Kiki Herfert brings over 30 years of worldwide chiropractic experience to her columns, convention presentations, and management work.
"We make appointments for patients, but a lot of people just walk in and expect to be taken care of. Recently a patient asked, 'Just exactly what does an appointment mean around here? From what I see, I could get in here faster without one!' I just sat there, because I knew she was right. I'd like to go to an appointment practice, but I'm not sure just how we should do it. I'd appreciate your advice." -- Dr. Dan C., New Jersey
Walk-ins are usually welcome, especially in new, growing practices. But as you grow and become busier, walk-ins can interfere with the smooth running of your practice. Patients pull into the parking lot and can't find a spot or they walk out when they see the waiting room is full. Patients who are used to being seen quickly find you are tied up with an unexpected new patient. You and your staff may begin to view new patients as a problem instead of a blessing.
Well, things have to change or you will your practice reaches a crest, stays there for a time, and then begins to slide back down to a lower level. One of the things that contributes to this "surfing" (which can happen over and over), is loss of, or no control of, appointments at the desk and over the phone.
You and your staff can change this in a relatively short time. You probably have visions of patients getting insulted, refusing to cooperate or leaving in droves. It won't happen if you and your staff agree that you need to get control and have a plan to do it. It can be as simple as posting a notice several weeks in advance that says something like this: "Beginning (date), patients with appointments will be seen before walk-ins. Of course, all patients will be seen as soon as possible."
Be kind, be understanding, be sorry, but take care of the patients with appointments on time and don't just take them as they signed in. You're not trying to punish walk-ins, you are trying to get control of a runaway practice! There may be a few patients who just won't cooperate, but for heaven's sake, hang in there. Don't penalize the patients who do cooperate by making them wait for the patient without an appointment. If patients question the change, before or after the starting date, explain the benefits to them, which will interest them more than your scheduling problems. Shorter waits, convenient appointments, more parking spaces, etc. Be sure they understand that you are flexible, and that they can call you if their schedule changes.
If they do "just happen to be going past," don't drop what you are doing. Be sure that you pleasantly remind them that they are early/have no appointment. Tell them you are happy you can fit them in today (if you can), and the doctor will be able to see them (pre-agreed between DC and CA) "in just a short time." The waiting time can be as brief as five to 10 minutes, to make a point. Don't let patients put the CA in the position of pleading each walk-in's case. Don't make the doctor make a decision on each walk-in.
For patients who "scope out" your parking lot or peek at your appointment book and then want to come in when you're not busy, explain: "We have this/those times reserved for new patients, phone consultations, x-ray analysis, dark room work, phone conferences, etc. A pleasant, polite understanding policy allows the practice to grow steadily and soon the doctor will be busy with new patients at those times!
Kiki Herfert
15852 Jefferson Ave.
Grosse Pointe Park, Michigan 48230
(313) 822-9199
Many relevant diagnostic signs are not performed deliberately by the examiner or by the patient at the examiner’s direction. They are observed as the patient reacts to their condition. Fortin’s finger sign, Minor’s sign, and Vanzetti’s sign are three examples of this principle.
Spearheaded by burgeoning scientific and clinical research literature, psychedelics have reached a level of media coverage and popular interest that has not been seen for over half a century. By “psychedelics,” we are referring to the unique class of substances that includes psilocybin (the active compound found in so-called “magic mushrooms”), LSD, dimethyltryptamine (DMT), ayahuasca, 5-MeO-DMT, and mescaline – each of which occurs in the natural world (except for LSD, which is a semi-synthetic compound).
While working at the Lovelace Medical Center in Albuquerque, N.M., one of the primary care physicians stated that imaging every patient prior to receiving chiropractic was not medically necessary. It was at that point I reconsidered the need for the imaging of every patient to avoid malpractice.
