Consistency in Patient Scheduling

Calendar surrounded by plants
By Nathan Risley

Many of the challenges we face each day lie in uncertainty.

We depend on planning and consistency to be the backbone of success. There are many instances where plotting and creating best practices will keep the train on track, steadily chugging away. It is the outside elements beyond our control that make for more difficult problem solving.

A faithfully followed plan of care may be the best indicator of success in both the health of our patients and the health of our clinic. If we can rely on that schedule of frequency, we can predict both cash flow and appointment management needs. The real challenge is that many times we feel, and in some cases are, not entirely in control of this factor. There are a multitude of reasons why a patient may have difficulty meeting their plan of care, and in turn, many ways to mitigate those interruptions in care to ensure consistent revenue.

The plan of care, determined at the initial evaluation, provides an opportunity for the patient and therapist to discuss the goals of treatment and the frequency that will best serve them. This discussion is the first point where things can go awry. It is everyone’s best intention to get back to health as quickly and safely as possible, and in that initial encounter there may be some tunnel vision on the part of the patient to truly understand the scope of what is being asked of them. While the therapist may have a good idea what they want to see in terms of frequency, many times that commitment is not realized by the patient until they are at the front desk scheduling future appointments with their calendar available to them. To reduce this from happening, consider implementing a script for therapists to use with patients that ensures all parties are on the same page regarding frequency by the end of the conversation. The therapist should accompany the patient to the front desk, if possible, to relay the plan of care to the administrative staff.

The initial scheduling session is a great opportunity for the administrative staff to connect with the patient and get a feel for what they can commit to. If the initial plan is to see them three times a week for the first three weeks, and they are having difficulty getting on the schedule more than twice over the first two weeks, it is a fair guess that they may have over committed themselves without realizing the scope of their treatment. If possible, I find it best to make the therapist aware at that time so that they can discuss this further with the patient and adjust the plan as necessary.

There are many tools at our disposal to maintain commitment to the patient’s plan of care. Patterns tend to appear, and we are able to assess patient commitment fairly quickly. Personal connections and meaningful conversations are powerful instruments to not only build and manage an efficient schedule, but also to add buy-in to the patient beyond recovery. Understanding patient work schedules, family commitments, hobbies, and social engagements will not only guide when to schedule, but also help understand what is important to our patients and what may motivate their treatment. For example, a high school student will generally not be able to come during the day. They may also have a sport or extracurricular activity three nights a week that they are reluctant to skip to make a physical therapy appointment. This could be a point of frustration when the hours they prefer are also the preference of many patients, but it can also be a bartering point to keep them committed. If they are all-in on physical therapy because it will improve their quality of life doing the things they love, they will be far more motivated to the schedule and the overall treatment. Offering to schedule the patient out for multiple weeks at their desired times reinforces your commitment to their schedule as well as their commitment to yours. Getting to know patients on a more personal level has many tangible benefits to treatment, but from an administrative standpoint, it is a great reference point in solving the puzzle that is our schedule.

Scheduling a plan of care in its entirety can have many benefits on the financial aspect of a business, as it allows for planning and budgeting of staff and space. Of course, there are some people who cannot commit to appointments more than a few weeks out for a number of reasons, such as an irregular work schedules or family responsibilities. But, as we all know, this means that more desirable appointment times will be less available as those dates approach. Every week successfully scheduled will help mitigate difficulties scheduling down the line even if it is hard to initially nail down a plan with a patient. A word of caution: scheduling someone who is not as flexible in their schedule or who isn’t dependable many weeks into the future can cause even more headaches than having to schedule their plan of care every other week. Sudden cancelations are possible, but the frustration of having to readdress a schedule that was already plotted out can make the therapy feel more like a nuisance to those patients and commitment to the plan will suffer. There is no absolute rule to understanding the right balance in these situations, so it will come down to some gut instincts.

We can never guarantee a schedule will be followed to 100% accuracy with elements that are out of our control. However, our responsibility lies in being able to anticipate potential threats and put ourselves in a position to be nimble and quickly adapt to those situations. We must do our best to create consistency where possible for both our patients and our clinic to minimize disruptions in the quality of patient care as well as financial stability of the practice.

Nathan Risley

Nathan Risley is office manager at Action Potential in Kennett Square, Pennsylvania. He can be reached at

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