Reply to: Lim C, Chodhari, R. Missed appointments — could evening clinics be a solution? https://doi.org/10.1080/13696998.2017.1360311
Original Article: Creps J, Lotfi V. A dynamic approach for outpatient scheduling. Journal of Medical Economics 2017;20:768-798
We found this letter to present an interesting option for addressing the problem of “missed appointments”. The authors suggest exploring “evening clinics” as an option to mitigate the pressure on service and excessive patient waiting time. The authors report positive results from a “pilot” program in which they had used an evening out-of-hours service in a pediatric clinic for 4 weeks in 2015.
The above option certainly merits further exploration in an environment where there is pressure on service providers, resulting in excessive patient waiting time. The issue at the authors’ clinic seems to be insufficient capacity, and the option of adding “out-of-hours” service results in increased clinic service capacity.
In our study, the situation was quite different. There was, in fact, excess capacity, as established by the relatively low clinician utilization of only 65.1%. In addition, the patients’ missed appointments in the clinic were not caused by excessive waiting times. Rather, they were partly due to the number of days to the scheduled appointment and mostly because of the patients’ population life circumstances. We believe controlled overbooking in such an environment, with rather sub-optimal productivity, is quite justified, especially if one is able to control the risk of potential appointment conflicts, as we have demonstrated.
Transparency
Declaration of funding
There is no funding to declare for this letter.
Declaration of financial/other relationships
None of the authors have any potential financial conflict of interest.
Acknowledgments
None reported.