A trial run at making doctor's appointments available on short notice has gone so well at the handful of practices in the Raleigh, N.C., area that tried it that fans of the approach have established a collective to teach other practices how to do it.
The group, which grew out of a collaboration of physicians with the health care systems at Duke University and the University of North Carolina, expects to train 25 North Carolina practices this year.
For patients, it could mean much easier access to their doctors when they really need it. Practices that have "open-access" scheduling leave at least half of their daily appointment slots open, clearing the way for patients with urgent medical needs.
The approach also makes it much easier to schedule preventive care, such as children's immunizations or annual physicals, which should work to keep patients healthier over the long term.
"Before, a patient would call up with a problem but we'd be full," said Tony Galiani, practice manager of Family Medical Associates in Durham, which switched to the system last spring. "To fit them in, we'd have to double book, and the doctors would have to stay late. It felt like we were always running behind. That doesn't happen any more."
The practice's patients are happier, and so is its medical staff.
Questionnaires showed that more than 80 percent of respondents rated their office visit excellent or better, compared to 62 percent in a survey taken six months earlier. Sixty percent of Family Medical Associates' office staff rated the practice an excellent place to work, compared to 20 percent in questionnaires six months earlier.
Other practices that switched to open-access scheduling saw similar results.
Getting patients in for appointments faster is just part of the payoff. An important goal of the open-access system is improving the practice's inner workings, so most of the patient's visit is spent on patient care, not idle in the waiting room.
At Family Medical Associates, for example, the clinical and administrative staff gather twice a day to look at how the schedule is shaping up.
If a physician knows that a particular patient is going to need lab work, the physician might ask a nurse to draw blood as soon as the patient is brought into an exam room. That way, time that would have been spent waiting is used productively.