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If you offer same-day appointments, this simple question can save your staff – and your patients – hours of time.

Fam Pract Manag. 2008;15(5):OA1-OA2

Dr. Fine is the physician operating officer for Hillside Avenue Family and Community Medicine in Pawtucket, R.I., and also sees patients there. He is co-author of the book The Nature of Health. Dr. Busselen is a third-year resident who completed a practice management rotation at Hillside Avenue Family and Community Medicine. Author disclosure: nothing to disclose.

Open-access scheduling has been praised for improving continuity of care and patient satisfaction and for increasing productivity. Our eight-physician practice, which began offering same-day appointments six years ago, can add another benefit to the list: Our staff spends much less time getting patients scheduled. It's all in how they answer the phone.

Your front-office staff members are probably familiar with long, painful, resource-intensive phone calls that begin like this:

Staff: “Hillside Family Medicine. How may I help you?”

Patient: “I don't feel well. I haven't been feeling right for days. There's this dull ache in my left knee that gets worse when I take a deep breath. And I coughed twice yesterday … ”

At this point in the conversation, your receptionist is probably fantasizing about getting a new job, and the phone call may drag on for five minutes or more. We discovered a polite way to keep calls short, accommodate patients quickly and rapidly inform them that our practice offers same-day appointments. It works like this:

Staff: “Hillside Family Medicine. Would you like to see a doctor today?

Patient: “Yes.”

Staff: “Dr. Fine can see you at 3 p.m.”

Patient: “Thanks. I'll see you then.”

Admittedly, there is a bit more to the conversation, which includes getting the patient's name, date of birth, primary care physician's name and a brief description of the reason for the visit, but the time saved by our approach is significant and allows our staff to focus on more productive work.

WHO WE ARE

Hillside Avenue Family and Community Medicine is the largest private family medicine practice in Rhode Island. Our eight physicians practice in both urban and rural sites. We care for the richest and poorest people in our state in a complex multicultural and multilingual environment. We were among the first in our state to implement open-access scheduling six years ago. The practice as a whole sees 50 to 75 previously unscheduled patients every day. We love the simplicity and patient-friendly character of the approach.

Putting it to the test

To confirm that the new phone greeting was working as well as we thought, we used a stopwatch to time phone conversations. We found that when a staff member asked “Would you like to see a doctor today?” when answering the phone, the average time to make an appointment was 106 seconds, or less than two minutes. Our more experienced staff can regularly complete appointment calls within 62 seconds. When the staff member did not ask the question, the appointment call lasted for an average of 232 seconds – more than twice as long. The two minutes we save on each call multiplied by roughly 150 appointments made per day saves more than 25 hours per week.

The new greeting caught on quickly with our staff because of its simplicity and the potential for improved efficiency. They have found that the greeting doesn't always deter patients from providing more information than is necessary for scheduling the appointment, but in such cases it does provide a congenial way to interrupt a lengthy account of the patient's problem. When our staff asks, “Would you like to see a doctor today?” and the patient launches into an epic tale, our staff waits a few seconds and then repeats the question. Admittedly, it probably helps that our staff repeats the question with patience and a kind tone of voice. They report that in the half-dozen times they've had to ask the question a second time, the patient has stopped his or her story and responded to the same-day appointment offer.

We do employ a few safeguards. If when asked the reason for the visit the patient mentions chest pain, shortness of breath, unconsciousness or threatens violence to self or others, the call is immediately routed to a physician. Our physicians are willing to be interrupted during office visits to attend to these calls.

The benefits

Greeting callers with “Would you like to see a doctor today?” provides an efficient and cordial way to convey to patients the opportunity for a same-day appointment, and it prevents lengthy, time-consuming phone conversations. If you have questions about your practice's approach to open-access scheduling, the reading list includes articles that may help.

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