North Carolina physicians promote open scheduling

Practice Management. By Mike Norbut, AMNews staff. June 30, 2003.

To many physicians, backlog equals business. But to some university-affiliated practices in North Carolina, a backlog equals inefficiency. They believe physicians can improve their performance and increase their revenue by going to an open-access scheduling system. They've set up a grant-funded collaborative to teach their theory to physicians across the state.

Primary care practices affiliated with Duke University and the University of North Carolina health systems have successfully employed open-access scheduling, a system that seeks to match supply with demand, work down the patient backlog, and increase the intensity of each patient encounter. It has not been an easy transition for many practices, but the results have been positive enough to convince health system officials to spread the word.

The collaborative's message: open-access or advanced-access scheduling can increase work relative value units, increase office efficiency, and improve patient and employee satisfaction.

"What happens is if you can get practices to work toward getting patients with their usual physician, increased RVUs are generated and you don't have to see them as often," said John Anderson, MD, a family physician and medical director of Duke University Affiliated Physicians. "The acuity level is higher because you end up doing more, and you can bill for that. The intent is it's going to build your practice."

However, the decision to switch to an open-access system does not simply mean creating more open patient slots. It means breaking down some rules and notions and focusing on continuity, Dr. Anderson said.