To the Editor:

I have a question in reference to “Tuning Up Your Patient Schedule” [January 2002, page 41]. Where I see patient flow bogging down is when patients A and B both need lab work or to schedule an outside consultation. We have two exam rooms per provider and one LPN per provider who rooms patients, takes them to the lab, gives immunizations and schedules all appointments. We have applied techniques similar to those mentioned in the article in our clinic, but when a lab takes 45 minutes (because the other six providers with two patients at the top of the hour also need lab work) the schedule falls apart. How do you deal with the backlog and still remain on time?

Author's response:

Two exam rooms are usually not enough if the doctor plans to see approximately four patients an hour, unless there is a separate area to park the patient for lab work or preliminary vital signs, weight checks, etc. One solution is to have providers start their hours at different times. For example, providers 1 and 2 could start at 8:30 a.m., 3 and 4 could start at 8:45 a.m. and 5 and 6 could start at 9 a.m. Then there would be less of a traffic jam at the top of each hour since the waves would all overlap.