Getting the  Most Out of Your Ortho II Scheduler

A scheduling system doesn't care whether it's electronic or paper, it's either designed to be smooth, productive and easy to use or it isn't. What makes your schedule smooth and productive is the effective use of the doctor, assistants and patients' time while providing the practice's services. The design of all computerized schedulers have certain elements in common:

1. All schedulers have specific types of appointments that are used to provide patient treatment, for example, exams, records, bandings, checks, archwire changes, debandings, etc.

2. Each scheduled appointment has a specified length of time (chair time) required by an assistant to adequately provide the treatment, for example, the appointment might be 15, 30, 45, 60, 90, etc., minutes in length.

3. Each scheduled appointment has a specified amount of doctor treatment time, for example: a 30-minute arch change might require 11 minutes of the doctor's time, or a 90-minute banding might require 36 minutes of the doctor's time.

4. The number of each type of appointment that defines the daily schedule depends on the level of productivity of a practice, which is measured in "Full Starts/Day" (FS/D) and usually ranges from 0.3 to 3.0 FS/D, nationally averaging 0.75 FS/D. A full start is a comprehensive treatment of typically 12 to 36 months, followed by 0.5 to 3.0 years of retention therapy. There are also Ph-I starts (requiring a Ph-II in a few years, for example, an RPE Tx), Ph-II starts (that already had a Ph-I start) and Limited starts (a partial, one-shot treatment, for example a one-arch Tx).
5. A daily structure, including, a specific number of columns, start and end times and a lunch hour, for example, 5 columns with a start time of 8:00, lunch from 12:00 to 1:00, ending treatment at 4:45, and out the door by 5:00.

There are many levels of scheduling design sophistication and the more sophisticated it is the better it accounts for items 1 through 5 above. For simplicity though, let's just consider three levels and explain them in detail; one of these levels is within your realistic grasp.

Simplistic Scheduling Design:

The design of a simple schedule is a step up from having just a blank page with a column or two and time slots for the hours of the day you treat patients. To design such a schedule, use the following sequence of thought and data gathering.

1. Define your day: the specific number of columns, start and end times and the lunch hour.
2. Set your New Patient Exams and Tx Consult times at convenient times of the day, so as not to occur during high volume time (non-school time).
3. Have records time available directly after the Exam to get the patient started as soon as possible.

More Sophisticated Scheduling Design:

The design of a productive orthodontic schedule follows a sequence of thought and data gathering.

1. Define the doctor's Tx Mechanotherapy (the Full, Ph-I, Ph-II and Limited services provided).
2. Define realistic exam, consult, initial Banding/Bonding, and DeBand/DeBond appointments, which realistically account for both the doctor and assistants' treatment time IN SEQUENCE.
3. Define your day: the specific number of columns, start and end times and the lunch hour.
4. Define the number of each appointments you need per day, for example, a 1.0 FS/D schedule may need 2 exams, 1 consult, 1 initial banding and 1 debanding.
5. Arrange these appointments in the various columns on your scheduler so that the large intervals of doctor time DO NOT OVERLAP. See example below; the black blocks represent Dr-Tx-Time.

EX = Exam, IR = Initial Records, TC = Tx Consult, 7B = 7-unit Initial Banding, DB = DeBand, A = 1-unit Archwire Change, 2A = 2-unit Archwire Change, 
CK = 1-unit Fixed Appl. Check, R = 1-unit Removable Appl. Check

The columns with the CK, A and R are done that way to account for doctor and assistant time. Typically, a doctor takes 2-4 (3 avg.) minutes for a CK, 3-5 (4 avg.) minutes for an A and 3-5 (4 avg.) minutes for an R. If we have a column each of CK, A & R, we have a total of 8-14 (11 avg.) out of 15 minutes of Dr-Tx-Time needed in a 15-minute unit. Typically, an assistant takes 10 minutes for a CK, 15 minutes for an A and 5 minutes for an R. Thus, if we have a column each of CK, A & R, we have 10 + 15 + 5 = 30 minutes total, the same amount of time available for two DA's with 15-minutes each.

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