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Average number of patients per day


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Hiya folks,

I tried searching the forums but didn't see this particularly discussed.  I've been out of school for five years and I'm working in a private practice.  My SP requires me to see 34-39 patients per day, 1 every 15 minutes…plus I stay an extra hour taking care of call backs, refills, paperwork, etc.    I know it can vary between specialties, but I want to get a feel if my numbers are much different than my colleagues.   It's starting to take its toll on me!

 

Thanks for any input.

 

 

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Hiya folks,

I tried searching the forums but didn't see this particularly discussed.  I've been out of school for five years and I'm working in a private practice.  My SP requires me to see 34-39 patients per day, 1 every 15 minutes…plus I stay an extra hour taking care of call backs, refills, paperwork, etc.    I know it can vary between specialties, but I want to get a feel if my numbers are much different than my colleagues.   It's starting to take its toll on me!

 

Thanks for any input.

thats slavery, you should be making at least 200 an hour

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@chunkstyle:  Are you in pain management and just doing refills?  What is a typical patient presentation and how long does it take to evaluate and treat?

 

I'm in FP and see about 14 a day and it is draining with all the junk we have to do with the computer before seeing the patient. 

 

34-39 a day is nuts and a recipe for burnout. 

 

What do you bring into the practice for revenue? 

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I'm in pain management, but it's an interventional practice so we do a lot of procedures at our surgery center. We wean most of the patients off opioids but there are some med refills. A lot of work comp, evaluating MRIs, disability forms, functional capacity evals.

 

Thanks for the feedback so far. I definitely see a trend. I just needed a reality check from other PAs. My SP sees a patient every 10 minutes and to him it's "being efficient" so he expects his PAs to be the same way. The money is good, but money ain't everything.

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E - you see 3-4 per hour at your urban center?  So 36-48 during a 12 hour shift?  That's nuts.  ACEP guidelines say it should be max 1.5-2 pph in the main ED.  

Busy place I've started at (about 35K visits/years) is double (and sometimes triple) coverage.  I usually see 1.5 pph, but that's because I only work there 2-3 shifts q month and I don't know the computer system well. 

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The pied pipers of health care, the health care insurance companies, are paying less and less per encounter so for individuals to earn what they did or for entities (hospitals etc.) to earn the same, the only choice is to see more. We need to stop paying the piper and take back control of healthcare. Not being wasteful anymore but by  giving quality care, which takes time. Technology has not lived up to its billing as to increase productivity to the point that we can see patients at a rate of 1 every 10 minutes. Our patients deserve better and we deserve better.  Remember the old Lucy at the bakery factory clip?  This is what it is becoming like. We need to stop highly paid insurance executives from  dictating that we work like a hamster in a wheel hooked to an electric motor. They don't work like that.  Just some thoughts.  I could see patients at this rate ONLY if they were no complicated and I had 2-3 good MAs at my beck and call.

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Over 100k per year. Four 10-12 hour days per week.

50 weeks/year, 45 hours per week = 2250 hours per year = $44.50/hour, roughly.

 

I make 90% of that, see 1/3rd the patients you do, and get overtime at 1.5x if I have to work more than 80 hours in two weeks.  Now, I probably have a worse benefit package, and work six days in a row (every other weekend) about half the time.

 

Would I trade places with you?  No way.  I get to have relationships with my patients, don't have to use an EMR, don't have Press-Ganey, and get to practice medicine like I wanted to when I started PA school.  You can keep the extra gross salary... which is about what I'd be making now if I'd stayed with Group Health.

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50 weeks/year, 45 hours per week = 2250 hours per year = $44.50/hour, roughly.

 

I make 90% of that, see 1/3rd the patients you do, and get overtime at 1.5x if I have to work more than 80 hours in two weeks.  Now, I probably have a worse benefit package, and work six days in a row (every other weekend) about half the time.

 

Would I trade places with you?  No way.  I get to have relationships with my patients, don't have to use an EMR, don't have Press-Ganey, and get to practice medicine like I wanted to when I started PA school.  You can keep the extra gross salary... which is about what I'd be making now if I'd stayed with Group Health.

Sounds like you're in a great place! It's really helpful to know that there's no way you would want to change places with me.  

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Sounds like you're in a great place! It's really helpful to know that there's no way you would want to change places with me.  

 

Sounds like you're getting hammered Chunk.

 

Can see by your prior posts you're doing some thinking, and while I in no way know your situation, I can definitely agree with your statement that money isn't everything.  Having that work-life balance is huge, as is not trying to cram in so many patients.  And if your CP is seeing 6/hr and considers that "efficient"....wow.  Just wow.  Can't imagine the time spent charting later, unless it's all templated. 

 

Best of luck!

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I typically am seeing 3-4 patients per hour and am at a GI practice.  I work three 7 hour days and usually in those three days I have seen 60-75 patients, taking 30 minutes to an hour for lunch.  I am very comfortable at 3/hour and feel like I can spend enough time and finish my charting and note in that time.  When I go to 4/hour I start feeling overwhelmed and then usually I end up behind and patients are frustrated.  This has been a continual frustration for me off and on.  I go through times where my schedule is very manageable at around 20/day and then others where they have 30 patients scheduled for me.  I try to remind them I am only here for 7 hours, I cannot come in earlier or stay later due to family commitments. 

I have a template I use and type the rest of my notes. Fortunately I work with some phenomenal RN's that call in meds, do call backs and refills so that helps tremendously.  I doubt I have the paperwork that someone in FP or workers comp has.  I honestly would have a very hard time working at this pace for even four days, by the end of my 3 days I am wiped out.  You are working at full speed for four days and more hours, definitely sounds like a recipe for burnout. 

The problem though is that MDs that do want to work that quickly and overbook their schedule do tend to want us to do the same.  That is the culture at my office as well.  I would point out though that you are not reaping the financial rewards even close to the degree that your MD is for working at that pace.  Sounds like your salary is good but honestly considering the hours you work if you figured your hourly rate it probably is about average. 

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jmj:  Not only is it the health insurance companies that are driving the system but the  large health care corporations sit right along side them in the passenger seat.  

 

They are in it together, along with the pharmaceutical companies being the back seat drivers, so that they all can make profits at the expense of the patients and the medical providers.    

 

The patients and providers are towed along on the back strapped to a deer trailer with bunge cords. 

 

IMO.

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Is that 34-39 in an 8 hour day?!!  That's insane.   In 12 hours shifts in urgent care I see 30-50 (those 50 days are killers and are typically the day after holidays, flu season, etc).  In my outpatient specialty, I am pretty overwhelmed when I start to get to close to 20 in an 8 hour day.  Even my SP in outpatient specialty gets frazzled >25.   I can't imagine how it's even possible to see close to 40 in an 8 hour day.  

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I am in a private family practice with a solo doc and my max has been 26 in an 8 hr day and I HATE those days.

My patients might as well Moo and have a brand on their butt when it gets to that point - it is nothing more than assembly line after 21 in my opinion.

 

Quality cannot exist at the numbers you quote - not insulting your abilities but  - quality does go out the window after a certain quantity. There is no way to make quality decisions, document them and interact with the patients to a satisfactory understanding when the numbers in an 8 hr day go beyond about 20-21 in my experience over the years. Medicine is not McDonalds and does not qualify for billions served…..

 

Your doc sounds highly profit driven. Have you had a conversation about quality, outcomes, phone calls back and such??? I wonder how your patients feel about the experience in and out of the office - does it feel like a machine?

 

I do NOT double book - PERIOD. It is rude and inappropriate. We do a few work ins for folks who show up at the front desk with chest pain ----- just a part of life - but otherwise try to make sensible appt decisions for patients without overlooking provider quality of life.

 

My office is one of the last offices that CLOSE for lunch - CLOSE - no phones, doors locked - we are expected to eat and manage our time accordingly - do charts, refills, etc. Staff can leave including me if we need to run errands but I am always full up on things to do during lunch. I am thankful every single day that my doc understands down time and locking the doors at lunch and treating staff like humans. We work hard.

 

The lopsided nature of reimbursement in family practice has forced a lot of practices to think quantity is the only way to keep the lights on. Corporate pushes and pushes to get folks to "quantity" to pay for the provider's salary and the overhead AND their greed for profit.  

 

So now I am baffled by the push toward reimbursement for "quality" with nebulous markers when the reimbursement sucks to begin with and the push to quantity is overwhelming. It is like chasing your own tail on fire. 

 

Anyway, the numbers listed for an 8 hour day are ludicrous and, in my opinion, dangerous. ….., Yes, Your Honor, I did see 40 patients on the day this patient received the wrong medication and OD'ed and died. No, I couldn't possibly have been rushed or distracted. What was the patient's name again?……"

 

Just my very old 2 cents.

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Hiya folks,

I tried searching the forums but didn't see this particularly discussed.  I've been out of school for five years and I'm working in a private practice.  My SP requires me to see 34-39 patients per day, 1 every 15 minutes…plus I stay an extra hour taking care of call backs, refills, paperwork, etc.    I know it can vary between specialties, but I want to get a feel if my numbers are much different than my colleagues.   It's starting to take its toll on me!

 

Thanks for any input.

 

 

just abusive

 

he/she is making a killing off you

 

find a different job

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UC: straight $55/ hour, I can see about 2.25/ hour with everything done, or 3.5/ hour if I stay an extra (paid) hour or so after the shift and do notes. No scheduled patients of course; walk-in basis.

Occ Med: same $55/ hour, and they schedule a max of 18-20 in an 8-hour day or 9-10 in a 4-hour shift. A mix of 20- and 40-minute visits. We also take walk-ins, but we can refuse those if the schedule is full. We do not double-book.

It's my own highly subjective opinion that as PAs, we have the luxury of not having to be tied to RVUs, and part of our appeal is that mystical "spending time with patients" thing that does seem to drive up satisfaction scores. We generate revenue a-plenty, but whether it's a procedure-heavy week, a ton of labs and X-rays, or just sitting around being ready, it all counts, and I enjoy not having to care, myself. My area is fairly competitive, with a big 3 or 4 health systems always jockeying for business. I'm also in Minnesota, where HMOs and the like have to operate as non-profits.

 

The other thing is that I document VERY well. Some of the UC people I see haven't had contact with our health system in years; many won't have contact for several more. Many colleagues' notes are very 'cookbook,' all templates and a few boxes clicked, and they're very short. I like automation, but my templates are custom to me and they are much more detailed. I also write a decent history up top and medical decisionmaking section at the end, on everyone. This takes maybe 6-8 minutes per person, but it has saved my butt at least once already and I'm not going to change it. Documenting is part of patient care, as far as I'm concerned.

Being pushed to see 4 people per hour would make me quit. Just flat out threaten to walk if they didn't scale it back, and then follow through and never look back. It's not safe, it's not smart, and in the long run I'm not even sure it's efficient or economial. Not sure how my situation's specific elements play into that, but if I worked a full 75-hour pay period I would be making about $107k, so...

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