Same-day appointments catching on with doctors

Physicians say patient satisfaction goes up and no-shows go down, but the transition to an "open access" scheduling system isn't always easy.

By Julie A. Jacob, AMNews staff. Jan. 29, 2001.

Imagine this: A patient calls his or her doctor's office for an appointment. The receptionist tells the patient there's an appointment available for 1 p.m. -- today.

That scenario isn't just wishful thinking. In a dramatic shift from booking patient appointments weeks in advance, some physician practices are switching to an "open access" scheduling system in which patients can be seen on the same day that they call for an appointment.

Patients love it because they can get in when they actually are sick.

Physicians say they like it, too, because patients are happier, their productivity has increased, their daily patient load has dropped and revenue has remained stable or has even increased.

Kaiser Permanente pioneered the open access system, also called advance access, a few years ago in northern California. It was developed by Mark Murray, MD, who formerly headed the Kaiser Permanente Sacramento Medical Center's family practice department.

When Kaiser began analyzing its operating procedures in the mid-1990s, it became clear that Kaiser patients hated having to schedule appointments months in advance, said Dr. Murray. Yet nothing that his staff had tried in an effort to whittle down that waiting time -- adding doctors, blocking out time for walk-in appointments, centralizing appointment scheduling -- seemed to help much.

Dr. Murray finally determined that because the waiting time for appointments stayed consistently at two months, "we were roughly matching supply and demand," said Dr. Murray. "But we were two months late." [...]