Time Management in the Clinic

I’ve worked in various clinic settings and because of that my schedule has varied. Some of those situations have been my own doing, and some of have been forced on me by the clinic owner. I’ve also hung around community acupuncture clinics, and seen some adapted schedules due to very high rent. I’d like to share three common clinic schedules so a practitioner can perhaps copy, modify, and make it their own.

The Single Room Schedule

There are two situations when it comes to having a single room - on the hour, and on the half-hour. In actuality, there’s really only a 5-10 minute difference.

A. On the hour
When patients come in on the hour, that means the practitioner has an entire hour to perform an intake (or a recurring visit check), administer needles, check on the patient, leave them again, remove the needles, and clean up for the next patient. A schedule of this nature would look like:

4:00pm - First patient arrives
4:20pm - Initial intake is finished
4:25pm - All needles are in
4:30pm - Patient is checked
4:45pm - Needles are removed; time to clean the room and/or cash the patient out if running as a solopreneur
5:00pm - Second patient arrives

A subsequent visit would look like:

4:00pm - First patient arrives
4:10pm - Subsequent intake is finished
4:15pm - All needles are in
4:20pm - Patient is checked
4:35pm - Needles are removed; time to clean the room and/or cash the patient out if running as a solopreneur
5:00pm - Second patient arrives

B. On the half-hour
When running on the half-hour, it’s important to have front-end staff support to have someone to cash out the patient. As I illustrated in the previous example, the patient rests for 20 minutes. Due to the cyclic flow of Qi, it is common knowledge that practitioners must leave needles in for 20 minutes. I have also been taught that 15 minutes is just fine as well, but that is the bare minimum.

At one point early in my career, I worked for a chiropractor’s clinic who had changed the terms of our agreement on the first day of my shift. I was young, inexperienced, and shy about negotiating business matters. The best scenario I could come up with was to adapt my schedule to fit the situation. I could no longer have two rooms to work out of, so I decided to fit new patients in an hour’s appointment, and subsequent visits would be 30 minutes. I made it work. Also, as I had done many times before while learning Chinese medicine, I let the medicine prove itself to me. Here’s what my subsequent visits looked like:

4:00pm - First patient arrives
4:05pm - Subsequent intake is finished
4:10pm - All needles are in
4:12pm - Patient is checked
4:25pm - Needles are removed; time to clean the room
4:30pm - Second patient arrives

Many times I would have a subsequent intake and needles in in 5-8 minutes. The key to checking on your patient is it has to be done after two minutes exactly, because it gives them that full 13 minutes rest - which will feel like a full 15 minutes. I learned so much about myself, the method of TCM-style acupuncture I practice, and, of course, the medicine was just as powerful at 15 minutes as it was at 20.

I ran a very tight ship, too. All my patients would show up on time and they would be taken in on time. All my patients appreciated that their appointment would be 30 minutes because they could schedule their busy lives around it.

The Double Room Schedule

This is likely the most common scenario for many practitioners. While some may feel more comfortable running a single room with no overlap for new patients, running two rooms on the half-hour is very doable and often leaves up to 20 minutes at the end of each appointment. This free time is important because it allows for a natural ebb and flow that occurs in the clinic when running two rooms. If a patient turns up 5 minutes early, it’s often a good idea to take them right then because it frees up a little more time on the end and allows a practitioner to end the other visit on time as well.

4:00pm - First patient arrives
4:10pm - Subsequent intake is finished
4:15pm - All needles are in first patient
4:20pm - First patient is checked
4:30pm - Second patient arrives
4:40pm - Subsequent intake is finished, leave second patient to get comfortable
4:40pm - Needles are removed from first patient
4:45pm - All needles are in second patient, go clean first patient’s room
4:50pm - Check on second patient
5:00pm - Third patient arrives

A patient can be left with needles for 20 or 25 minutes depending on what the other patient needs in terms of care, what time they showed up, etc.

Mandatory Cleaning Schedule

It was brought to my attention by a colleague that they are required to schedule 30 minutes between patients due to mandatory COVID-19 cleaning and disinfecting procedures. Disinfection has become a huge part of our lives as practitioners. One of the hardest parts of this is the dent it has made in our schedules and the cost. Some practitioners, or clinics, have decided to charge a modest COVID-19 fee. Many have chosen just to eat the cost.

Whether a practitioner has decided to eat the cost or not, there’s no denying that time is the biggest factor if we can’t get to the next patient. In this case, I propose a combination of the single room on the half-hour and a double room in order to run doubles - it can be done!

One of my acupuncture mentors was working in a very expensive chiropractic clinic. He decided to run two rooms on the half-hour. Think about that for a second - a new acupuncture patient every 15 minutes:

4:00pm - First patient arrives
4:15pm - Second patient arrives
4:30pm - First leaves, third patient arrives
4:45pm - Second patient leaves, fourth arrives
5:00pm - Third patient leaves, fifth arrives
5:15pm - Fourth patient leaves, sixth arrives
5:30pm - Fifth patient leaves, seventh arrives
5:45pm - Sixth patient leaves, eighth arrives
6:00pm - Seventh leaves
6:15pm - Eighth leaves

That’s 10 patients in 2 hours and 15 minutes. While it doesn’t leave any room for error in terms of ebb and flow in the clinic, but it was done, and it can be done - by anyone.

Now, if there’s a 30 minute gap that must be scheduled in between patients, we can modify the schedule to look like this:

4:00pm - First patient arrives
4:15pm - Second patient arrives
4:30pm - First leaves, mandatory 30 minute cleaning break
4:45pm - Second patient leaves, mandatory 30 minute break
5:00pm - Third patient arrives
5:15pm - Fourth patient arrives
5:30pm - Third patient leaves, mandatory 30 minute cleaning break
5:45pm - Fourth patient leaves, mandatory 30 minute cleaning break

At the end of the day, it’s YOUR schedule. They’re YOUR bills. Many practitioners may ask, “Won’t my patients be upset if I let them sit for only 20 minutes instead of 30?” Or, for those who already use 20 minutes, “Won’t my patients be upset if I let them sit for only 15 minutes instead of 20?”

The answer is always, “No. It’s only a big deal if you make it a big deal.” I know the medicine works in 15 minutes. 20 minutes. 30 minutes. Over an hour - look at all the therapeutic naps happening at community acupuncture clinics (without anyone’s Qi being completely drained, too!). If we can adapt our schedule to the clinic, rent or sign-of-the-times situation, our patients will adapt, too.

Copy, modify, and make it yours. Then share your journey with the world so they can learn from it, too.

Kenton SefcikAugust 5, 2020