9905x codes also apply to visits before 8am and saturday - I start seeing patients at 7 am - break between 1pm - 2 pm for admin/lunch then finish pt visits by 4pm - another 1-2 hrs of admin stuff and I'm done. usually by 5 pm somedays 4;30! But I avg only 12 pts per day. My goal is to avg'g 15 pts daily in the same # clinical hrs.
Seems the more charts completed in the exam room, the earlier I go home - so I am making whatever changes possible to facilitate real time charting. Most patients don't mind my typing so long as I maintain appropriate eye contact and when looking down give the appropriate verbal and facial cues. They also like it when I dictate (DNS)the HPI or A/P - a chance to hear a summary and occasionally correct. I am still developing a style but find both effective. Either way, it comes down to taking time to make time - producing templates, training DNS, preparing handouts, learning to touch type (it is doable !) etc. i have also scribbled hand nots on paper during an exam and then dictated a full note next door while the patient dressed. My goal is only touch the HPI ,Plan and when indicated the PE then correct the CC. I am still trying to figure out ways to have staff do all the other stuff... maybe as hosting options for AC are deployed there will develop shared virtual backoffices - or virtual practice managers ...different post
I am slowed down mostly when searching for ICD 9 codes or when stumped and need to complete realtime review or get distracted and talk politics/sports.
i suspect that when i achieve efficiency nirvana i will remain financially in whatever the opposite of nirvana is ?? I don't know the term but we all know the feeling. For independent IM docs in Maryland, medicare generally exceeds private insurance reimbursement - hence the growth of practices that bend the revenue curve - again, different post.
I enjoyed reading the posts here - some benchmarking, new ideas and a reminder to myself of what i need to do. It is also encouraging to see so many comments to help a fellow provider in distress.
