By Jovita, Beyer MD CCFP
So, you are finally done, ready to dive into family medicine and your clinic! You get to see all your own patients now and get to know them… but the task can seem very daunting to start from scratch. Or maybe, you are taking over from a retired physician with a whole panel already made that you have never met.
Over the last year, I have been building a patient panel and have made a few mistakes and learned a few tricks that I would like to share with you. This is by no means an exhaustive list of rules but rather just my experience. Everyone is going to have a different practice style, different practice load, and different goals of their meet and greets.
Booking the Appointments:
- How long should the appointments be? Your receptionists/admin assists will be the gate keeper to your appointments and so communicating with them how much time you need is important. There are a few easy screens they can do, such as asking how many medications the patients are on. Generally, more medications = more complex.
- What should patients bring to their appointments? If available, a medication list or blister pack, any specialist reports, or if out of province any medical records they may already have.
- Some clinics will have a handout to give the patients on arrival with clinic policies. A no show policy is very common and should be made clear to the patient.
- How many appointments in a day? This is entirely up to you and your practice style. Personally, I book about 2 per half day, but sometimes increase to 3-4 if it’s a family.
During the Appointments:
- What to talk about? I created a bit of a speech (blurb, really) to quickly rehearse at the beginning of my meet and greet appointments. In the first few months, I used to say more. I would go on about who I was, where I trained, where I worked, etc. When I got more experienced with the appointments I cut this back a lot. I found that if patients wanted to know a lot of these details, they would ask. Instead, I just tell them the important things: my scheduling including when I will be away from clinic (for hospitalist, ER shifts, obs shift). Remind patients again of any of your clinic policies or personal policies.
- What to update? Each EMR is slightly different, but generally they all have history and medications bands. Take this time to get the medication list up to date, all history and surgeries.
- What next? Patients coming from another family doctor/retired doctor will often not need any follow up immediately. Patients who haven’t seen a physician in a while will often need follow ups or tests. I found that opening my practice for up to 50-100 patients at a time, catching up on those patients, and then re-opening when the schedule seemed to open up again was a good approach.
- How many patients should you have? There are many algorithms online, feel free to use any of them to get an estimate but generally speaking I recommend as above, open to 50-100 and then close while catching up. Your final numbers will depend on your clinic, patients, and days you work. Here is a tool to determine panel size based on your practice type: https://patientsmedicalhome.ca/files/uploads/PMH_Best_Advice_Panel_Size.pdf
And finally, enjoy it! I found that patients are so excited to find a family doctor and getting to know people from your community is rewarding and interesting.