this is a constant issue for me. I schedule patients at a reasonable visit rate.  I do not allow them to bend those rules (asking for refills via phone in lieu of coming in).  However, I've found the major key is to give them the level of care that knocks their socks off.  They want to come back. They want to suggest you to their friends and family and your reputation will quickly spread.  

We did a study and presented it at the International Headache Congress last year.  We surveyed our patients and their conclusion was 97% reported that our headache care was the best they have ever received in their life. In other such published studies by headache clinics, the next highest level of satisfaction was around 69%.

 

But we work very hard at this.  My next plan, starting next week, is to call every new patient, which I had seen the week before, and to ask them how they are doing.