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Getting Creamed?

Apr 28, 2019

Family medicine is tricky. You want your patients to be able to pre-book but you also want to see your own patients when they are unwell. Ideally you want a good mix of "complex" and "easy" presentations.

Additionally, patient continuity is super valuable. If you can see your patients your appointment times can be 2-3 minutes shorter and you may be able to prevent hospitalization for some of your patients - as you know them well and can schedule close follow up when they are unwell.

When I first started in family medicine my patient panel was 75% children. Then it morphed into women and their families - including elderly parents. And now 14 years later, my patient panel is very complex. I have less than 20 children under 5 on my panel of 1400 patients.

The "cream" of your day are the easy consultations. These easier consultations give you space in the day to catch up. They are less overwhelming.

However, unless we are intentional, often these easier consultations don't get to see us - depending on your access.

Fast track was a strategy that I implemented 12 months ago. It had to be simple so that the booking staff knew the rules. I started with three per day. I increased to four per day - once I was confident that they would be respected as short consultations and for a specific acute need.

My patients were pleased as they could see me the day they were unwell, rather than waiting or having to make alternative arrangements. I was happy as I could see my patients in a timely manner for their acute need. The staff were happy that they had a strategy for these patients.

If you are going to implement this strategy, the conditions that you chose for your fast track appointments should be conditions that you are comfortable seeing, assessing and managing quickly. Additionally, try to make sure that you can recognize that the appointment is a fast track booking so that you focus on the acute presentation and re-book non urgent concerns.

xx Sarah, the Charting Coach

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