Office Visit Volume, Flow & Changes

Curious how offices are doing in this post-peak middle ground. Here are some observations from a small private practice in California. Keep in mind, California went into lock-down early and have been slow to lift restrictions.

  1. Our well checks were up 7% the first quarter from a year prior, but down 13% this quarter to date from a year prior.

  2. We implemented a virtual pre-physical almost immediately which consists of all the anticipatory guidance discussion and vaccine discussion. As some point soon, all these children will come in for a quick physical and vaccines. Only then will we bill. If those children are added to our numbers, we are only down 0.7% this quarter to date from a year prior and up over 4% year to date from last year. Growth in the office has been lost, but from the well check standpoint, it’s been manageable.

  3. On a weekly basis, sick visits are down 65% from the year prior. We captured ~10% through telemedicine, but basic ailments and concerns have vanished. The number of daily phone calls has also dropped off markedly too. I expect this is only temporary, but I personally don’t expect the normal number of sick visits to resume this year. I’m guessing (hoping), when averaged out, overall sick visit volume to be off ~20% for the year. This is assuming we don’t have another shutdown and kids go back to school.

  4. The number of newborns per quarter has remained on par with last-years numbers. Let’s all hope for a bump up in those numbers come January – just saying.

  5. Our office is divided both morning and afternoon with regard to the type of visit. Well checks come in first and then sick visits follow. Aside from the lower numbers overall in terms of sick visits (well checks are now back to normal numbers), this process has improved flow in the office tremendously and it’s a system I am hoping to maintain moving forward. Prior to this event, such a change would have met with parent resistance. Now that it has been forced upon everyone (and expected by most), keeping such a divide will be easier to maintain.

  6. Virtual visits will hopefully be a short-lived novelty. It’s very limiting. Interestingly, parent interest has dropped rather rapidly. I only had 2-3 last week and one was a get acquainted visit. Even the virtual pre-physicals we offered are no longer being requested. People would rather just come in and be done. We will probably keep this as an “added value” option even if not requested. It adds to the perception of availability.

  7. During the slow period, I kept everyone employed and we did a lot of internal housekeeping. We cleaned up records, purged charts and called up anyone who was behind in their well check. We ordered new uniforms and fixed a few items in the office. We went through cupboards and did a deep Spring cleaning.

  8. My sights are on the Fall. When flu season kicks in, ferreting out COVID-19 from influenzae will be joyous. I’m guessing we will not bring such patients into our waiting room and I’m pressing the local IPA to cover the cost of a rapid flu test.

A little long-winded, but that has been our experience. What has been your experience?