How many patients are you expected to see daily?

[URGR8T]

So I am a fairly new grad (graduated Sept 2013). I am working in a clinic where I see newborns to advanced age. The majority are pediatric (about 80%). Today we had a "meeting" where I was told that I need to increase the amount of patients I see per day. I am seeing around 25 pts/day. I often have to work through lunch to catch up and I come in early to stay on top of all the extra's. I feel maxed. I was told that many providers are seeing up to 50 pts/day! I said I can't do it, and I would end up compromising patient safety if I even attempted that.

So I would love to hear how many patients you see a day, and what your thoughts are about this issue. Is this a reasonable expectation?

[blusueNP, MSN, APRN]

Tell them to kiss your ass in Macy's window.

[sadiemae1123]

If your seeing 25/day and they want more then I would insist on seeing a breakdown of how much revenue your are already bringing in to the group vs the cost to employ you (salary, benefits, etc). My instructors always insisted that if your seeing that many and are reasonably paid then you are making the group money. We even had to make out a small business plan to compare compensation using Medicare and our cost to a company (salary, benefits, overhead).

[reddgirl]

What I'm 3 months in my position and barely up to 16 per day!! I'd say put on your Nike's and haul buggy!!!

[URGR8T]

Thanks all! I'm feeling a little more justified now! Just seeing 25 pts/day (being a new grad).. I'm charting during lunch and coming in early just to keep up!! Frankly, I never want to get to the point where I would see 50 during an 8hr shift. I just don't believe I would be giving good quality care if I did.. While money is important, safety will always come first. So if that is the expectation, then there are plenty of other jobs out there!

[BlueDevil, DNP]

I work 3 1/2 days per week. I don't mix and match conditions that I see on specific days. My schedule is very structured. Tuesday is all wellness visits and chronic conditions, so 15 and 20 minute appointments. I don't do 30 minute appointments anymore at all. I see patients for 6 hours, the last 2 hours of the day are my "admin time." I usually see about 20-24 patients on Tuesday. I see the fewest patients per hour Tuesday, but it is my business feeling day, and most stressful.

On Wednesday I work a half day in the morning and it is "ortho clinic" day. I typically see 18-22 ortho pts in the half day, but these appts typically take 5 minutes. I often double book them if I know it is an injection that is going to take 90 seconds. I only discuss one joint complaint per visit, lol. If both knees hurt, that is two visits. These visits are often f/u from my "acute day," especially for sports injuries.

Thursday is acute day. Those are all 10 min appts, *one acute issue only.* If you have cold symptoms AND tennis elbow, that is two visits. Pick which one you want to discuss today, because I will only do one at a time. Again, I see patients for 6 hours and have 2 hours for admin time. In those 6 hours, I typically see anywhere from 30-40 patients. I double book a lot of them, but this day still doesn't feel busy to me. It is easy as can be: pink eye, sinusitis, back pain, headache, etc. all day long. It takes 4-5 minutes to see the patient and 3 minutes to chart them. Every rare once in a while there is some catastrophe that could not have been predicted, but we roll with it.

I set limits for the patients and stick to them, such as one acute complaint at a time, etc. No chronic issues on acute day and vice versa. The patients that don't like it go elsewhere by mutual decision. This keeps me sane. I would not be able, even on my best day, to see 50 patients. I am quick and efficient, but I am not a machine.

You need to set some guidelines about when you will do certain things. For instance, when I used to mix acute and chronic complaints on the same days, I didn't do physicals or establish new patients after 2pm. I saved the end of the day for easy acute stuff so I could leave on time. When I was new I would only do so many physicals per day, I think it was 4 or something, I don't remember. I tried to spread the out over the week. You also need to not be afraid to make people come back for procedures if it is going to throw off your schedule. If what was supposed to be a simple I&D turns out is going to need extensive irrigation, packing, sutures, etc, make them come pack and block out enough time. Don't be afraid to tell people, "No, we can't discuss your eyelash pain today, there isn't enough time. we are only going to talk about your elevated blood pressure today." Ultimately you are in charge, so don't be bashful about assuming some control over how you spend your time. Prioritize and set boundaries. Don't let your employer or your patients take advantage of you. They both will try. Set limits, keep them.

[LadysSolo]

I have never gotten paid for my charting, and usually see 16 - 30 patients/day. With EMR (which I STILL hate!) it takes me about 15min (with a template) for an established pt and 30 min for a new pt to chart. So after an 8 hour day I have 4 to 7 hours of charting to do. Per my employer, my salary is based on a 10 hour day (8 hours seeing pts and 2 hours for charting.) Yes, I am looking for a new job.

[Senny.ANP.FNP]

In a mixed Primary care practice about 25 should be the top of your patients seen per day. Is it ran as a Patient Centered Medical Home (PCMH)? If they continue to pressure you beyond your comfort level I would suggest definitely looking for a new position. Also are you salaried? Partner? Or paid fee for service-like a set amount per patient?

[globalRN]

I work acute care: mainly complex geriatric patients with multiple comorbidities and social/family issues.

We see 22+ patients a day.

One day there were 6 discharges or transfers and 4 new patients.

It is a crazy workload!

Which is why I am looking for another position.

And you cant just look after one problem like in primary care.

You have to deal with it all...and deal with family as well as the patient

[OCRN3]

I must be in the minority each provider, we are expected to see 8-11 pt. Per day. They give us more than enough time. Not sure why though, I could probably see more than that if I wanted to.

[chillnurse, BSN, RN, NP]

That place sounds ridic. I'd tell them to stuff it. Not safe to see 50 a day for anybody

[pedspnp]

I am a PNP I normally see about 15-18 the only time it gets crazy it when I get 2 new patients double booked in a 20 minute slot. It's not possible to do it with out running behind, and having established patitents kept waiting is a nightmare I'm bringing it up at our next meeting. I've only been at my new position 3 months and want to approach this in a way that I don't seem like I'm a whiner but at the same time let admin know this is not working

[TheDude77]

Kind of off topic.,,but, you get paid based off the # of pts you see, right?