Friday, April 25, 2008

Group Practice Lowers Wait for Consultation

When you refer a patient to a specialist, how long should it take to get a consult? The wait time for a doctors office partly depends on how the partners of the speciality practice have arranged their partnership. Most practitioners will be familiar with a group practice either being cost share, where you each have an individual practice but share expenses or a true partnership. The value of a true partnership is that patients can choose to be referred to either the partnership or an individual doctor.

Kishore at Plain Brown Wrapper is a urologist and has been working on an advanced access program to decrease wait times. He discussed with his partners allowing referrals to be defaulted to the entire partnership unless otherwise specified. The result: a significant drop in wait times for consultation. He presents the data here.

Our practice does the same (and has for years). When a referral comes in (email, fax, phone) and "initial contact" is made which specifies which doctor will see the patient and whether or not that doctor has been specified as the only provider (eg. No substitutes). An example of the difference is in the request for a basic consultation (15min). The data below shows that when the "only provider" option is selected the wait is 50% longer (19 vs 14 days) and the standard deviation 15% longer. When the consultation is longer, the wait times grow and the difference becomes even more stark.




Merging referral management and scheduling technology is critical to making this process work and it is not an easy task. We've run into minor problems in unifying phone, fax and email referrals but other than that the EMR technology has been problem free for referral management. The bottom line is that a true group partnership lowers health care wait times.

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