See patients sooner with same
day scheduling

"What do you mean I can see the doctor this
afternoon? Is this April Fools Day?"

By Abe Konigsberg

Open access scheduling, sometimes called same-day booking, is a system where patients get seen the very day they call. No, it's not fantasy, in fact it's taking the United States by storm and it's slowly gaining popularity in Canada. The system was first developed in 1993 by California-based FP Mark F Murray and nurse Catherine Tantau who experimented with a number of different schemes to try to improve wait times without much luck until they decided to try booking patients the day they called, no matter what was wrong with them. The idea seemed outlandish at first but they found same-day booking worked much better than anything else they tried. They were so impressed with the results in their six-physician practice that they began teaching conferences in order to spread the word about open access scheduling.

IF THE SHOE FITS
If you think the concept of seeing patients the very day they call sounds positively quixotic, just look at your appointment book. Before perusing the book you may ask 'what if hardly anyone calls on Tuesday?' Conversely, you may toss and turn all night plagued by nightmares of your entire roster wanting to see you all at once. But if you take the time to look at the number of calls you get each day, you may well find same day booking quite doable.

There are a number of reasons for a Canadian MD to consider same-day booking. One big reason is its tendency to put the kibosh on no-shows — after all, even the most absent minded of patients aren't likely to forget an appointment they booked that very day.

As a rough rule of thumb, based on the experience of a number of Canadian, British and American family physicians, a 2,000 patient roster seems to be about the right size for implementing same day booking. Enormous rosters can get unwieldy under open access scheduling. Your mileage may vary as patients and practice styles are never quite alike. Two thousand is about the number of patients that Dr Vicky Mitchell has on roster.

AN FP'S TALE
About a year ago, Dr Mitchell, a Halifax family physician, decided to take the same-day booking plunge. She was appalled by the fact it was taking patients about six weeks to see her. Something had to give.

She got the idea to change to same-day booking after attending the conference in the United States. She told the Halifax Chronicle Herald that so far the whole open access scheduling thing is going swimmingly.

The way Dr Mitchell made the switch should serve as a warning that it isn't a decision that you should take lightly. She described the switchover as a six-week 'boot camp' where she not only saw all the patients who had already booked appointments, but she also took on same-day bookings. After her backlog was cleared she told the Chronicle Herald that she "felt as light as air" and that so far she's only had a handful of unfilled slots.