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J. M. Smith, G. D. Seitzman; Maximizing Clinic Volumes in Resident-Run Ophthalmology Clinics. Invest. Ophthalmol. Vis. Sci. 2007;48(13):2397.
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To address the challenges of maintaining clinic volume in a resident run ophthalmology clinic.
Retrospective tracking study monitoring patient volume, no-show rates, and patient characteristics (age and sex) in a resident clinic over a two month period, before and after a phone call program was instituted The call back program consisted of calling all no-show patients on the day of the missed appointment and selecting a new exam date.
A "no-show" patient is defined as a patient who was scheduled for a clinic appointment but does not arrive. This excludes patients who rescheduled appointments beforehand. Over the same time period, the average no-show rate in an attending clinic was 5.7% compared to 23.4% in the resident clinic. In 2006, we initiated a program where every no-show patient in the resident clinic was called and rescheduled. Prior to initiation of the program, the two month total clinic volume was 981 patients. Daily no-show rates, Monday through Friday were 23%, 20%, 17%, 26%, 18%. After initiation, the total number of patients seen over same time period numbered 1046 and the daily no-show rates were 29%, 25%, 21%, 18%, 22%. Older patients were not more likely to no-show. In fact, there was a trend for the no-show population to be younger with an average age of 45.5 years. The average age of scheduled patients was 53.3 years. The call back program did not have an effect on the total no-show rate but did alter the rescheduled patient’s no-show rates. Before initiation of the call back program, 33.3% of the no-show patients rescheduled and were seen within two months of their initial scheduled visit. In contrast, after initiation of calling, 50% of no-show patients were seen. There was no significant trend for the no-show group to be of a certain sex.
Maintaining clinic volume in a resident clinic environment poses many challenges. Patients may have limitations in their access to health care and may require additional assistance for clinic arrival. Adequate volume is necessary for residency education to allow diversity of pathology and to allow residents to establish independent relationships with their own clinic patients. With the use of a call back program, we increased the percentage of no-show patients that were successfully seen within two months of their initial scheduled appointment. The overall number of no-show patients was not significantly altered by the calls, likely due to the constant flux of new patients. The call back program is one way to increase patient volume, improve patients’ continuity of care, and maximize educational opportunities in a resident-run ophthalmology clinic.
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