how many patients?

Wow...that is unbelievable. I am still a student, but in peds/obgyn we saw about 20ish in an 8 hour day (not including lunch). At my current internal medicine site we see 15-20 with the 1st patient at 7:30 and the last at 3:30. Elderly folks with multiple issues, 5 or more scripts needed to be rewritten, bps needing to be rechecked, listening to their heart, lungs, carotids, palpating pedal pulses and checking for edema cannot be seen and documented on in 15 minutes. That doesn't even include digging through all the notes from specialists that have come in since their last visit and addressing their long list of questions/concerns. We don't have EMR, so I bet that would speed up the documentation some.

I really think it takes time to provide quality care. I don't want to work at a "drive by" type facility where the provider was in with you such a short time that you don't remember seeing them! I think we became or are becoming NPs to provide quality care with a holistic approach including lots of teaching and primary prevention-which takes time. Wow...40...really?

Wow!!! None of the practices I've been involved with made any of their providers see 40 in any given day. Over 30 is usually really busy for one provider. But I guess it's what you get used to doing.

I did hear from one NP her group required a patient every 12 minutes..... Sounds so much like cattle herding. Moooooooo!!!

JD, what kind of practice do you work in? What age group are the patients? At our primary care practice we get a lot of strep, influenza, allergic rhinitis, hypertension, diabetes, pretty common stuff. We do get some crazy off the wall things, but mostly they get referred. And for full physicals we get about 15 minutes. There isn't much time for patient teaching though (likely because there's not billing code for patient teaching ha!)

I do feel like 40 is a lot, which is why I wondered how it is everywhere else.

We see appx 25-30 a day. Chronic pain patients. They often change the subject but usually not much has changed.

JD, what kind of practice do you work in? What age group are the patients? At our primary care practice we get a lot of strep, influenza, allergic rhinitis, hypertension, diabetes, pretty common stuff. We do get some crazy off the wall things, but mostly they get referred. And for full physicals we get about 15 minutes. There isn't much time for patient teaching though (likely because there's not billing code for patient teaching ha!)

I do feel like 40 is a lot, which is why I wondered how it is everywhere else.

Probably a little more than you asked for:

Neighborhood Health Clinic maybe 30 but usually 20's (whatever walks through the door)

Prison clinic 20-30s have hit the 40s more than a few times (adult male ages teens to 80's with conditions that makes me happy that at least one of the two doctors I work with is always willing to teach, help and we bounce ideas off each other) When I say clinic I have an office, I also do 99% of the emergencies and if the patient is coming back from a consult I see them so a schedule of 10 can end up being 35.. The plus here I can tell the nurse at almost anytime to clear my schedule. The negative is its prison medicine: Defensive health care and wading through those gaming the system to care for the truly sick (this kind of practice can only be imagined by those who have gone through it or who are doing it). My clinic actual covers the things like you mentioned like strep, influenza, allergic rhinitis, hypertension, diabetes but add HIV, hepatitis, MRSA, etc., etc, plus since I am also ordering test and consults it gets way deeper almost every day.

Hospital: Adults all ages, all floors except OB and rarely the ER (this is like being a RN sometimes it depends what doctor you are on with is how you get to work) Usually in a 8-10 hour shift around 25 patients. Why rarely the ER: I just hate the ER at this particular facility.

We see appx 25-30 a day. Chronic pain patients. They often change the subject but usually not much has changed.

Oh my chronic pain patients! How do you do it day in and day out?

I only see about 5-16 pts in 10 hours.. sometimes it gets pretty boring..And when I have "more" patients it is usually all at once, so I see 10-12 pts in 2-3 hours, then nothing for 6 hours, then maybe 2-4 more..

I work night shift, which is why the patient ratio is low.

I work at a College walk-in/urgent care type clinic. Mostly minor acute, lots of cold/flu/gastro.. but I do get to do some cooler stuff/procedures. I love suturing and procedures so i get to do that sometimes, and I can take my time and not be rushed (most of the time) I usually spend more time with the patients then i would actually need to because i have the time.. I am able to do a TON of teaching.. (not sure how much is actually retained..)

I'm a fairly new grad, just been in outpatient/walk-in type setting since Jan and LOVE it, I can probably see 3-4 pts an hour easily depending on what the problem is. If its colds/flu i could/can go faster.

I work alone as the solo provider, with a RN and a CMA so i do have to look stuff up a lot which takes more time, but I am learning probably more than i would be if I just asked another provider.

I LOVE this type of setting and am not sure if i will be able to do tradional Family Practice and rush visits.. I like having time, if i need it, and i like not knowing what is going to come in the door.

I only see about 5-16 pts in 10 hours.. sometimes it gets pretty boring..And when I have "more" patients it is usually all at once, so I see 10-12 pts in 2-3 hours, then nothing for 6 hours, then maybe 2-4 more..

I work night shift, which is why the patient ratio is low.

I work at a College walk-in/urgent care type clinic. Mostly minor acute, lots of cold/flu/gastro.. but I do get to do some cooler stuff/procedures. I love suturing and procedures so i get to do that sometimes, and I can take my time and not be rushed (most of the time) I usually spend more time with the patients then i would actually need to because i have the time.. I am able to do a TON of teaching.. (not sure how much is actually retained..)

I'm a fairly new grad, just been in outpatient/walk-in type setting since Jan and LOVE it, I can probably see 3-4 pts an hour easily depending on what the problem is. If its colds/flu i could/can go faster.

I work alone as the solo provider, with a RN and a CMA so i do have to look stuff up a lot which takes more time, but I am learning probably more than i would be if I just asked another provider.

I LOVE this type of setting and am not sure if i will be able to do tradional Family Practice and rush visits.. I like having time, if i need it, and i like not knowing what is going to come in the door.

Even though I have other providers around me most of the time I still look things up it just seems to stick with me better. I also use goggle images: Nothing like showing your patient what they have on another person to reinforce diagnosis and treatment. 100% of the time I keep a dermatology book on my desk. Serving the undeserved populations usually the education levels are lower and comorbidities higher. Anything I can use that breaks my teaching and diagnosis into concrete examples helps.

This is neat hearing how the patient flow works in different settings. I've always been intrigued by healthcare in correctional facilities.

I see about 6-10 patients/day at an outpatient HIV clinic. Sometimes it's slow when the patients don't show up, or crazy when there are tons of walk-ins who are really sick. We also have an urgent care type area where we stabilize and sometimes transfer patients to the hospital. The patient population is low income with a lot of social issues and mental health co-morbidities... they would not respond well to the 15 minute visit.

Sometimes it takes awhile for the patient to share what is really going on, or for me to identify all the social services they need. Sometimes they are just plain sick, or taking their meds all wrong, and I could not do that in 15 minutes. Sometimes the patient is telling a story that needs to be told. I'm so glad I don't have to cut them off when that happens.

The grants we receive from Ryan White allow us the luxury of not focusing on billing. I'm not going to be filthy rich doing this vs. say, private practice cardiology, but that's not why I chose nursing in the first place.