Double Booking Worsens Wait Time

I"ve been meaning to come back to this article but I was surprised to see an op-ed piece in the WSJ about a doctor proposing double booking patients to fill in the number of no-shows. I'm sure the logic is that over the course of the day there is always one or two no shows that need to be filled in. Double booking will result in 100% utilization of the day and untimately decrease the time to get an appointment. I disagree with this practice for two reasons. The first is that the doctor is looking at the situation from his perspective and not the patients. As I've been advocating in my posts, the yardstick by which we measure wait times (and service) is not the provider of care but the patient. If you look at the practice from the patients' perspective they will have a longer wait the day of the appointment. Second, increased variation decreases efficiency. Depending on how often he double books the net result may be that efficiency is so badly decreased that it actually takes longer to get an appointment. No show's can plague many practices. We've found that having a single administrative point of contact for patients develops a personnal relationship and decrease the liklihood of no show.