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    Should doctors extend their practice hours?

    In a world in which consumers book travel, shop and attend school all day, any day of the year, consumer demand for easier access to medical care can come as no surprise. Additionally, the Affordable Care Act adds to the pressure on primary care providers to offer extended office hours. It includes provisions that promote the medical home model, which strives to improve access to primary care in ways that include longer office hours.

    Patients are not patient

     “Our patients’ number one complaint is that they can’t get in when they’re sick. Number two, they don’t like waiting,” says Kathy Severa, the practice administrator for Family Medicine Associates (FMA) in Lawrence, Kansas, a four-physician, independent practice. The practice solved both problems, she reports, with three different options that extended hours.


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    “Patients can be seen at any time that’s convenient, and the doctors aren’t trying to squeeze patients in to keep the flow going,” she says.  

    First, one physician starts seeing patients at 7 a.m., and the practice closes at 5:30 p.m. Monday through Thursday and at 5 p.m. Fridays. Second, each doctor keeps several time slots open for same-day appointments. Third, they offer a walk-in clinic that also opens at 7 a.m. It serves both FMA’s patients and the general public.

    Nathan Bloom, MD, is one of the four FMA physicians. He says that the three options enable the practice to provide “more personal, efficient, cost-effective care” to patients who might otherwise use emergency rooms or urgent care clinics. He also says that extended hours help him and the other FMA physicians to avoid problems and waste that can arise when care occurs in a piecemeal fashion  at various sites, where the providers lack familiarity with the patient and have no access to patient records.


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    Brian Adamczyk, MD, is interim Medical Director for Henry Ford Allegiance Medical Group (HFAMG). It’s a multispecialty group with 100 physicians in 40 locations in Michigan. Fourteen locations are primary care practices. Some clinics employ as many as 15 providers while others employ only one or two. Dr. Adamczyk, for instance, works as a sole physician along with a physician assistant, and opens doors to patients at 7 a.m..

    Despite the scale differences across the HFAMG practice locations, its policy is to encourage all the practices to offer extended hours and to stay open through lunch, even though this can mean that some physicians have no break for a midday meal. At one central location, the group has an extended hours clinic that’s open from 5 a.m. to 9 p.m Monday through Friday, and from 8 a.m. till noon on Saturdays.

    Next: Advantages of extending hours


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