I have a salaried physician friend who was recently told by her employer that she needs to up numbers, i.e. start seeing more patients. Because she wasn't seeing enough patients to earn her salary.
Truthfully, in the real world you have to see a lot of patients. In residency, I saw anywhere from 4-5 to 15-16 per day, depending on the rotation. As an attending, I average 20.
How many patients do you see each day?
When I was employed by an FQHC, the pressure to see more patients was palpable. Now, in the academic practice where I work, the doctors and I see 3 patients per hour, except for sick call. I average about 22 patients/day. Once I get into the high 20s, things start to get fuzzy...
ReplyDeleteAs a student, I see the number of patient my attending scheduled.
ReplyDeleteThe highest numbers I have seen were on my dermatology (~46/day) and obstetric (~40) rotations.
Then again patients would wait for 3 hours to be seen in the waiting room and we'd finish our day at 18 or 19 o'clock.
I am curious do you think it will get worse or better when Obama Care finally kicks in?
DeleteI believe it will become much worse.
DeleteI'm an ID attending 1 year post fellowship I see 25 in clinic daily plus an average of 20-25 in the hospital daily.
ReplyDeleteI'm considering hospital based ID only same volume of patients but much better hours not managing clinic based patients.
Wait.. so 50 per day??
DeleteI'm a PGY2 medicine resident.
ReplyDeleteThe numbers we see inpatient and outpatient vary.
For first year we are capped at 8-9 patients for inpatient and I believe there is a national cap of 10 patient for medicine interns now.
The second-third year we are responsible for overseeing 2 interns so usually 16 patients when inpatient, up to a max of 20.
For outpatient the numbers really ramp up as we go through the year. We start with only 6 patients per day, and can go up I think to a max around 16 3rd year. The patient in our office are much sicker than the typical IM office though.
I am an Internal Medicine resident in the US, and considering a career in Primary Care. I have a question for those of you who are already practicing. I would like to limit the number of patients I see per day by having 30 minute encounters for follow ups, 15 minute for acute visits, and 1 hour for annual physical or new patient visits. I plan to request these time slots at interviews. How plausible would that request be?
ReplyDeleteThat doesn't sound plausible to me, but I'm no PCP.
DeleteI've worked in both private practice and Kaiser as an internist. Typically I see 15-20 patients per day (it is difficult to break even in private practice seeing less than 20). It is not plausible to request 30-60 minute visits. In private practice I had 20 and 40min visits (but 40min was used rarely for the VERY complicated patients). When you needed less time for acute visits the extra was used by visits that took more than their allotted time or to work in my EMR inbox. Currently at Kaiser I have 20 minute appointments across the board with four 20 minutes slots blocked for EMR inbox or overflow appointments. I typically schedule Medicare physicals, hospital follow ups, or new complicated patients in a 20 minute slot just before one of the blocked slots to have an effective 40min appointment.
DeleteI am an internist in Iowa. I see about 12 patients on most days. I get 45 minutes for new patients and physicals, 30 minutes for follow-ups, and 15 min for acutes. Another physician in my practice gets 60 min for physicals/new patients. So I think it is a possibility in the right place! Good luck!
Delete@Anon Kaiser Doc: 10 years ago a doc told me that at Kaiser docs have 10 minute visits (8 min to see the patient and 2 min to chart) while PAs had a total of 12 minutes. That sounded awful but your situation sounds somewhat better. Does this include charting time?
Delete@PGYx
DeleteTheoretically the 20min visit should include some charting. However, I typically don't complete all my charts during the actual visit time. I have quite a bit of 'down time' during the day during which I do EMR work and charting. My first scheduled visit is at 8:40am, the last at 4:20pm, and I get 1.5h for lunch. That allows me to empty my EMR inbox and do all my AM charts by the time I start my afternoon.
I am curious what is your opinion Fizzy and others, do you think this 'increase' in seeing patients will get worse or better once Obama Care comes into full effect?
ReplyDeletePGY 3 general surgery resident.
ReplyDeleteReally depends on the day - I did almost no clinic last year so I can't remember what a typical clinic day was like.
Inpatient was anywhere from 5-30 patients to round on, plus whatever came in the door. For trauma or general surgery consults, that might be another 5-10 patients per day.
Gen peds. I average about 25 patients per day. During the winter months, I see about 32-35 patients a day. And to the internal medicine resident who is planning to ask for 1 hour visits, please don't ask that, they will not hire you (unless it's a boutique practice or something equivalent). :)
ReplyDelete50 to 70 per day. Primary care. India.
ReplyDeleteinternal medicine, private practice, typical patient is older, multiple medical problems, 15-20 patients a day. any more than that and i'd be looking for another career.
ReplyDeletePediatric neurology sub-sub-specialized. 60 minutes for new patients, 30 minutes for follow ups. I do 1/2 day of clinic at a time, which is usually 3 new patients and 4 follow-ups. The actual visits often take about 15 minutes longer than allotted, so I am running a hour or so late by the end of the session and completely frazzled.
ReplyDeleteTransplant Hepatologist. In my transplant clinics, I see about 12-15 patients in a day. In my Gen Hep clinics, I see a F/U pt every 15 minutes, and new patients are booked for 30 minutes. So in a half day, I might see about 12-15 patients, and about 25-30 patients in a full day (I hate full day clinics). On a scope day, I see about 8-10 patients (or do 8-10 procedures) in a half day. And I am salaried.
ReplyDeleteI average 25 patients per day - primary care. However, I have partners that see upwards of 40 patients in a day on occasion, which ruins everything (admin thinks this is acceptable). I know I can't provide quality care at that level. At least, not without staying until 7 pm every night.
ReplyDelete