How many patients are appropriate in a family practice during 8 hours of office hours?

[TWR]

Patients are mostly over 18 with maybe 20% Medicare. Also, what times are set aside to do "Tasks" assigned through EMR (Athena).  Most providers are doing the majority of admin work at home and weekend and still impossible to keep up.  Anyone deal with Wellmed in their practice?  Very time consuming.  I believe the practice gets $700-$900 when well med is done.  Not sure of the exact number.   Thanks for any and all thoughts.

[ventana]

14-17 is max

Athena has a ton of tasks and silly work  

 

 

 

[rev ronin]

If you can get away with it, simply let "mandatory" tasks go undone. Most of them aren't.

[Aunt Val]

I'm in FM now and supposed to be seeing 30 patients in an 8 hour shift.  It's insane.  Used to be 32, but my boss granted the APPs a lunch break now after complaints.  I'm always falling behind with charting and getting in trouble for it.  Charting at home stinks but I have no choice.  15 minute appointments are fine for school physicals on healthy kids, but definitely not for new diabetics or other complicated patients.

I don't know what would be considered "appropriate", but I wish I had +/- 30 minutes per patient, depending on complexity.

[Mayamom]

32 patients in 8 hours.   No wonder why people are leaving medicine.   And if your charting at home your mind never gets to shut off.   Not good. So sorry.  

[ventana]

20 and 40 min appointments and 30 min for admin time in an 8 hour day puts you about right

When you realize you are generating about $100/patient (don't forget the facility fee) for 30 patients is $3000 and you get paid $500 you realize all they care about is money......

Hard call, if you refuse they might fire you, but if you continue you will burn out, miss something or kill someone.

 

For comparison - I have 2 patients an hour in my own practice(just started)  projections are for 150k with full bennies on a 4 day work week.

 

[Reality Check 2]

In a 10 hour day in a VA setting - max 14. 

Mind you, 14 of the sickest folks you have ever met with enormous psychological issues.

Our appts are 30 or 60.

No one comes in for a runny nose - it is 10 problems or an annual with 18 problems.

I was in a private family practice where volume meant you were doing good things. The doc prided himself on seeing 35 patients a day. 

Quantity NEVER equals quality.

I cannot in good faith do a sports physical in 15 minutes - it takes that long for the MA to room the patient and get vitals and - depending - on who answered all the questions on the form - it could take a long time.

Medicine is not McDonalds. It is an art. 

Quantity is not a measure of good practice or good medicine. 

 

[LT_Oneal_PAC]

You can have care that is good, fast, or cheap. Pick only two.

 

[Reality Check 2]

And I forgot to factor in the billion refills, messages, incoming documents, specialist reports, imaging reports and chronic daily walk ins.

Sanity must be a component to daily practice - sanity and logic.

Logic seems to be dying along with common sense however.

[sas5814]

49 minutes ago, Reality Check 2 said:

And I forgot to factor in the billion refills, messages, incoming documents, specialist reports, imaging reports and chronic daily walk ins.

Sanity must be a component to daily practice - sanity and logic.

Logic seems to be dying along with common sense however.

It all went south when patients became customers and medicine became a business.

[iconic]

10 hours ago, Aunt Val said:

I'm in FM now and supposed to be seeing 30 patients in an 8 hour shift.  It's insane.  Used to be 32, but my boss granted the APPs a lunch break now after complaints.  I'm always falling behind with charting and getting in trouble for it.  Charting at home stinks but I have no choice.  15 minute appointments are fine for school physicals on healthy kids, but definitely not for new diabetics or other complicated patients.

I don't know what would be considered "appropriate", but I wish I had +/- 30 minutes per patient, depending on complexity.

you do know what’s appropriate. You are the medical provider and you know that 30 is too many and 15 mins is too short 

[Reality Check 2]

How many patients does a doctor see daily? | Elation Health EHR

There are varying estimates as to the ideal patient panel size as well as the realistic number of patients a provider sees each day. A 2018 survey found that most physicians saw between 11 and 20 patients per day. A small percentage, 1.3%, saw between 51 and 60 patients each day.

That survey also found that most physicians spent between 17 and 24 minutes with each patient during the day. The time spent with the patient is a critical part of the patient-provider relationship. If the physician seems rushed or seems to not be listening to the patient, that can degrade the level of trust and diminish the quality of care. In addition, when the doctor is seeing too many patients each day, that can lead to burnout.

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Not a great article - mentioned "delegating" patients to Mid Levels (insert eye roll).

But at least a study of some sort was done at some point.

I will never again work on an RVU basis - very poor and negative motivator for providing good care.

If the US would actually adapt to PREVENTATIVE care instead of crisis care - this whole issue would be a hell of a lot easier to navigate.

Another soapbox......

Edited March 27, 2023 by Reality Check 2

[SedRate]

9 hours ago, Reality Check 2 said:

Quantity is not a measure of good practice or good medicine. 

I will say that quantity can be a measure for certain things like skill competency. It's hard to be good at something you only do once in a while. So shoot for a nice middle road.