Guest guest Posted October 20, 2006 Report Share Posted October 20, 2006 A pure open access system means you have the ability to offer and appointment " today " with the pt's PCP. In our practices the issue of continuity is moot. Open access doesn't mean you have to see pts in the office 7 days a week and 24 hours a day, but remember that for each day you cannot see patients, you have to problems: 1: You have to screen demand based on urgency and triage the urgent to some place for same day care 2: You have to make up the backlog of non-urgent demand on the day you return to work. Doing this elegantly is not that difficult. If you want to work three or four days per week, just spread the time out. Don't take of Mondays, Fridays, and weekends. Of course we'd all love a three or four day weekend, but the burden of working the two issues above and the rightful disgruntlement you'll get from your pts will make that a painful choice in the long term. One strategy that works very well is to work just a little bit in the office at least 4 or 5 days per week. Load up Mondays with more office time to catch up the weekend backlog. Give an hour or two on your out-of-office days or if you live close to the office, catch messages regularly and make a special arrangement to see the urgent pt in the office (and remember to bill the extra code for coming in special! 99050 - this is on top of the E & M code). There are definitely some patients who make for a difficult negotiation for a visit. We try to accommodate, but we don't change our schedule. I'll go to the office on a weekend to look at a kid's ear, but I'm not going in 'cause that's the only time someone can come in for a HTN recheck. Gordon At 07:44 PM 10/19/2006, you wrote: Gordon, how many people do you have in your panel? Also, another thing I seem to have trouble managing is that promise of seeing you today. I really do see people today if they want me to, but I think I would prefer to have a day off during the week or if I'm on vacation. I can't tell you how many times I offer 4or 5 appt times and still can't get someone in at a time they like. __ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 20, 2006 Report Share Posted October 20, 2006 and may I add to that of course brillianlty said, and on one of my favorite topic email from GM , that there is this formula I heard late into doing open access. That you can expect about .75% of your panel to call that day for a vist. That was helpful to me. You gotta look realisitically at your panaelsize and how many you pre-book I currenlty try to book not more than 1/2--3/4 of the day This leaves enough open slots for the Day-callers. If I have booked too many- like in t helast 3 weeks it is becasue I was away for a week and should have either planned that better or I simply had MORE day-callers. I just made up day-callers three seconds ago..In doing open access I think you have to accept that some days like flu season you are gonna be there later and osmedays you go home earlier That makes most docs nervous becasue we think the dollar sign so much, and onthe days they leave early they could view that as a sign of " not OK " I will testify that it works! It works great! One of my greatest joys frankly is haveing a slow morning worrying about money only to catch up on cups of tea and paper work( hmm what do we call t hat in a paperless system?) and then the lab courier calls and says at 5:30 are you still there I need this awful noseblled cauterized or I find Jody in the waiting room saying " is there any chance you can see Kaitleyn she's in the car " and I do not mind --these are not 1 hr visits , and they avoid the ER and are cared for and happy ,and I get great satisfaction and maybe relaly only leave 30 min later. Can you tell I like this?? Advance/Open access A pure open access system means you have the ability to offer and appointment " today " with the pt's PCP. In our practices the issue of continuity is moot. Open access doesn't mean you have to see pts in the office 7 days a week and 24 hours a day, but remember that for each day you cannot see patients, you have to problems: 1: You have to screen demand based on urgency and triage the urgent to some place for same day care 2: You have to make up the backlog of non-urgent demand on the day you return to work. Doing this elegantly is not that difficult. If you want to work three or four days per week, just spread the time out. Don't take of Mondays, Fridays, and weekends. Of course we'd all love a three or four day weekend, but the burden of working the two issues above and the rightful disgruntlement you'll get from your pts will make that a painful choice in the long term. One strategy that works very well is to work just a little bit in the office at least 4 or 5 days per week. Load up Mondays with more office time to catch up the weekend backlog. Give an hour or two on your out-of-office days or if you live close to the office, catch messages regularly and make a special arrangement to see the urgent pt in the office (and remember to bill the extra code for coming in special! 99050 - this is on top of the E & M code). There are definitely some patients who make for a difficult negotiation for a visit. We try to accommodate, but we don't change our schedule. I'll go to the office on a weekend to look at a kid's ear, but I'm not going in 'cause that's the only time someone can come in for a HTN recheck. Gordon At 07:44 PM 10/19/2006, you wrote: Gordon, how many people do you have in your panel? Also, another thing I seem to have trouble managing is that promise of seeing you today. I really do see people today if they want me to, but I think I would prefer to have a day off during the week or if I'm on vacation. I can't tell you how many times I offer 4or 5 appt times and still can't get someone in at a time they like. __ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 20, 2006 Report Share Posted October 20, 2006 and may I add to that of course brillianlty said, and on one of my favorite topic email from GM , that there is this formula I heard late into doing open access. That you can expect about .75% of your panel to call that day for a vist. That was helpful to me. You gotta look realisitically at your panaelsize and how many you pre-book I currenlty try to book not more than 1/2--3/4 of the day This leaves enough open slots for the Day-callers. If I have booked too many- like in t helast 3 weeks it is becasue I was away for a week and should have either planned that better or I simply had MORE day-callers. I just made up day-callers three seconds ago..In doing open access I think you have to accept that some days like flu season you are gonna be there later and osmedays you go home earlier That makes most docs nervous becasue we think the dollar sign so much, and onthe days they leave early they could view that as a sign of " not OK " I will testify that it works! It works great! One of my greatest joys frankly is haveing a slow morning worrying about money only to catch up on cups of tea and paper work( hmm what do we call t hat in a paperless system?) and then the lab courier calls and says at 5:30 are you still there I need this awful noseblled cauterized or I find Jody in the waiting room saying " is there any chance you can see Kaitleyn she's in the car " and I do not mind --these are not 1 hr visits , and they avoid the ER and are cared for and happy ,and I get great satisfaction and maybe relaly only leave 30 min later. Can you tell I like this?? Advance/Open access A pure open access system means you have the ability to offer and appointment " today " with the pt's PCP. In our practices the issue of continuity is moot. Open access doesn't mean you have to see pts in the office 7 days a week and 24 hours a day, but remember that for each day you cannot see patients, you have to problems: 1: You have to screen demand based on urgency and triage the urgent to some place for same day care 2: You have to make up the backlog of non-urgent demand on the day you return to work. Doing this elegantly is not that difficult. If you want to work three or four days per week, just spread the time out. Don't take of Mondays, Fridays, and weekends. Of course we'd all love a three or four day weekend, but the burden of working the two issues above and the rightful disgruntlement you'll get from your pts will make that a painful choice in the long term. One strategy that works very well is to work just a little bit in the office at least 4 or 5 days per week. Load up Mondays with more office time to catch up the weekend backlog. Give an hour or two on your out-of-office days or if you live close to the office, catch messages regularly and make a special arrangement to see the urgent pt in the office (and remember to bill the extra code for coming in special! 99050 - this is on top of the E & M code). There are definitely some patients who make for a difficult negotiation for a visit. We try to accommodate, but we don't change our schedule. I'll go to the office on a weekend to look at a kid's ear, but I'm not going in 'cause that's the only time someone can come in for a HTN recheck. Gordon At 07:44 PM 10/19/2006, you wrote: Gordon, how many people do you have in your panel? Also, another thing I seem to have trouble managing is that promise of seeing you today. I really do see people today if they want me to, but I think I would prefer to have a day off during the week or if I'm on vacation. I can't tell you how many times I offer 4or 5 appt times and still can't get someone in at a time they like. __ Quote Link to comment Share on other sites More sharing options...
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