Bert,
I agree with Leslie on the Medicaid. We stopped taking our medicaid patients about 5 years ago and only take current patients with it. We limit how many new patients a day we take. Currently 2 in the AM and 2 in the PM. and we will limit it even more it necessary or stop taking new patients if it is a really busy time of year. We do physicals at certain times of day and these are generally booked out 6 to 8 weeks since it is routine this leaves us more room for f/up, acute and urgent appts. We do send patients to urgent care from time to time. We have spoiled our patients a lot and they have the mentality that we will get them in any time they call but unfortunately that can't always happen. We have been known to reschedule appts that can wait in order to get in the sick patients that need seen sooner. I would assume if the patients that are wanting the same day are truly that sick and can't wait a day then they probably should be at the ER or Urgent care. Most can wait from my experience.
We are not a solo practice so we have the luxury of having another provider see the patient if necessary. Have you every thought of adding a PA or ARNP to help out? Can start out Part-time and work up to full time until they have a full schedule.
One person cannot do it all. That is how we started over 21 years ago. I think you should review how your schedule is set up and see where you might be able to make some changes.
Best of luck.
