PRIME TIME… Its Where It’s At

 By Sam Reader

            There is a widespread belief that capacity growth can be facilitated during the slower parts of the day. It is this belief that keeps so many stunted with their practice-building efforts. A typical phone call I receive from the confused and distraught is, “Sam, I’m doing just fine during the busy part of my day – that’s not the problem – I need help building the slower part of my day. If I could just spread out my new and routine patient flow, I could be at a comfortable 275 visits a week in no time. Can you help me?” My response (given a typical D.C. clinic) to these folks is, “No!” I can’t, nor will I attempt to fill a clinic’s slow times. In fact, attempting to fill your slow times would not only be a misdiagnosis on my part, but a “pipe dream” on yours.

            Let’s talk reality. Reality is how we spend our energies and procedures during prime time. Prime time is defined as the busiest and / or most profitable part of the day. Prime time usually runs for one and one-half hours, typically in the evening (after work) from 4:00 to 6:30 p.m. Prime time may vary according to the area, industry, … etc. It may appear you don’t have a specific prime time because patients are strung along in waves for two to three throughout the day. If you can’t locate your prime time (again, given a typical D.C. clinic), we have a problem – probably due to mismanaged (open book) patient scheduling.

            Why a prime time? Multiple visits. Patients generally are not going to take off work 2 to 3 times per week to accommodate the less filled slots of your day. It’s more practical to come in after work. Therefore, a wave!

            Many clinics have placed a tremendous amount of energy, money, and time in trying to fix the (wrong) problem. Remember this one concept: The primary focus in building your practice lies within your efficiencies (capacity) during prime time.

            If I have a goal to see 275 visits a week and 25 new patients a month because I am available 40 hours per week, common sense tells me I will average one to two new patients per day and average 6 to 7 routine visits an hour – THINK AGAIN! With respect to reality, let’s talk 70% of the 275 weekly visits (bulk of visits during prime time) and divide that number of visits (192) by 15 (prime time) hours of the week –  not 40 or 30 or 25. With a plus or minus of  10 % you are looking at an average of 12 to 13 routine visits per hour, considering all 12 to 13 show up. Again, with respect to reality, you may only average 6 to 7 routine hourly visits during Wednesday’s prime time, picking up the difference on Friday and Monday (traditionally busier days) by 15 to 16 routine hourly visits.

            Now compound this sort of traffic by 45-plus weeks in year! Blow your mind? This model workweek is not a one or two month exercise. This is a hitter’s life with procedural machinery designed and built for 45-plus weeks in a year.

            So, how do new patients fit into prime time? Typically, they don’t, which has been the problem.  It is an aspect of business we haven’t considered and, for this reason, the clinic limps along from low new-patient syndrome.

            May I suggest a quick inventory of yourself and staff members during prime time?

  1. Do you and/or staff members feel locked into a comfortable benchmark of routine visits during prime time?
  2. Do you and/or staff members feel rushed and/ or stressed out on extra busy days when you have surpassed your standard (comfortable) benchmark of routine visits?
  3. What is your current hourly average during the prime time wave?

Now double that number.

Does that figure feel totally unrealistic to you? Why?

List obvious breakdowns with such a prime time wave.

  1. Do you find yourself and/ or staff members saying:

“We’re swamped!”

“We’re really busy!”

“I can’t wait until the day is over!”

“Just imagine if we were busy like this all the time: we wouldn’t get anything done!”

“If we double what we’re doing, I’m going to need help at the front desk!”

“I don’t think the doctor has the physical stamina or energy to increase his prime time!”

“This is madness! Why can’t we spread these visits evenly throughout the day?”

  1. Are there more staff members than patients running about the clinic during prime time?
  2. Do you find yourself (the doctor) running up and down the hall looking for the next patient, escorting patients from room to room and frantically saying to yourself, “Where the heck is my staff? This is chaos!”
  3. As a staff member, do you find yourself saying. “What’s taking the doctor so long! I’m tired of these patients looking at me!”
  4. As a staff member, do you find yourself saying, “I don’t need this stress. I will have to outsmart the doctor and schedule these patients accordingly…he’s not going to change!”
  5. When was the last time your clinic processed two new patients and a re-exam during prime time?
  6. When was the last time you found yourself saying, “Are you sure we saw 50 patients this afternoon? It felt like 25 or 30!”

If you feel the least bit concerned or distraught about the honest appraisal in responding to these questions, you’ve got work to do!

Again, if you want to increase your practice, you need to concentrate on increasing your capacity during prime time…70% of your profitability will be concentrated into 30% of your day. The clinic movement becomes orchestral to facilitate such a small window of production. Every practice-building discussion should be centered into increasing efficiencies and capacities during prime time.

[As a side note – a strong prime time will provide a greater energy reserve for the doctor by the days-end and more down time for staff to accomplish office work with minimal interruptions and mistakes.]

This simple practice-building concept will reduce energy, money, and time frustratingly spent trying to fix the (wrong) problem.