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How many patients in a week? Key Performance criteria

Discussion in 'General Issues and Discussion Forum' started by JacksonMccosker, Jul 22, 2014.

  1. JacksonMccosker

    JacksonMccosker Welcome New Poster


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    Hi All,
    I have just been offered a new job after becoming redundant from my current employer. The new employer has only ever employed physiotherapists and is following the Health Professionals and Support Services Award 2010 for my salary decisions. I am a New Graduate so im not as concerned about remuneration as I am about further education and expectations as I am now the only qualified podiatrist working at this sports clinic.
    My key performance criterion states that:
    That i need to demonstrate that I can see a minimum of 75 patients per week (40hours) for at least 3 months.

    At my current position (within the same building)with a well established podiatrist we are covering 54hours a week between the two of us and only averaging 46.7 patients a week

    Considering the director of the business has really only employed physios is this a case of comparing apples and lemons?

    What would be a reasonable 40hr week patient numbers schedule?

    * please note it is a sports medicine clinic so primary patient issues are MSK

    Kind regards
     
  2. W J Liggins

    W J Liggins Well-Known Member

    How long is a piece of string? Presumably some will be new consultations - therefore require more time, some will be sports assessments/treadmill and therefore require more time. Some will be reviews and follow-ups and therefore require less time. You should be able to ascertain this from the employer. On the face of it, 75 per week seems reasonable provided you have the mix referred to above. I would advise you to have this all worked out, breaks etc. included and get a detailed contract in writing.

    All the best

    Bill Liggins
     
  3. Griff

    Griff Moderator

    I personally can't see how this is realistically achievable at all. Assuming a 5 day working week that is 15 patients a day every day, (and gives you only 30 mins with each of them). Not going to happen in private MSK setting in my opinion (I assume this is a private practice?). I dont know where you are based but I'm in London and have never seen 75 patients in one week (nor would I want to!)

    I suspect these numbers were based on Physiotherapists. I'd sit down with the boss and talk things through. Don't sign up to targets that can't be hit.
     
  4. It really depends on what type of patients you are seeing, how many are new patients and how many are return visits. In general, in my full days, I see 25-30 patients, with about 5 of these patients being new patients. However, I'm only seeing patients in my office three and a half days per week so I suppose I see 100+ patients per week. However, when I first started practice, a big day for me was 10 patients a day. I'm now in my 30th year of private practice. I suppose I have gotten faster as I've gotten older ...grey hair does have some benefits.

    I would take the job if you want it and just try to keep the visits concise and to the point. 75 visits in one week, for a 5 day a week, 8 hour per day practice seems reasonable to me, but for a new practitioner, seems a little too much.
     
  5. JacksonMccosker

    JacksonMccosker Welcome New Poster

    I performed some calculations yesterday and this is what our found based on our company structure of appointments 20min review and 40min initial/extended/castings.

    40 hours per week
    = 120 (20min appointment slots)
    - 33 (lunches/tutes/admin/breaks)
    =87 (20min appointments)
    - 20% (extended appt/NP/casting/Sx) [equivalent of 8.7pts]
    = 69.6 slots – 66.3 patients
    = (3.3 x 20) divided by 60
    = 1.1 hours divided by 5 days
    = 13mins 20sec free a day

    That 13min is where I would have time for orthotic modification/ GP letters
     
  6. Griff

    Griff Moderator

    I don't know whether that maths is correct, but based on your calculations of 8.7 (9) new patients a week hopefully you can see that your employer setting targets of 75 consults a week is wildly unrealistic. You cant have follow ups without new patients! Furthermore, and you touched on this already, but when is the time for all the other very important aspects of private practice (writing good notes, generating reports for referrers, answering emails from patients, modifying orthoses, networking with other professionals, giving presentations to patient groups/other professionals, CPD... Etc etc)

    I see you are based in Australia so perhaps it is different there. But I'll say it again - no way (in my opinion) a purely musculoskeletal caseload will generate that much work for you. Even if all the above were not true... Would you really want to see 75 consults per week? Do you feel every single one of those would get the level of care they deserve? Work smarter not harder is the motto to live by.
     
  7. RobinP

    RobinP Well-Known Member

    I worked out that for every hour I spend seeing a patient, I spend a further hour generating notes for the consultation, writing letters to referrers/to the patient, generating orders to manufacturing labs, boxing up casts/imps, sending the boxes in the post, receiving the goods at the other end and checking them and dealing with the invoice. In a private setting, I think 70 consultations per week is quite a lot if you are dealing with people like triathletes etc as the time spent in patient interaction is almost as critical to them as the treatment you provide. Factor in all the stuff required in non patient contact time, 70 patient contacts is quite a bit

    I also do NHS work where I see 20 patients per day, but someone else is responsible for typing notes, processing orders, boxing up and receiving, appointing and we do not send correspondance to the referrer. It is only possible because someone else is doing the donkey work. This is rarely the case in private practice.

    Like Griff, I think these are probably physio targets where the initial assessment is in depth and requires more time. Thereafter, a course of 6 sessions is recommended. This has 2 effects - firstly, it guarantees a caseload for the next 6 weeks and secondly, these 6 sessions will largely involve the same treatment so notekeeping and further correspondance/further work is limited. Most biomech patients will be seen a maximum of 4 times before discharge. In most cases, three times? The same targets and goals cannot be applied to physio and podiatry and you need to have that discussion
     
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