Strategies to Reduce Demand for Appointments

Reducing the ‘demand’ for appointments from a panel of patients helps to open the schedule up for providing same or next-day access to care. Implementing the following strategies can help.

1. Decrease your panel’s ‘return visit rate’ (RVR)
   RVR reflects how often your patients typically see you over the course of a year. You can find data related to RVR in your HQCA Primary Healthcare Panel report. Although it may seem counterintuitive, reducing the overall RVR actually opens up space for your patients to see you for their more acute needs – visits that often go to walk-in clinics or urgent care sites. Physicians who do this report that they do not have fewer booked appointments in a day, but they do see a bigger cross-section of their panel during those appointments.
   
   There are several strategies physicians and teams can use to reduce the panel’s return visit rate. These include:
   • ‘Max packing’ visits – When a patient is at the clinic, take care of as much as you can while he or she is there. The team can help by reviewing the chart ahead of time and preparing as much as possible.
   • Extending prescription renewals – When a patient's condition or diagnosis is stable, consider extending the time between visits by providing multiple repeats per prescription. Most patients appreciate not needing to come in for frequent prescription renewals and are less likely to have urgent situations when they run out of medication.
   • Extending follow-up visit intervals – When a patient's condition or diagnosis is stable, consider longer intervals between appointments.
2. Share the load amongst the team
   Offering team-based care allows everyone to work at their full scope of practice, which is highly satisfying for everyone – including patients. Through taking an organized and structured approach to sharing responsibilities, non-physician team members can support and provide certain aspects of care that free up physician time for the care that only they can provide. For more information, see ‘Introductions with Intention’, ‘Team Huddles’ and ‘Roles and Responsibilities’ guides.
3. Offer virtual appointments
   ‘Virtual appointment’ is a broad term that encompasses a variety of ways healthcare providers can remotely interact with their patients. In addition to providing care to patients via telephone, physicians may use live video and secure messaging to communicate with their patients remotely.
   
   The majority of virtual care can be successfully delivered by phone. Appointments by telephone are well-received and preferred by many patients. Examples of visits that may be appropriate by telephone:
   • Review of lab results
   • Follow-up visits for certain conditions
   • Prescription refills (not requiring physical examination)
   • Patients with chronic health conditions, cardiac and lung disease, undergoing cancer treatment, immunocompromised, low-risk pregnancy, etc.
   In some cases, a patient’s concerns can be better addressed by using a video call, or secure messaging. Patients are often very grateful to avoid the disruption of coming in for an appointment when the concern is quick and simple to address. Consult our Virtual Appointment Guide for more guidance.