General practice clinics and laboratory patient service centers share an age-old customer service problem: patients cannot get an appointment when they need one for urgent care, and, when they can get an appointment, they end up waiting for hours to see a physician for a few minutes. For patient service centers, it’s the problem of surges in patients showing up for blood draws, causing long waits.

For general practice clinics, the problem, according to Dartmouth Medical School professor and practice redesign expert John Wasson, is “The office practice hasn’t changed much in 50 years.” By contrast, industry and business continually do analysis and make incremental improvements in their business and manufacturing design, whereas doctor’s offices have stayed the same and cannot properly cope with patients whose expectations for quality service continually increase.

Numerous solutions to the problem of cutting patient wait times have been proposed. They range from common-sense ideas such as leaving afternoon appointments open for urgent visits and having patients fill out paperwork they download off the Internet ahead of time, to more radical ideas, such as using email in lieu of follow-up appointments and reducing office staff to almost nothing.

The “Ideal Micro Practice” idea calls for a sharp reduction in office staff and reliance on electronic health records and practice-management software to quickly dispense with administrative tasks. When properly implemented, doctors can see just 12 patients a day and earn 130% of the salary they would earn in a large practice seeing 25 or 30 patients a day. The reduction in overhead allows the doctor to earn more money from a smaller number of appointments. The most efficient way to run this type of practice, according to Dr. Wasson, is to offer same-day appointments by leaving 60 to 70% of slots open all day. This is because, typically, only 30 to 40% of patients call in wanting to set a future appointment and those that do schedule an appointment in advance are more likely to fail to show up for it.

Clinical Laboratories should consider the strategic insights of the Ideal Micro Practice model and the potential to save money by implementing electronic solutions and reducing administrative staff. Because patient service centers (PSCs) are the public face of the laboratory for most patients, anything that improves the customer’s experience at your PSC is a win-win outcome. Thus, use of sophisticated software systems that can evaluate work processes and identify ways to improve outcomes could pay major dividends in the management and operations of patient service centers.

Clinical laboratories should also consider Six Sigma principles for analyzing workflow and reorganizing their laboratory accordingly. The Dark Report has interviewed numerous laboratories that have successfully implemented Six Sigma principles to increase efficiency and workflow.

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Cutting Waits at the Doctor’s Office (PDF)