What type of scheduling is used when seeing a patient at a specific scheduled times?

The concept’s founder explains how to do “today’s work today” and improve patient access to your practice.


Fam Pract Manag. 2005;12(3):59-64

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What type of scheduling is used when seeing a patient at a specific scheduled times?

Same-day scheduling, also known as “advanced access” or “open access” scheduling, allows medical practices to dramatically decrease patients’ waiting times for appointments. Very simply, it requires that practices do today’s work today by offering a same-day appointment to all patients who call. The result is more timely care, increased patient satisfaction and improved practice efficiency.

While the concept has great potential and has garnered much interest, it is often misunderstood. The key mistake practices make is thinking of same-day scheduling as a ready-made product or a specific solution guaranteed to reduce a practice’s waiting time. In reality, there is no such product or solution; however, there is a proven process and a set of proven principles, which if applied in a customized fashion to each environment, will result in improved access to care. The course of action is similar to any quality-improvement process and involves four steps:

  • 1) Assemble a team to address the problem;

  • 2) Set an aim or a goal;

  • 3) Make changes;

  • 4) Measure to see whether your changes have resulted in an improvement.

The principles to apply throughout this process are fairly simple:

  • 1) Understand, measure and achieve a balance between supply and demand;

  • 2) Recalibrate the system (or reduce the backlog);

  • 3) Reduce the number of queues by reducing the variety of appointment types or lengths (queuing theory);

  • 4) Create contingency plans for times of heightened demand or lessened capacity;

  • 5) Influence the demand (e.g., by matching patients with their own physicians, making the most of current visits and rethinking return-visit intervals);

  • 6) Manage the constraints or bottlenecks (e.g., remove from the physicians any work that can be done by someone else).

Same-day scheduling, then, is really all about the process and the principles, not about a specific product or solution. It will require some thought, customization and experimentation to apply these principles to your specific environment. If you’re ready to embark on that, read on. What follows are commonly asked questions about open-access scheduling submitted by FPM’s readers.


  • Under advanced access, practices do “today’s work today” by offering a same-day visit to all patients requesting an appointment.

  • Advanced access is not a specific product or solution, but it involves a proven set of principles, which can be applied to individual practice environments.

  • To begin eliminating waits, practices must ensure that the physician’s supply of appointments is balanced with patient demand for appointments.

    In today’s competitive climate, many doctors are content to have a steady stream of patients each day. However, failure to implement a structured appointment system could mean missing out on revenue. Clinical management expert and AAO presenter Zachary Cain notes that an effective scheduling program is essential to achieve smooth practice operations and the satisfaction of both staff and patients.

    There are many different ways to design an appointment schedule, and Cain cautions against a one-size-fits-all approach. It’s tempting to simply schedule a patient every 15, 20, or 30 minutes. This revenue-driven method, known as standard scheduling, may add up to high productivity and financial success for some practices. For others, it results in long patient wait times, reduced patient satisfaction, and little to no time for walk-ins or emergency appointments.

    A customized scheduling template designed with your practice needs and physician work styles in mind can do more than alleviate patient wait times and staff stress. Altering the composition of your schedule often frees up blocks of time, allowing for additional appointments. Depending on your average revenue per appointment, it could add up to real income over the course of a year.

    Keep in mind that there is more to scheduling than the frequency with which appointments are timed and when certain practices are performed. The top way to make a positive impact on your scheduling is to use a digital self-scheduling tool. Digital schedulers are increasingly popular for everything from oil changes to dinner reservations, and customers are becoming more and more familiar with them, and many now prefer them over traditional phone appointments.

    In addition to being preferred by patients, digital appointment tools can reduce strain on your staff and free them up for more engaging and profitable exercises. While some patient visits will always need to be handled over the phone, a move to digital scheduling allows staff to handle administrative tasks more efficiently and allows a clinic as a whole to operate more smoothly.
    Which scheduling strategy is right for your practice? Below, Cain suggests some alternatives:

    Integrated Scheduling

    Also known as long/short scheduling, appointment slots are set aside for either long, full exams or short follow-ups. Many times, one type of appointment is allocated to the first half of the day, while the other type fills the second. For practices with multiple doctors, the day is coordinated so each doctor gets a mix of appointment types. For example, in a two-doctor practice, Doctor 1 might see all long appointments in the morning and short appointments in the afternoon. Doctor 2 would do the opposite.


    • Helps doctors get in the mindset of doing quick appointments or full exams.
    • Frees up the pretest area, since short appointments usually don’t need pretesting.
    • Allows for more efficient use of tech time since shorter appointments usually require little tech time.
    • Eliminates any guesswork in scheduling staff, since you can anticipate the flow from hour to hour.


    • Short appointments sometimes turn into long appointments.
    • Must be careful to assess your overall patient needs to avoid an imbalance of available appointments.

    Top of the Hour

    The goal of top of the hour scheduling is to allow the physician’s schedule to “reset” every hour. It allows for a set amount of appointments per hour, leaving an open block of time at the end of each hour for administrative tasks or to be repurposed for the physician’s needs at that time. Sometimes, all patients for an hour are scheduled at the beginning of that hour and seen in the order they arrive. Other times, complex appointments are scheduled for the first half of the hour, with the remainder of that hour’s patients arriving on the half hour.

    Before a practice decides to implement top of the hour scheduling, Cain suggests conducting a detailed review of historical data to determine average number of patients seen and patient contact time, and to predict the number of work-in visits needed and the likelihood of no shows.


    • Emergency visits or same day appointments are more easily accommodated due to the time at the end of the block.
    • Physicians are less likely to fall behind on administrative duties, thus achieving more complete and accurate patient records.


    • Patients may become upset if they notice that other patients were given their same appointment time. An explanation will require some finesse from your front desk staff.
    • Not finishing the block on time will result in back-ups over the course of the day.

    Cluster Scheduling

    Cluster scheduling involves grouping patients with similar exam types, conditions, or treatments, and scheduling them within a certain time block during the day. For example, a practice might have “injection afternoons” or “procedure afternoons.” Aside from the normal considerations like exam room availability and number of support staff, you’ll also need to take into account things like the number of surgical instruments on hand and the turnaround time for sterilization.


    • Streamlined appointment types allow a large number of patients to be seen in a short amount of time.
    • Diminished wait time for patients who return on a monthly basis for chronic treatments.


    • Performing repetitive tasks can increase the risk of physician or tech error.
    • Staff shortages (like call-outs) particularly affect this type of scheduling.
    • Patient availability and timeliness is more of a factor, as are geographic considerations. For example, if you practice in an area with harsh winters, there could be chronic backups due to late patients.

    Zachary Cain’s 6 Steps to a No-Fail Scheduling System

    It’s critical to realize that patient scheduling is one of the most important elements of a smooth-functioning, revenue-optimized practice. Nailing scheduling can increase your revenue and patient satisfaction while unburdening your staff. As patients are increasingly searching for better experiences, reducing wait time can help unlock hidden revenue.

    1. Establish a target goal of patients to be seen each day.
    2. Create appointment types based on practice needs using realistic physician times for each appointment type.
    3. Build a high-performing team of administrative and clinical staff.
    4. Allow for work-in visits from established and new patients.
    5. Communicate throughout the day.
    6. Request feedback from physicians, patients, and staff

    You can help your practice improve its scheduling by following some of these practices:

    • Send text or email reminders to patients when their appointment is coming up, and make sure to include your address, directions to your office once the patients are in the building, and anything specific patients need to do before arriving, such as fasting. Automating this process can yield even better scheduling results.
    • Digitize your scheduling process. As mentioned, many patients prefer and expect this — and may favor practices that offer it. Many third-party providers supply plug-and-play options that can that integrate with your website with just a few clicks and pasted code.
    • Set up a waitlist to quickly fill cancelled appointments. Many patients will accept an appointment at a later date but gladly snag a nearer date offered at short notice if another patient cancels. This can be advantageous to practices with a high number of cancellations.

    Are you looking for more ways to optimize your practice’s scheduling? The pros at Eye Care Leaders have years of experience in helping to ensure that practices of all sizes operate efficiently. Contact Eye Care Leaders today for a free no-pressure consultation

    What are the 5 types of scheduling?

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    Wave scheduling. ... .
    Time slot scheduling. ... .
    Stream scheduling. ... .
    Open booking scheduling. ... .
    Clustering scheduling. ... .
    Double scheduling..

    What are 2 methods used to schedule patient appointments?

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    What are the different types of appointment scheduling?

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    Time-slot scheduling..
    Wave scheduling..
    Wave and walk-in appointment scheduling..
    Open appointment scheduling..
    Double scheduling..
    Cluster scheduling..
    Matrix scheduling..
    40/20 scheduling..

    What are the 2 methods of scheduling?

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