American health care is in disarray and in dire need of repair. Nearly every urologist agrees that there is uncertainty about the future of health care in America. Medicare cuts are looming in our future, and private payers are likely to follow the lead of Medicare and decrease reimbursements. This is compounded by rising costs of overhead. The result is that urologists are being squeezed, and their incomes may decrease. That’s the bad news. The good news is that there are opportunities for urologists to become more productive, to see more patients, and to avoid the erosion of their incomes. This article will review 10 suggestions that have been tested in my and other practices and may help make us more efficient, more productive, and, yes, more profitable.

1. Develop a time management philosophy and make staff and patients aware of your desire to maximize your time during the office. It all starts with a commitment to being an on-time physician. The doctor must commit first to this concept and then obtain the commitment of the staff. You can’t have a staff trying to be on time if the urologists don’t embrace the same philosophy.
2. Have everything ready. This includes equipment, supplies, pathology, lab reports, and imaging studies before the doctor sees the patient. All these issues can be resolved using checklists placed on the chart or in the electronic medical record. These checklists can be reviewed the day before the patients’ appointments, and any missing reports or equipment can be obtained before the patient is placed in the exam room.
3. The doctor must start on time. If the patients are to be seen at 9:00, the urologist must arrive before that start time and be ready to commence with patient care at 9:00. You might also inform patients that you are trying to be on time and request that they arrive 5 to 10 minutes before their appointment. By the way, this only works if the urologist is on time.
4. Avoid interruptions. There should be no interruptions when doctors are involved in patient care. Acceptable interruptions include calls from the emergency room, the ICU, or the operating/recovery room.
5. Instruct new patients to arrive 20 to 30 minutes before their appointment to fill out paperwork or complete the paperwork online if your website provides the forms for patient demographics and a health care questionnaire.
6. Manage patients who take longer than the allotted time. It is common to have a patient who requires more time than you allotted. You can offer the patient to make another appointment, come at the end of the day when you will have open-ended time to spend with the patient, or offer to call the patient at home to answer their additional concerns or questions. Patients will rarely object to one of these options.
7. Cushion your schedule to allow you to take a short break or catch up if there are delays or patients take longer than expected. It helps if you have a 5- to 10-minute cushion every few hours.
8. Obtain prior authorizations before the patient’s appointment. Nothing can be more frustrating than having a patient occupy a seat in the reception area because they don’t have authorization from their primary care physician or insurance carrier. This delay can be avoided by telling the patient that they are responsible for obtaining the authorization and that failure to obtain the authorization will result in a delay.
9. Allow for emergencies and urgencies. Every physician will have 1 or 2 patients who call and request a same-day appointment. You can accommodate extra patients by having time slots that are left open in the midmorning and midafternoon.
10. Estimate how long each visit will take. Follow-up and post-op patients require less time than a new patient. It may be challenging to determine how long a visit is needed for a newly diagnosed cancer patient. Consider seeing this patient at the end of the day to be thorough and answer all their questions.

Bottom line: Being on time for patient appointments is crucial for establishing trust, maintaining efficiency, and promoting a positive patient experience. Seeing patients on time is an effective marketing strategy. Patients expect to be seen on time by the dentist, the stockbroker, the lawyer, the hairdresser, and their urologist. Suppose you develop the reputation of being an on-time physician. In that case, you will have a more enjoyable practice, less stress, less risk for burnout, and even arrive home in time for dinner.