How One Practice Uses Same Day Appointments to Help Patients
Written by Dr. Grace Paradela, Dixie Primary Care
A few weeks ago, we had a patient call around 9:00 am. She had been recently diagnosed with the flu, and was struggling to keep down any food or fluids. We were able to get her an appointment at the office within two hours of the call and administered IV fluids to prevent dehydration. If the patient hadn’t called us first, or if we didn’t have open-access scheduling, she would have likely ended up in the emergency department.
In the same week, another patient contacted us and said that she didn’t feel quite right. Again, we leveraged our open-access scheduling to get her into the office quickly. This patient was also scheduled for a knee replacement surgery within the next two weeks. She was concerned that her current condition would prevent her from proceeding with the surgery. I evaluated her and determined although she was without a fever, she had pyelonephritis, an infection of the kidney. At the visit, I gave her intramuscular antibiotics to treat the infection and contacted her orthopedic surgeon to provide a report on her visit and treatment plan.
Through the rest of the week, I saw her every day at the office to monitor her progress and keep her surgeon informed on her course of care. She was very anxious about the surgery but trusted that since I was monitoring her closely, I wasn’t going to let her go through it if I felt she wasn’t ready. Thankfully, she was able to make a full recovery in time to have the knee replacement. This could have resulted in significant perioperative complications had she not called us first.
At Dixie Primary Care, our patients know that we can be available if they reach out to us when they experience health concerns. If a patient can contact us before they go to the emergency department, there’s a good chance we can care for them at the office immediately, thereby saving them an unpleasant, lengthy, and expensive visit to the ER. Each of our providers keeps four acute appointments open every day which create 16 same-day consultation slots for the whole practice.
When I tell other doctors about our scheduling process, they often ask whether it is difficult to fill all of the same day appointments. Our response is that this is a conscious choice in an effort to serve our patients, regardless of whether we fill the slots. In some instances, we have used these appointments to reconcile medications after patients get discharged from the ER, hospital or rehabilitation facility. We have decided that it is more important to be available for our patients than to overbook our providers’ days.
This scheduling process parallels our mission to provide value-based care as it leads to remarkably low rates of ED utilization by our patients. Our rates are among the lowest in all of Aledade’s partner practices, which are already lower than many primary care practices across the country. It helps our patients get the right care, at the right time, for the right reason, thereby improving patient experience and compliance and decreasing costs.
A patient’s fears and concerns can be enough for them to turn to just anyone for help. For my family and friends, I would want them to see a doctor who knows them well and whom they can implicitly trust. This is what being a primary care provider is all about.