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I worked the late shift today.

I started out at 8:30 this morning and saw about 22 patients over the course of the day - until my schedule ended at 4:30.  I had a few new patients, a few well-checks, and overall had a steady, if not slow, day.  From 5:30 to 7 PM we have a walk-in clinic for our patients every weekday (and one on Saturday from 9 AM - Noon).  I covered it today and saw 13 patients - many with sore throats or urinary symptoms.

So in 8 hours, I saw 22 patients. which equals 2.75 patients/hour.  I usually see more in the order of 25-28 patients per day, but for some reason it was slower today.  In the evening clinic, I saw 13 patients in 1.5 hours, which amounts to 8.7 patients/hour.  It was steady, but not overwhelming and I finished at 7 sharp.  Here are some other facts to consider:

  • Our patients are absolutely delighted that we offer this clinic.  We also offer a walk-in clinic in the morning from 7:30 AM-9:00 AM.  
  • We are fairly strict at not letting anything but simple problems come to clinic.  If they are really sick, they go to the ER.  If they are not sick, we make them schedule an appointment.  The rule of thumb is that it must be a 5 minute visit.
  • We actually earn more per visit during after-hours clinic because we can charge an after-hours charge for all (except for Medicare and Medicaid).
  • For our one capitated contract, we get paid an over-and-above for these visits.  In other words, we just get the copay if they come during the day, but get paid per visit (at a fairly good rate) for after-hours visits.
  • We earn roughly 1/4 of our income in these clinics - they are extremely busy during the winter months, with some days getting over 30 patients in the evening clinic.   This is revenue we would have otherwise lost.
  • We run a disproportionate number of strep tests and urinalysis tests during these clinics, which ads to the revenue.

This is one of the main ways our practice is able to be so profitable.  Our EMR allows us to document very quickly and thoroughly.  At 7 PM, I had finished charting all of my clinic visits.

Why am I saying all of this?  You have to look at medicine as a business.  In this case, we make our patients very happy, build loyalty, and increase revenue with very little increase in expense.  The only negative of this is that three people have to stay late to do it.  Most doctors won't do this.

It mystifies me why more doctors don't follow suit.  I guess they don't want to run their practice like a business.  I am the last one out of the building tonight, but I have a lot to show for it.

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