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How many clinic patients do you see a day?


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Looking for information from those who practice in a clinic setting.

Please state your specialty and number of patients in what total timeframe (8 hr day? 10 hr day?)

How long are the patient slots?

Also if working in primary care, please state if you are a paneled provider or not.

 

cheers !

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Family Practice: 12 per 1/2 shift (4 hours) + 2 phone encounters + 2 work in = 16 encounters per half shift. Add 1 patient per 1/2 shift if given a scribe. (I handle all the urgent / work in appointments like fu from hospital / admission and acute care with taking care of most of the follow up, not much in Routine Px and WCC / WWE). 15 minute appointmemt slots

 

Urgent Care: 20-30 patients per 8 hour shift or however walk through the door that I can handle when I'm solo.

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Scheduled 9:30-4:30, I have a terrible commute and kids that I have to drop off, otherwise I would actually ask to start at 8:30. Outpatient clinic in gastroenterology.  I have my own panel of patients and he has his.  Most of the time I am in the office while he is scoping, rarely do we overlap. 

Usually double booked every 15 minutes, not my preference but this is how they have always scheduled, have asked for different scheduling but unfortunately we have a lot of no shows some days  so this is just how they book to make up for that.  When everyone shows up it is a holy mess, I am usually an hour behind.

 

Typically average 20 patients but have had up to 30 in a 6 hour time span, taking 1 hour for lunch.  I do all my charting right after I see the patient, I have templates and type, this usually only takes me 2-3 minutes.  20 patients is very busy, 30 is downright miserable in 6 hours.  I would love to have 20 minute slots for each patient and see 15-20 patients a day since my day is so short.

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2-4 patients an hour depending on type. We have 15, 30, and 45-minute slots to accommodate acute visits, physicals, and Medicare Wellness, etc.. I work 8.5 hours (9 hour shift with 30 minute lunch) 3 days a week, one day off, and 5.5 hours on Fridays. We have 4 hours of busy-work built into our "mid-level" schedules that are outside of clinic hours, and entail cleaning up in-baskets, etc. Total patients each day varies from 10-24.

 

It is actually pretty nice, even with 1/5 weekday and 1/7 weekend phone-only call.

 

ETA: I forgot to mention I am in FP. We all see each others patients.

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I'm incredibly lucky - I work in outpatient neurology and the PAs get 30 minutes for returns and 1 hour for consults (docs get 15 min returns and 30 min csts). All of the providers have told management that we will never double book. I see patients from 7:30 to 4:30 with a 1 hour lunch, so usually scheduled for around 13 per day.  Even though we don't double book, sometimes I'll try to squeeze someone in or add someone on before or after my normal schedule. 

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I work in a solo private practice - one doc, 2 PAs. 

35 yr old practice with over 10,000 patients.

We each have our own panel.

 

We see patients from 8 to 4:20 in 10 and 20 minute slots with the office completely closed from 12-1:30.

 

My doc sees up to 28 - lots of OMT appts.

I see max 23 and usually closer to 18 depending on sickness season.

 

I hate the 10 minute slots and wish we did 15/30 but don't get a say yet.

 

It flows pretty good for the most part. 

 

Lots of over 65 and multi problems - more Internal Medicine most days.

 

Currently weaning the herd from years and years of benzos and ambien from the old docs who retired.

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In 50/50 Occ med/FP I see 12 in an 8 hour day--half hour slots, hourlong slots for special needs like interpreted visits.  Admin time is 25%, protected in each scheduled day, catch-as-catch-can on walk-in days.  Last night I saw 14 in 9 hours, 3 scheduled and 11 walk-ins.  I have no idea how y'all see more patients, because I wouldn't want to practice medicine that way.  I'd have to cut way back on relationship-building, motivational interviewing, shared decision making, patient education... you know, the things that differentiate me from Google.  I have a low base hourly rate, but chart on the clock and get overtime >80h in 2 weeks.

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I work in internal medicine 3 days/wk, urgent care 1 day/wk (all in the same clinic) and wound care at a different clinic.  8 hour days most days, some 9 hour days.  In internal medicine I average 14/day (I'm still working to establish my panel - I have space for about 18/day).  In urgent care it really depends.  Can be 32 in 8 hrs.  Average is probably 24 in 8 hours (we double cover the urgent care).  In wound care I average 10 patients/day, have room for 16+, but we have 2 providers in office so if the other person is gone I cover 20+ patients. 

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Guest Paula

Family Practice.  I have 30 minute appointments.  It does not matter the level of acuity, so a TW (Train Wreck) gets 30 minutes and it might take an hour. Other 30 minute apps I can get done in 20, so it balances out.  I am required to have 36 hours of face to face appointment slots open per week.  I work one 12 hour day, and 3 - 8 hour days.  I have every Tuesday off.   No built in time for charting.  I usually work thru lunch to chart or finish appointments if I get behind. 

 

If patients no show, the management breathes down our necks because for some reason, it is our fault.  But I like the "little" vacation I get with a no-show and maximize it for paperwork, charting, phone calls, and chatting it up with the MA and physician in our little division. 

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Urgent Care: in 8 hours, I might see 6 people or I might see 32. About 20 seems to be the sweet spot. But of course, I have little to no control over how many people I will be seeing, or what time I will be punching out. I'm leaving urgent care after 6 years.

 

Occ Med: in 8 hours, I will see a handful of pre-employment visits (20 minutes), some DOT physicals (40 minutes), and one or two walk-in Work Comp injury patients (20 or 40, but 40 makes more sense). Never more than about 18 or 20, ever.

 

In my new job, in primary care, all appointments are scheduled as 30 minutes, and an hour a day is set aside for admin and catching up on charting. It's the 21st century, so we aim to work smarter. Don't let anyone try to tell you that the most efficient system is one where you try to jam the maximum possible number of patients into a day, because it's not. Being fast doesn't matter if the care sucks.

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I currently work in an internal medicine clinic, non-paneled position, seeing a lot of acute care visits, chronic dz f/u, hospital and ER f/u, and anything else.

Currently have 30 minute slots, 15 patients per day.

Administration just informed me we will start seeing 22 patients per day and I'm less than happy about this.  No pay increase.  That translates into 50% greater patient volume. 

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Administration just informed me we will start seeing 22 patients per day and I'm less than happy about this.  No pay increase.  That translates into 50% greater patient volume. 

Start looking now, unless this was a previously agreed upon change.  I wrote my patient volume expectations into my current contract.

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It was somewhat previously agreed upon.  When I initially took the job several years ago, PAs were seeing 22.  As a new grad, I was advancing up to that number, but renegotiated 15 since I was still learning leaps and bounds.  They now want to bring it to 22.  I agree with you, it's not the type of medicine I want to practice, and I am concerned it will adversely impact my work life balance

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It was somewhat previously agreed upon.  When I initially took the job several years ago, PAs were seeing 22.  As a new grad, I was advancing up to that number, but renegotiated 15 since I was still learning leaps and bounds.  They now want to bring it to 22.  I agree with you, it's not the type of medicine I want to practice, and I am concerned it will adversely impact my work life balance

I've only started practicing in December 2015. Initially I was only seeing 8 per half shift (16 per day).

I knew they wanted me to get up to 12 per half shift + 2 work-ins per half shift so as I got more comfortable and had my templates and order sets building I was slowly adding more patients. I believe by my 4th month I was eventually comfortable enough to see a normal patient load.

 

Maybe it would be worth it to ask if you can scale up to that number like I did rather than just being slotted that off the bat. You'll find more efficient ways to get through your patient load and how to better time manage your patients as a result. Just some food for thought.

 

Best of luck!

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Timon,

 

There's really a bifurcation of what I would call mutually exclusive approaches here:

1) Seeing a bazillion patients per day is legitimate and delivers quality medical care, if only practitioners would get efficient enough.

2) Each patient has a unique set of biological, psychological, emotional, and spiritual needs, and to strip the patient-provider relationship of the last three in the name of efficiency is to deliver substandard care that does not meet our ethical obligations, regardless of what the business medicine demands.

 

I'm an advocate for #2, specifically in my context as a family medicine PA.  I don't mean to say that #1 is inappropriate for all clinicians, but I know I work best (best personal satisfaction, best patient satisfaction) when I can counsel, educate, and listen to my patients.  I don't want to practice family medicine in the first model, but acknowledge that for specialist care it's probably a good bit more appropriate.  But let's be honest: #1 generates more revenue with no appreciable increased risk of malpractice payouts, so the business of medicine pressures clinicians to see more and more folks. It's that I am in open rebellion against: the imposition of efficiency at the expense of quality patient care, as I understand it.

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When I speak of efficiency, I mean spending more time with patients and less time with admin side of medicine like charting, referrals, etc. I spend a solid 15-30+ minutes with a lot of my patients despite having a 15 minute appointment slots. Ya, I admit there are times where I'm very behind and I have a wait time in the lobby, but everyone gets the time they deserve individually. My practice has a team of support staff that I can leverage my time to and delegate tasks accordingly.

 

Our EMR works very well in allowing me to place my orders and move to the next patient and allowing me to finish my charts afterwards or when there is downtime. I'll spend maybe 2-3 minutes between patients to finish my note minus the HPI.

 

I may get slotted for 24 per day plus 4 work-ins but I get maybe 1-6 call offs / cancelled or rescheduled appointments per day too. Im in FM too, so an ear infection or sinusitis or rash gets very little time from me compared to the train wreck establishing care who just got insurance and laundry lists 10+ complaints.

 

I'll make that train wreck patient come back multiple times in shorter time frames until I can ease off them while my f/u on labs and imaging will typically be slotted as a phone encounter between patients. Sometimes those phone patients will need to come back in, but it takes less time to just do a phone follow up instead of tying up my MA taking vitals and checking in patients to hear their labs are normal or that they have abnormal studies and will need further work up.

 

Everyone has their own system that works for them. I was only suggesting the OP find a way to ramp up his patient total as it was already in his contract to see that many patients versus have the increase in patient load all at once.

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There is no virtue in seeing a zillion patients per shift in the name of revenue.

 

I truly believe every FP patient deserves 20+ minutes in order to deal with their needs and those things discovered - BP 170/110 and hasn't been seen in 1 yr or more. Or heart murmur or that pesky chest pain no one wanted to mention.

 

10 min appts suck and I am stuck with them.

 

I still don't take the computer in the room. I make eye contact, take notes and touch the patient.

 

My perfect day would be no more than 18 - 9 in the morning and 9 in afternoon. No more.

 

But that evidently doesn't keep the lights on with current FP reimbursement......

 

Then we go back to the Catch 22.

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But that evidently doesn't keep the lights on with current FP reimbursement......

See, THAT I just don't understand.  I see 12 patients in a day, and almost all of them are 99214, 99204, or physicals.  2 stable chronic conditions and/or prescription drug management meet moderate risk criteria, and that's pretty much everyone! We don't do medicaid, have maybe 10% medicare, and so my day is about 45% commercial, 50% L&I, and 5% medicare.  With L&I patients, I get paid per form I fill out, as well as per phone call or email, and that ends up a consistent few hundred dollars more revenue every week.  As I understand it, I'm the highest producer among our APPs.

 

So how is it that people can't keep the lights on in FP with fewer visits?  Maybe it's another medicaid problem, and my being able to do this profitably is an artifact of our payer mix.

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We are at least 35% Medicare and 15% Medicaid.

 

I have never fully understood the pay formulas.

 

We get phone calls daily from patients wanting to be seen RIGHT NOW, regardless of insurance payor - our front desk tends to shove them in for "customer satisfaction" even though the patient KNEW they were overdue 3 MONTHS ago or has had the sniffles for 2 HOURS.

 

Medicaid patients often know they pay nothing and overuse the "service" because they can.

 

So, now factor in the Burger King argument and patient responsibility.

 

Corporate FP pushes volume as a sign of success and being a "good provider".

 

Nowhere have I ever seen an article in a journal touting numbers as a sign of this. But I don't read financial journals.

 

I give my patients the time they need. The best I can do....

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I've pulled the "no way" card a few times.  Don't schedule me a patient during my 11:30 charting time (which is meant to keep me from being late for lunch) when there's another provider starting at 12:00.  At least in a small office, I can explain to the front desk staff what I will and will not do.  As I've said elsewhere, giving patients a late and overbooked provider is not good patient care.

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They told me in order to make profit, I should be seeing at least 22 per day. Since I'm new their starting me off with low numbers for now, so I usually see around 13-15. I'm happy with that number. In fact, if the cases are complicated 15 patients can feel like nonstop work. They had be booked for som15 appts appointments recently. OMG, I feel like I can't do anything besides listen to their hx, do a quick exam and fax their med, but yeah, no time for rapport, education, and all that jazz. It's almost like you have to be robotic to move that quick.

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They told me in order to make profit, I should be seeing at least 22 per day. Since I'm new their starting me off with low numbers for now, so I usually see around 13-15. I'm happy with that number. In fact, if the cases are complicated 15 patients can feel like nonstop work. They had be booked for som15 appts appointments recently. OMG, I feel like I can't do anything besides listen to their hx, do a quick exam and fax their med, but yeah, no time for rapport, education, and all that jazz. It's almost like you have to be robotic to move that quick.

 

22 patients in how many hours?

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I believe "on average" w/o procedures, reimbursement is around $85 per patient. This family medicine. So if my numbers are ballpark close then you are bringing in $1870 a day. Maybe a practice owner could correct this $$.

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