Calls to the clinic improves care, save $1.5 million annually

509th Medical Group Patch

509th Medical Group Patch

WHITEMAN AIR FORCE BASE, Mo. -- Have you ever had difficulty getting an appointment at the Base clinic? When you call for a problem you need solved today, do they sometimes send you to a network Urgent Care center? This situation can be frustrating.

"One of the major problems we have with access is patients who simply never show up," said Lt. Col. William Malloy, 509th Medical Support Squadron Commander. "No-shows make military healthcare less efficient, consume appointment slots other families could use, decrease the continuity of healthcare for patients disengaged to the network and costs American taxpayers a lot of money," Malloy says.

So, approximately, how much does an medical clinic appointment cost? With a fixed budget, each appointment's cost varies based on the number of appointments within a fiscal year.

"Say you have a fixed budget of $100 and you have ten appointments," Malloy said. "Each appointment then costs $10. What if five people no show? Now each appointment costs $20."

Malloy added that not only does the cost of per appointment go up, but it also affects other patients who need care, yet have to either wait longer or be sent off base to a community health partner.

"It's truly remarkable how many people a missed appointment touches, including other patients, our clinic staff and the clinics in our community" Malloy said. "Once we take the time to understand the ripple effect caused by missed appointments, we begin to fully understand the gravity of the problem."

Some people believe if they no-show then another patient simply takes their place.

"That's a myth," Malloy says. "Although they try, the Medical Group is usually not able to fill the time slots lost by no-shows. "If we can get a 24 hour notice then we have a good chance at filling the appointment time slot. Unfortunately, the vast majority of no-shows are not known until the appointment time."

The average cost for a medical visit, including ancillary and administrative costs, ranges between $295-$330. On average between five to six percent of appointments are missed each month.

"At around 4,000 appointments per month," Malloy said. "That's as high as 240 missed appointments, which represents about $79,200 in lost productivity per month. Time is our most precious commodity. If a time slot is being reserved for a patient who fails to show, we often don't have enough time to fill it with your fellow Airmen, a family member or retiree who really needs an appointment."

According to Malloy, the number-one complaint is not having enough appointments available.

"People could really help their neighbor by simply planning ahead and giving us a call 24 hours in advance," says Malloy.

Missed appointments also impact the clinics in the surrounding communities by consuming civilian healthcare capacity unnecessarily and negatively impacting the quality of a patient's care.

"Continuity of care is one of the most important aspects of quality healthcare," said Malloy.

He went on to explain, "if a 'no-show' blocks you from seeing your provider on Base, and you need to be seen today, you're often forced to see a provider off base who doesn't know you or your medical history which degrades the quality of care."

Malloy further explained that being seen downtown doesn't really save the clinic or the patient any time.

"Our patients usually end up waiting for hours at the Urgent Care center. Also, our administrative staff still needs to track down the care report, send it to the primary care nurse who then sends it to your family provider for review, signature and then it finally gets filed into your medical record, " Malloy said.

This tracking, review and filing process can take 30-60 minutes of time per disengaged appointment.

"Instead of being sent to a civilian Urgent Care, it would be better if a patient would ask the appointing clerk for a nurse T-CON [telephone consult]," Malloy says. "Our nurses are great and they really care. I know they will take care of our patients in-house if we just give them a chance."

No shows cost American taxpayers a lot of money per year, in additional to lost productivity and time.

"The clinic spends approximately $47,000 a month for urgent care visits downtown excluding the cost for facility fees, prescriptions, x-rays and lab work. Many of these visits could have been avoided if we knew about no shows 24-hours in advance," Malloy said. "That's a swing of at least $1.5 million per year that could be saved by simply calling the clinic 24-hours in advance."

He further explained we also need to better control the inappropriate use of the Emergency Room by patients, but that is a topic for a future article."

For now, he cautioned patients to only use the Emergency Room for potential loss of life, limb or eyesight otherwise patients could be held responsible for paying some or all of the charges.

What's the Prescription for Success? Some tips suggested by Malloy for patients:

-- If there are no appointments available, ask for a nurse T-CON instead of going to Urgent Care
-- When you get an appointment, write it down and email yourself a reminder appointment
-- If you're married, let your spouse know; he or she can help you remember
-- Record it in your smart phone and tell your Wingman
-- Tell your boss so he/she can build it into the schedule
-- If you can't make your appointment or have a conflict, call the clinic 24 hours in advance

To schedule or cancel an appointment call 660-687-2188.