The challenge is that waiting lists are harder to use than they seem. Here’s how you can make one work for you and your clients with no cost and minimal effort.

The Challenge

We were doing well with our scheduling strategy, but we still had a lot of holes coming from last minute scheduling changes. We don’t double-book, over-book, charge for missed appointments or use any other fixes that I feel reduce our level of service, but we really needed to do something to get the schedule filled more effectively, while still serving clients even better.

The waiting list was the answer. We just needed to use it the right way!

The Benefits

We were already using a waiting list, but it wasn’t working the way we thought it should. This time, we fixed our process for good and noticed the following in just a few days:

• Less waiting for new and existing clients
• More client visits in fewer clinic hours
• More convenient scheduling for patients
• Better daily flow for practitioners
• Greater revenue with the same or lower costs

To make that happened required five key shifts. Not difficult ones, but each is important.

Shift 1: Work Less

In the past, we’d tend to scale up available hours as things started to get busy. Once the schedule approached the 70-80% mark, it was harder for patients to get in at certain times, so we’d add a few hours here and there. It seemed sensible – after all, if there’s not much room in the schedule, you add more, right?

Wrong. This year, we took a new approach. Faced with a busy appointment book, we actually reduced our consult hours. This was the real turning point.

Reducing available time is really a way to push the adoption of a waiting list. It forces you to find a way to truly use the time that’s available in the schedule.  Why book only 75% of 30 hours when you could book 95% of 25? The deliver similar “billable time” but the latter involves a lot less time in clinic.

The result for us? We’re seeing more patients in the new reduced schedule than we did before, and providing much better service.

Shift 2: Change the Intention

In hindsight, “waiting list” isn’t the greatest phrase. I mean, who wants to be put on a list for waiting?

In the past, we might ask someone, “Can we put you on our waiting list in case there’s a cancellation?” Many would say, “No thanks.” A waiting list wasn’t really a patient-centered offering, and people weren’t interested. And for our staff, who take our clinic values very seriously, the waiting list wasn’t much fun either. For them it felt like a frustrating exercise that was all about making the clinic more financially efficient.

The solution? We changed our waiting list to a rapid care service. I know – it sounds like fluff, but it’s not. It was a fundamental shift in the purpose of the tool. Now the staff can reassure patients who can’t get in as soon as they’d like by explaining our rapid care service that will get them in sooner. Then they delight them a day later when they say, “Guess what? We’ve got a space for you.” Patients love it. It’s helpful for the staff. The practitioners love it. And the clinic is busier than ever, with fewer wasted clinic hours.

This shift is simply about service. A waiting list that is built around the intention of, “not wasting time we could be billing for,” will never work as well as one that’s built to serve.

Shift 3: Just Start

Don’t make this a big deal.  You can start your own rapid care service with a scrap of paper taped to the front desk. That’s what we did, and it worked great. Just get started, and figure it out as you go.

And don’t wait until you’re busy. The waiting list isn’t a tool for booked-solid practitioners. It’s a way to increase the speed and convenience of services in your office for everyone from the clients to the staff to you. That means no matter where you are in your practice, day one or day one thousand, you can use this tool to make life in the office easier for everyone. Even if it’s just you and a small roster of patients, get this habit in place now.

One of our early problems was making this bigger than it needed to be – that kind of thinking puts up too many roadblocks and “buts.” Just get started.

Shift 4: Get Involved

A real turning point was when I manned the front desk for a few days over the school break when we had some staff shortages because of vacation. It’s a job I used to do more in the clinic’s early days, but haven’t done much recently. It’s a great way to appreciate a) the challenges of filling a book effectively, and b)just how often a waiting list can be put to work.

You may be doing your own scheduling, and know exactly what those challenges are, but if you haven’t done the job in a while, it’s worth making a few hours to live in your staff’s shoes by answering the phone and booking appointments.

If you’re not doing your own booking, you’ll still need to be on top of gaps in the schedule. Make a point of checking the schedule regularly through the day. Help your team think of ways to fill any holes. “What about Mrs. So-and-So? She could come in.” Getting your waiting list to work is about changing habits, and that’s going to require you to be leading the charge.

Shift 5: Collect Better Information

To make this work, you’ll likely need to start learning more about your patients than you currently do – or you’ll at least have to start writing it down somewhere. Focus on these three areas:

• Best contact: To make your system work, you need more than just a way to get in touch with people. You need the fastest and most certain way to reach them. If you have a sudden opening in the schedule, you won’t be able to fill it quickly if you’re calling someone at home, but they’re at work for the next six hours. That means you need to know the best way to reach them now. Is it their cell phone? Email? Text? Work number?

• Patient preference: You waiting list needs to have some details – like what service patients are waiting for, and their preferences for times and days

• Patient flexibility: You’d be surprised how many clients have flexibility in their lives. The trick is to know who those people are. They’re the ones that are going to be a) great candidates for your waiting list, or b) the people whose appointment you can shift to accommodate someone else on the list who’s less flexible, and waiting for a specific time slot.

How you collect that info is up to you. Whoever does your bookings will develop a good sense of patient flexibility and preferences, but only if they ask in the first place. You need to be asking patients this information during the booking process. If you can’t reach flexible people in the fastest way possible, your list is going stumble before it gets out of the gate.

Small Effort, Big Benefits

Once you get this in place, you’ll find the benefits tend to spread into the schedule. When you have a great intention, and you can reach flexible clients easily, it become easy to shift the schedule to make it more efficient even when there aren’t people waiting. That frees up more blocks of scheduled time that help you get people in right away without ever having to be on the rapid care list at all.

Don’t be scared to work less to make this work. Test-drive it for a couple of weeks – you’ll be surprised not only at how efficient you can be, but how well your clients will respond.

To calculate a useful dollar-per-patient-per-year figure, you’ll need to know two things:

• Your active patients in the past year
• Your revenue over the same one year period

From there, it’s a simple one-step: divide the revenue by the number of active patients. If, for example, you billed $60,000 last year, and you had 250 patients visit your practice (counting each patient only once), then your average annual revenue per active patient is $240.

How to Use It
This is another of our favorite decision-making tools, and it’s particularly useful when it comes to making choices around advertising.

Right now, for example, we’re making a decision between two different locations for the new clinic (we’ve outgrown the current space). One space has no real street visibility, the other has a large awning facing a busy street.

The high-vis location is considerably more expensive. Is it worth it? One of the tools we use to help make that decision is annual revenue per patient. Knowing our annual revenue per patient, we can then ask ourselves, “Well, we need to get three new patients a month just from that big sign to justify the expense. Will the exposure generate that?” That question seems easier to answer than, “Should we spend an extra $20,000 a year on this space because it has more exposure?”

Why One Year?
You may be wondering why we don’t use lifetime patient revenue, instead of just one year – after all, lifetime revenue is almost certainly higher. I use a year because:

• It’s more accurate. After one year, the numbers start to vary. Some patients disappear, some stick around.
• I like to get my money back in a year from an investment whenever possible. If we spend $1000 on something, I want to know how many new patients it takes to get that money back in the first 12 months, maximum. Revenue per patient after that becomes bonus return.
• A year provides a more conservative estimate. Lifetime revenue per patient certainly is higher, but I work off a single year, and that provides a good margin of safety.

Using the annual revenue figure allows you to put financial decisions in a language you can more easily understand and work with. Give it a try. It works wonders for marketing decisions, and once you figure out the annual revenue per patient, you don’t have to recalculate it every time – just once a year, to keep the number fresh.