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July 10, 2018
March 14, 2017

Maximize Your Time with Effective Scheduling Part 1: A Case Study

Mark Opperman

Are you maximizing veterinarians’ time within your practice? Consider the following scenario: a veterinary practice has three full-time veterinarians, including the owner-doctor. They have a beautiful, state-of-the-art facility with four exam rooms. This practice is open seven days a week and offers evening hours until 8:00 pm Monday through Friday. Unfortunately, the practice in this scenario is struggling financially. Can you guess what might be the reason?

The practice in this scenario is based on a real-life case and the problem was that they were not using their facility even close to its capacity. The result was that the practice suffered from a lack of profitability. In an attempt to meet their client’s needs, they had spread out their office hours and surgery over an extended amount of time. The net result was that their support staff costs were very high, their income did not support the additional overhead costs, and these factors created a lack of profitability.

This scenario is not unusual. Many practices stretch out their hours for various reasons, which may or may not affect their profitability. In this particular example, the practice could support two or three doctors working at any one time. If the practice had two doctors seeing appointments while another doctor did surgery, their overhead costs would not have changed dramatically and they would have generated more income per hour. This would have resulted in increased profitability and they would have practiced smarter, not harder! Does your office hour and surgery schedule allow for optimum profitability and enable you to practice smarter, not harder? 

Office Hours

Let’s start with evaluating your office hours. Do you have office hours all day long? Do you have them everyday? How many doctors do you have scheduled for office hours at various times of the day? How well are you using your physical facilities?

When determining your office hours, you should consider your client’s needs but the office hour schedule should not be driven by this need alone. For instance, if many of your clients have nine to five jobs that make it inconvenient for them to come in during standard business hours, you might want to consider offering some evening hours. These clients could then be scheduled for a Tuesday or Thursday evening appointment instead of having to rearrange their schedule to come in during a weekday morning or afternoon. 

You also need to consider how many doctors you have and when they are scheduled. Do you have the capacity to schedule two or three doctors at a time? A secondary consideration would be your support staff. I feel strongly that you need to determine your office hour and surgery schedule first and then schedule the support staff necessary to appropriately leverage your doctors.

The old adage “build it and they will come” may apply to a certain extent. If you have evening hours Monday through Friday, they may fill up, but how about your hours during the day? Are they full? Will they fill up if we do not do evening hours every day? These are some of the questions that you will need to have answered within your practice. These answers may be critical to your practice’s financial success.

Another consideration is the manner in which you schedule your appointments. I am a firm believer in what is known as 10-minute flex scheduling in which appointments are scheduled using 10 minute increments. With this system you can use one appointment slot, or 10 minutes, for procedures such as re-checks or suture removals. Two time slots, or 20 minutes, can be used for comprehensive physical exam and vaccination office visits, and three time slots, or 30 minutes, can be used for the initial puppy or kitten office visits, second opinions or for an extended comprehensive physical exam. If you are doing birds and exotics, you may wish to schedule 40 or 50-minute office calls. The cost for these visits is based on the time scheduled for the appointment. 

Surgery Scheduling

When scheduling surgery times, we need to consider how many doctors we have in the practice and how much demand there is for surgery. I would normally try to schedule each doctor for at least one day of surgery, unless a doctor desired not to do surgery. I also like to schedule surgery first thing in the morning so that a doctor can come into the practice and immediately begin surgery. I do not like scheduling a veterinarian for office hours first, then surgery, then office hours. This requires too much “changing of gears” and is inefficient. If the support staff is scheduled and the patients are there, a veterinarian can get a lot more surgery done when it is the first thing they do in the morning. So we might schedule a doctor to perform surgeries from 8;00 am to 12:00 pm, then have 12:00 to 2:00 pm off for lunch and catch-up time. Then this doctor would be scheduled for office hours from 2:00 to 6:00 pm in the afternoon. If a doctor is scheduled for surgery but does not have procedures scheduled on the day of surgery, he or she could then be made available for office hours.

Time Management Scheduling

When determining a doctor’s schedule, we also need to consider the additional duties and responsibilities that may be required of the doctor. As an example, an owner-doctor may need to spend time managing his or her practice or meeting with the practice manager. If so, we need to allow time in our schedule for the owner-doctor to do this. Therefore, we might schedule the owner-doctor to attend to management duties on a Wednesday morning or afternoon. Another example would be if an associate doctor was responsible for orienting new associate doctors into the practice, then we would again need to schedule time for this to occur. And while I’m not in favor of having veterinarians responsible for managing inventory or personnel management, if a doctor is responsible for these tasks within your practice, then appropriate time needs to be scheduled for these tasks or the practice will suffer.

So far we have reviewed some of the things to consider when evaluating your veterinarians’ schedule. Next month we will take an in-depth look at an office hour and surgery schedule based on the practice case study noted at the beginning of this article, and we’ll create a new schedule that maximizes doctors’ time and productivity within the practice.

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