Practice Notes

Physician shortage—or working below capacity? Get 2 ways to solve your access problem.

by Rachel Woods and Eliza Campbell

Patient access remains a challenge for medical groups: For primary care, the average time to the third next available appointment is 16 days for new patients and 12 days for established patients, according to Advisory Board benchmarks. In many specialties, wait times stretch even longer

The medical group executive's guide to access expansion

In the past, a medical group's response to an access problem was to add new physicians and advanced practice providers (APPs). But, cost constraints and fierce competition for new providers mean this strategy is no longer feasible. Medical groups can't just hire their way out of their patient access problem—instead, medical groups must continue to serve more patients without adding more providers.

There's good news, however: According to research from the Advisory Board and McKinsey & Company, provider schedules are only 80% to 85% full, meaning most medical groups have an opportunity to tap into unused provider capacity to create more patient access. To do so, take these two steps:

Two steps to increase provider capacity

  1. Reduce wasted patient appointments. Time on provider schedules goes unused when patients cancel on short notice or no-show. Rather than just spending resources on reducing no-shows across the board, zero in on your biggest problem—repeat no-showers—and personalize their schedule to increase the chances that their appointments aren't wasted. First, use practice management data to identify potential repeat no-showers. These are usually patients who have no-showed in the past or are booked out far in advance. Then, give these patients a personal phone call or use predictive overbooking to ensure their appointment slots are used.

  2. Enfranchise physicians to optimize schedule capacity. In addition to eliminating external access barriers, executives need to turn the lens inward to examine their own providers, too. According to Advisory Board benchmarks, 14% of appointment slots go unused due to provider template decisions. To use that untapped capacity, medical group leaders need to:
    • Engage their physicians in access expansion: With many physicians already feeling the strain of today's practice of medicine, groups must secure physician buy-in if their access efforts are to succeed. The best way to increase physician engagement for access expansion is to link access to patient care or group financial performance.

    • Select a measure of provider capacity: Nationally, many medical groups find the core access metrics they track—third next available and time to appointment—are difficult to act on.More and more, medical groups are measuring what they can control: the time providers spend with patients.

    • Manage physician performance: Access expansion hinges on effective physician change management—but that doesn't just mean tying metric performance to physician compensation. Medical groups must manage each physician's access performance individually to find what works for them if the group is to avoid burning out its physicians.
 

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