Patient-Centered Appointment Scheduling: a Call for Autonomy, Continuity, and Creativity
- PDF / 234,239 Bytes
- 4 Pages / 595.276 x 790.866 pts Page_size
- 53 Downloads / 176 Views
and Rozalina McCoy, MD, MS
Division of Community Internal Medicine, Department of Medicine, Mayo Clinic, 200 1st ST SW, Rochester, MN, USA.
When making an appointment, patients are generally unaware of how much clinician time is available to address their concerns. Similarly, the primary care clinician is often unaware of what the patient expects to accomplish during the visit, leading to uncertainty about how much time they can allot to each sequentially appearing concern, and whether they can reasonably expect to address necessary preventive services and chronic disease management. Neither patient nor clinician expectations can be adequately managed through standardized scheduling templates, which assign a fixed appointment length based on a single stated reason for the visit. As such, standardized appointment scheduling may contribute to inefficient use of valuable face-to-face time, patient and clinician dissatisfaction, and low-value care. Herein, we suggest several potential mechanisms for improving the scheduling process, including (1) entrusting scheduling to the primary care team; (2) advance visit planning; (3) pro-active engagement of ancillary team members including behavioral health, nursing, social work, and pharmacy; and (4) application of innovative, technologically advanced solutions such as telehealth and artificial intelligence to the scheduling process. These changes have the potential to improve efficiency, patient and clinician satisfaction, and health outcomes, while decreasing low-value testing and return visits for unaddressed concerns. KEY WORDS: primary healthcare; appointments and schedules; healthcare quality; professional autonomy; call center.
Abbreviations EHR
Electronic health record
J Gen Intern Med DOI: 10.1007/s11606-020-06058-9 © Society of General Internal Medicine 2020
“Those three things - autonomy, complexity, and a connection between effort and reward - are, most people will agree, the three qualities that work has to have if it is to be satisfying” Malcolm Gladwell
Marie’s asthma was flaring. She was long overdue for depression follow-up, needed multiple medications renewed, and craved relief from her nagging knee pain. Full-time work and child-care responsibilities, limited parking, and inconvenient hours made getting to the clinic, at best a difficult task, feel impossible when she wasn’t feeling well. When Marie called the clinic hoping to see her physician, she was told by the triage nurse that she could not see Dr. Smith, her primary care doctor within the recommended time frame, but should instead come in today to see another physician she had never met. At the clinic, a young physician introduced himself 20 min after the scheduled appointment time. He swiftly asked questions about her breathing, formulated a treatment plan, and entered electronic orders. Marie, anxious about bringing up her other concerns, gingerly asked for medication renewals and mentioned her knee pain. As the physician glanced at his watch, she felt a pang of guilt, knowing she was causin
Data Loading...
