Average pt load and pt contact hours in outpt hostpital system setting

[krj]

I'm currently 1/2 time with discussions about going full time in the near future in an OB integrated care setting (outpatient in an employed non-RVU position). I'll be expected to have some research responsibilities and a few clinic specific meetings. Patients will generally see me for 6mo - 2 years before going back to primary care and I need to have some availability for urgent consults. Current set up has 1hr new and 30min follow up. Most pts are seen q4 weeks, some are q6weeks, a few are q1-2weeks.

For people doing outpatient psychiatry, how many pt contact hours vs admin time do you consider full time? How many patients are you generally seeing in a day and at what patient load are you full? Thanks

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[Sushirolls]

30-36 clinic hours is the range you'll see for Big Box shop jobs for clinical hours.
Full is variable, based upon follow up frequency. Might take 60 patients to fill 8 clinic hours in follow ups, might take 120 patients. Really just depends.
If you schedule meetings during clinic time, then that's less patient follow ups.
Research? Depends on how that's factored into your schedule. Better off doing that as FTE carve out to make sure you have the time?

If being embedded in OB, highly recommend a shared medical appointment block. Do 90 minutes, and have it be open for any patient who signs the consent. Allows fast add ons if your schedule is full. And very convenient for women with babies to roll into the group room, set the carriers down, and its also almost a 'group therapy light' and allows the women to observe the same struggles the others are dealing with. Perimenopausal women gain value from it, too.

*For my garden variety outpatient adult practice, with follow ups usually in 4-6 weeks, or 12 weeks if stable, I'm using 100 per 8 clinic hours. I do 90 minute consults. 30 min follow ups.

 

[calvnandhobbs68]

I'm currently 1/2 time with discussions about going full time in the near future in an OB integrated care setting (outpatient in an employed non-RVU position). I'll be expected to have some research responsibilities and a few clinic specific meetings. Patients will generally see me for 6mo - 2 years before going back to primary care and I need to have some availability for urgent consults. Current set up has 1hr new and 30min follow up. Most pts are seen q4 weeks, some are q6weeks, a few are q1-2weeks.

For people doing outpatient psychiatry, how many pt contact hours vs admin time do you consider full time? How many patients are you generally seeing in a day and at what patient load are you full? Thanks

If they feel you need to have availability for urgent consults, then this needs to be built into the agreement with them so everyone understands this from a scheduling standpoint. You should probably have 1-2 dedicated 60 minute intake "urgent consult" slots a week. I'm assuming you already have a relationship with this department if you're 1/2 time there so you have some idea of if there's risk they would abuse "urgent" psych availability because you're likely to have to triage in some aspects (it's not cost/time effective or even helpful for them to put a patient in your slot for "anxiety" if you're not going to have time to see the post-partum case who's telling them she's hearing voices telling her to hurt her baby).

You're gonna have a smaller caseload if you're seeing patients q4-6weeks on average. Just take your average followup length, multiply by hours and multiply by average length of f/u to get an estimated caseload for various hours and followup freq. Ex. 2 PPH x 35 hours x 4 weeks avg f/u frequency = 280 patients max caseload.

But yes full time is generally considered in that 30-36 hour range above (at 35 hours you still have at least an hour for lunch and notes every day). 40 patient contact hours a week is pretty high.

 

[nexus73]

Agree with 30-36 patient hours as full time. Personally I’d push for 32 being considered full time. But potentially driven by local market norms.