Patient panel sizes often feel unmanageable because they don’t effectively account for patient acuity or the increasing amounts of nonvisit work that physicians must complete as part of their workday.
The right-sized patient panel is essentially an equation — right-sized panel = (days worked per year × visits per day)/visit rate — but it only works if the data is based on a physician’s actual patient behavior, not external benchmarks, and takes into account nonvisit work.
Rachel Weber, MS, and Mark Murray, MD, MPA, propose a five-step method for right-sizing your patient panel.
1. Attribute patients to each physician or other provider within a like category in the practice (e.g., primary care or a set of clinicians with a similar scope of practice who could provide coverage for one another). You can use the “four-cut method” for this.
2. Complete the panel-size spreadsheet, which captures current panel and visit rate on the demand side and days worked and visits per day on the capacity side.
3. Decide how you will measure nonvisit work (using weighted discrete events or EHR log-in time, for example) and adjust capacity (clinician visits per day) accordingly in the spreadsheet. This may require discussion within the organization.
4. Derive the right-sized panel by dividing clinician visit capacity by the panel visit rate (the spreadsheet does this automatically).
5. Compare the current active panel and the right-sized panel to see whether you are over- or under-paneled. Identify opportunities to balance the panel equation by closing or opening to new patients, influencing the visit rate or length through greater efficiency, enhancing physician capacity through team support, or other strategies.
Read the full FPM article: “The Right-Sized Patient Panel: A Practical Way to Make Adjustments for Acuity and Complexity.”
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