Chiropractic Practice Bottlenecks: How to Increase Capacity by Removing Hidden Barriers

The theory of capacity management, as developed by Eli Goldratt and explained in his books, including the best selling The Goal, discusses the theory of constraints as applied to a manufacturing environment.

The same principle applies to chiropractor’s business. According to Goldratt, “Capacity is the available time for production.” A bottleneck is: “what happens if capacity is less than demand placed on resource.”

Bottlenecks can be hide anywhere in an office.  For example:

  1.     Peak Periods. Between the 4-6 pm slot, where there is extra traffic, extra staff or increased capacity is not provided.
  2.     Paperwork. Old forms that are redundant.
  3.     Poor scheduling of patients: (not cluster booked, not booking for NP paperwork)
  4.     Doctors waiting for therapy patients. (No CT or therapy after adjustment)
  5.     Front Desk doing insurance and scheduling at each visit (no MAP and PIA)
  6.     Not enough exam rooms
  7.     Clutter in front desk/insurance area
  8.     Quitting time. After a long day, all staff and doctors are looking forward to leaving and really don’t want extra patients to call or come in. Patients are inadvertently discouraged to come in extra, bring in friends or family , or call in during the last hour.
  9.     Backlogs. Undone reports from the two summers ago, partially completed projects, cluttered desks or office space, all discourage more an increase in production. You only have so much mental capacity, and if it gets frittered away on projects that are not completed, you will have “too many irons in the fire” to add any more. Finish what you started, and make room for more.
  10.     “Difficult people“. Some staff, or patients, will seem to drain you of your energy, or consume too much of your time trying to keep them happy.

Warning: Too much capacity can also be a barrier.

A) Personnel. A staff that has to make up work can retard production. Happy staff are productive staff, and the opposite is also true. Unhappy staff will not make for happy patients. This will also suck up the doctors time to try to remedy his “staff problems.”

B) Space. Too large of a space can disconnect the staff from each other and the patients and minimize the synergy.

 

Exercise – Getting Rid of Capacity Restraints and Bottlenecks.

Make a list of any bottlenecks in your office. Start by considering the flow of patients, of paper, and anything that slows it down or gets in its way. Consider patients waiting, paperwork waiting, any times of the day or days during the week where there is a slow down or back log. You can organize it into four categories:

Physical space
Personnel
Procedures
Difficult people
Incomplete projects

Once you have listed these, give yourself 30 days to fix all these capacity restraints.

NOTE: Bottlenecks can sometimes be difficult to locate, and even more difficult to remove.  Need help: Give us a call. (414) 332-4511

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