Running a Practice Means Running Behind, Survey Shows

Running a Practice Means Running Behind, Survey Shows

Six percent of physicians claim that they never fall behind on their appointment schedule.

These are same physicians, no doubt, who fill in a New York Times crossword puzzle in 15 minutes and never get coffee stains on their white coat.

For most physicians, however, running late is a way of professional life, according to the Medscape Practice Workflow Report 2017: Physicians’ Bottlenecks, Challenges, and Time. Thirty-six percent said they fall behind schedule several times a week. For 28%, it happens every day.

Despite frequent losses to the clock, a majority of physicians said they are very satisfied (15%) or somewhat satisfied (40%) with their office’s overall efficiency, Medscape found. In contrast, 8% said they were very dissatisfied with their efficiency, while 23% were somewhat dissatisfied.

Another 14% were in the middle.

When physicians can’t keep up with their appointment schedules, most aren’t terribly off the pace — 15 minutes or less for 37%, and 16 to 30 minutes for 45%. The most cited reason for falling behind, by the way, is a Hippocratic one. Seventy-nine percent of physicians said they spend as much time with a patient as required, even if it means making the next patient wait.

Physicians don’t harbor an efficiency-be-damned attitude, however. Sixty-six percent complained that patients arrive late to appointments, with insufficient time to complete the necessary forms. Forty-seven percent said appointment slots aren’t long enough to address their patients’ needs. And 49% said they fall behind because they’re recording patient notes between visits.

Physicians completing the Medscape survey offered some tips on staying on schedule:

• Be sure the front desk doesn’t overbook.

• Remind patients the day before to bring in their paperwork.

• Create a more efficient rooming strategy.

• Take fewer breaks.

It’s not as if physicians are lolly-gagging through the day. Close to 30% don’t take time off for lunch, and another 40% or so shrink lunch hours to less than 30 minutes. And 36% of physicians are seeing 21 to 30 patients per day, while 31 or more is the norm for 14%.

Technology to the Rescue?

When physicians were asked what would improve practice efficiency, better technology (43%) topped the list of recommendations, followed by more nonphysician clinical staff (38%). Only 18% of physicians recommended hiring more physicians.

However, technology didn’t exactly shine in the Medscape survey in other respects:

• Nine percent of physicians said patients are frequently frustrated with their use of an electronic health record (EHR) system, and another 36% said patients are occasionally miffed. That’s not surprising, in light of the common patient complaint that physicians give more face time to their computer screen.

• Online patient portals, where patients can request a prescription refill or view their test results, have yet to catch on big time. Seventy percent of physicians reported that only 25% or less of their patients use the portals. This finding corroborates results of a recent study by the Government Accountability Office about the importance of portals to patients.

• The go-to technology for communicating with patients outside the office is still the one invented in 1876 — the telephone, named by 93% of physicians. Thirty-four percent of them said they used email (physicians could choose more than one method), with text messages (8%) and videoconferencing (2%) at the end of the list.

The Medscape Physicians’ Practice Challenge Report 2017 is based on a survey completed this summer by almost 1200 physicians in more than 25 specialties. The full results are available here.

Follow Robert Lowes on Twitter @LowesRobert

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