How to Increase Visit Efficiency and Feel Less Rushed With “Showtime” Scheduling

With primary care physicians increasingly facing unrealistic demands on our time,^1,2 many of us are looking for ways to reclaim precious minutes in our day without reducing meaningful time with patients. A scheduling model that our practice refers to as “showtime” scheduling could be part of the solution.

Showtime scheduling involves creating two distinct start times for each visit:

• An “official” start time for general scheduling, indicating when the patient will arrive and clinic staff will begin the visit,
• Another start time (15 minutes later, or another preferred interval), indicating when the physician will enter the examination room — “showtime.” In our practice, the physician portion is either scheduled for 15 minutes or 30 minutes, depending on the type of visit.

This approach gives clinic staff dedicated time to handle preparatory tasks such as verifying insurance, updating demographic information, verifying medications, identifying care gaps such as overdue screenings or vaccines, updating quality measures, and obtaining the initial history of present illness (HPI) without cutting into the dedicated patient-physician interaction time. This gives staff sufficient time for administrative tasks, lets physicians focus on medical decision making, and helps everyone feel less rushed.

Implementing showtime scheduling requires significant preparation in two areas — EHR configuration and staff training — but it is doable. Here are some issues to consider, based on our practice's experience.

Configuring your EHR to support dual schedules. Creating two distinct start times for each visit (one for patients, front-desk staff, and clinical support staff, and another for physicians and other providers) requires having two separate but interconnected schedules in your EHR. Creating dual schedules will likely require changes to the software's existing scheduling module. Enlist your IT department or EHR vendor to do this work. To maintain cohesion, the EHR must be able to link visits across the two schedules. Linkage ensures that any changes in one schedule (e.g., cancellations) are automatically reflected in the other schedule. This may require leveraging the EHR's existing capabilities for handling related appointments or developing new integration logic. To lessen concerns about data duplication and integrity, you should also take steps to ensure that patient information, appointment details, and other relevant data are consistent across both schedules. Strategies include using unique identifiers for appointments and having front-desk staff perform daily schedule checks.