by adgrooms on October 2, 2019

Physicians are often working with maxed out patient schedules that have no room for deviance. Otherwise, there is pressure on them to "get back on track". Take this story for instance:

A provider has a full load of patients for the morning clinic until 11:30 and must go immediately into a full afternoon of procedures starting at noon, with maybe enough time to sneak in a quick snack. But one patient is over fifteen minutes late, right at the end of clinic hours. The physician doesn't have time to squeeze in another patient without being late to procedures, which is unfair to those patients and staff.

The front desk says the patient checked in 15 minutes late. Of course, the patient says they were on time but stuck in the waiting room for those 15 minutes. Either way, it doesn't matter. Now, the physician has to make the tough reschedule the late patient, making them angry, or see the patient and be late to procedures, making those patients and staff unfairly wait.

Scheduling woes are commonplace in the healthcare industry, and as in this case, can put an undue burden on providers that contributes to burnout. They quit, and they are replaced by another provider that will experience the same scheduling mess over and over. Is there a solution?

The airline industry moves millions of passengers per day. One plane on a domestic route may have 4-5 stops. They have people connecting, and sometimes weather to dodge. For the most part in this highly complex web of travel, people usually get to their destination on time. Most airlines have a practice of padding flight times to allow some flexibility in their schedules. Somewhere along the route, they may experience a hiccup. With the padding, these can be absorbed throughout the course of the day unlike with a rigid schedule where it would cause an immediate problem.

This means that they aren't operating at maximum revenue potential. In a clinic, this would mean cutting a schedule slot or two to allow for the padding to exist. One result is that the doctors don't have to scramble to get all of the scheduled patients in. If they need extra time with a patient, it doesn't wreck the rest of the shift schedule. Patients aren't rescheduled because of a scheduling mishap (and end up blaming the provider). Most importantly, there is time for the doctor to breathe and make well thought out decisions.

I wonder - who is best served by each approach to scheduling?