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Traditional scheduling can set physicians up for failure and frustration. Here’s a better way.

Fam Pract Manag. 2022;29(6):19-24

This content conforms to AAFP criteria for CME.

Author disclosures: no relevant financial relationships.

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The way practices schedule patient visits can be a major factor in physician job satisfaction. A well-constructed schedule allows physicians more time for complex patients by reapportioning time left over from more straightforward patients. By scheduling appointments within each hour on a wave (i.e., front loading), practices can balance access and timeliness, improve continuity and financial stability, and reduce frustration and waste.

This article outlines seven steps, starting with wave scheduling, that can set up your practice for success.


  • Scheduling office visits in rigid blocks of time doesn’t account for differences in the complexity of each visit, making it hard for physicians to stay on schedule.

  • Scheduling “on a wave” (e.g., two patients on the hour and one on the half hour) allows more flexibility to shift time from patients who don’t need it to the ones who do.

  • Other strategies for staying on schedule include building in a buffer of unscheduled time on certain days, using team-based care, and scheduling follow-up appointments at the conclusion of the current visit.


Scheduling on a wave rather than in a series of rigid time blocks allows practices the flexibility to adjust to patient needs on the fly. It isn’t always clear in advance which patients will require five minutes of a physician’s time and which will require 25 minutes. What is predictable is that some patients will take more time, and some less. It’s also predictable that, despite a practice’s best efforts (phone call reminders, text confirmations, etc.), some patients will fail to show up for their appointments entirely. This is predictable unpredictability, and we can adapt to it if our schedules are flexible.

The traditional method of scheduling patients in a rigid series of consecutive time blocks (i.e., non-overlapping 15-, 20-, or 30-minute appointments) often leaves physicians and staff stressed and frustrated. Practices with that system run behind whenever a patient arrives late or requires more time than allotted. They are also unable to repurpose any time that goes unused when a patient scheduled for, say, 30 minutes requires only 15, or when a patient no-shows.

A certain percentage of patient visits will always go shorter than average, and wave scheduling allows practices to take that time and repurpose it for the percentage of visits that inevitably go longer than average.

Here’s one way to do it: For many family physicians, scheduling two established patients on the hour and one on the half-hour works well. This builds in flexibility. The physician begins with whichever patient staff have ready first. If one of the first patients is late or a no-show, you can use that time on the others.

Even if two patients arrive at the exact same time, they’re unlikely to have to wait more than about 15 minutes. This is where setting patient expectations comes in. Let your patients know that, due to the way you schedule, they might have to wait a short time when they show up for a visit, but they will also have more face-to-face time with you when they really need it.

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