Scheduling Patients: What Is your Magic Number?

So what is a reasonable number of patients to see in a day? How long do you spend with each patient?

When I was a fellow, if I recall correctly, we scheduled 12-16 patients in an afternoon. An afternoon being about 4 hours. Officially. In reality, it turned into 5-6 hours because after we, the fellows, saw the patients, we needed to present the case to an attending, who, in addition to managing the patient, also had to use each visit as a teaching moment. Now, we only saw office patients 3 half days a week, and saw very few inpatients. Much of the rest of the day was spent on research and other scholarly activities. RVUs and productivity were not words we heard at all.

Boy, that does not prepare you for private practice! I have been speaking with several colleagues, and it looks like most private practitioners see between 18-22 patients a day, every day. The length of each visit ranges from 30-45 minutes for new patients, 15-20 for follow ups. Our patients are too complex to book for shorter visits, and sometimes even the allotted time is not enough. I have a couple of very complicated patients that I book for two slots each time so that I don't fall behind schedule. And while it may seem that 18-22 for 8-9 hours a day is less than the 12-16 patients per half day that we used to see as fellows, in addition to patient visits, we also have to deal with phone calls and the administrative part of private practice. And we still need to get our required CME hours.

I have also heard from colleagues in cash-only practices. Because there is less overhead, less paperwork, and less uncertainty about payment, they can afford to see fewer patients each day. 

Of course, whether a physician is employed or is the physician owner also makes a difference. If you are employed, you often have little say in your schedule. And (as a former employed physician) I recall there being a “productivity expert” who would chastise you periodically for not seeing enough patients. As a self-employed physician, the number of patients you see is dictated by numerous things, including how much income you want to make, how much overhead you have, what other commitments you have, and how altruistic you want to be. I’d love to cut back my hours and take a pay cut, but I think I would have a local uprising of my referring physicians and potential new patients. They are mad enough as it is that they can’t get in sooner. So, 18-22 a day it is.  How about you?