FNP student with ? re: how many minutes per patient?

westcoastgirl · Mar 24, 2008

I think that is unfortunately not rare in Pediatrics and Family Practice.

Are you asking about negotiating ramp up period where you'd have a bit more time, or something permanent?

I negotiated ramp up time, but of course ultimately must see the same patients per hour as all the other mid levels and docs and it is 15 min per patient. I don't know how you would negotiate something permanent, the practice has numbers to meet. The only thing which comes to mind is negotiating a straight productivity only package with a practice if you don't want to work 15 min per patient?

middlekane · May 7, 2008

It is very practice dependent. Where I work, the NPs are expected to see one patient every half hour for the first few years of practice. Then, if they want to, they can increase their pace to 3 patients per hour. In general, other than with occasional squeeze ins, they are not expected to see 4 patients an hour. They say that NPs and MDs are trained differently and work differently; an NP can't do the holistic care often in a 20 minute visit.

One site I had my clinical at was one patient every 20 minutes. Another one was every 15 minutes and that one was awful and the NP was miserable. It is definitely varied.

VivaRN · May 8, 2008

I think it also depends on the overall practice environment. For example, at a private family practice I was at the pt. visits were 15 minutes (except for physicals and paps, which were 30 minutes). Because the population was generally healthy and uncomplicated this was not unreasonable. I felt we had sufficient time with patients. Educational handouts were also used with good results.

At the HIV clinic, however, the patients are from an underserved population. They can be complicated and have different psychosocial needs. A 15 minute visit with this population would be a disaster. We see maybe 6-8 patients a day with a few walk-ins squeezed in. Seeing one patient at this clinic is like 3 patients at the private family practice, so it all evens out.

So I guess it depends on what you're dealing with and if you feel you have time to do your job. Another trick with the 15 minute visit is, if you want to address something else and don't have time, you can always ask the patient to come back in a week or two. Personally I think if you throw too much at people in one visit they forget it anyway.

jemrn56 · May 8, 2008

The MDs in the Peds practice I worked saw ill pts every 10-15 min and during busy periods were double booked. I saw ill kids in 15 min increments and negotiated to see well kids every 30 min; most times they squeezed in 2 wells and a sick every hr.

This is definitely an area you can negotiate. Good Luck!