Doctor schedules in a polyclinic: sessions, rooms and visiting consultants

The session is what the clinic sells

A patient books a time with a doctor. What the clinic actually schedules is a session: one doctor, in one room, for a block of hours, offering a defined set of services. Tuesday 5pm to 9pm, Dr. Hany, Room 3, orthopaedic consultations and follow-ups. Every appointment sits inside a session.

Thinking in sessions changes the questions an owner asks. Instead of "how many patients did we see?", the question becomes "how many sessions did we run, and how full was each one?" A clinic with 60 sessions a week and no view of which ones are half empty is carrying costs it cannot see.

Build a weekly template, then manage the exceptions

Most of the rota repeats. Write it once as a weekly template: each doctor's sessions, the room for each, the services offered and the slot length for each service. Appointments are then booked into the template, and nobody rebuilds the week by hand.

What changes week to week are the exceptions: leave, conferences, a public holiday, a doctor running late from a hospital list. Each exception is recorded against the template with a date range. The template stays clean, and the history shows how often each doctor's sessions actually ran.

Two templates are often needed in this region. Working hours shift in Ramadan, and many clinics also change hours in summer. Prepare the alternative template in advance and switch on a set date, so the hours are not being edited day by day.

Rooms are the limit, not doctors

Most polyclinics can find more doctors than they have rooms for. The room is the scarce resource, and it should be scheduled as carefully as the people.

• Every session is assigned a room, and a room cannot hold two sessions at once
• Rooms with fixed equipment, such as ultrasound, a treadmill or a procedure chair, are reserved first for the specialties that need them
• Room occupancy is read by hour of the day, and the empty hours are what you offer to a new doctor

Lay the week out as a grid of rooms against hours. The grid shows what the doctor list hides: that every room is full from 6pm to 9pm and half the building is empty before noon. Morning sessions for specialties with older or flexible patients, home-visit coordination, or a visiting consultant who prefers mornings all turn empty hours into revenue without adding a room.

Visiting consultants need written terms

Visiting consultants bring patients and reputation, and they cause most of the rota's uncertainty. Agree these points in writing before the first session:

• How they are paid: a percentage of their revenue, a fee per session, or room rent with the consultant keeping the fees
• The minimum number of booked patients for a session to run, and when that decision is made, usually the day before
• How much notice they give to cancel, and who contacts the patients
• Whether their patients may be seen by another doctor for follow-up
• Who owns the patient relationship and the record if they leave

The minimum-patients rule protects both sides. A consultant should not travel for two patients, and the clinic should not hold a room and a nurse for them.

Cancellations and leave: the rule and the list

A cancelled session is a group of patients who each need a call. Two things make it manageable.

The rule. Planned leave is given with fixed notice, for example two weeks, and is entered in the system on the day it is approved so that no new bookings land in it. Anything shorter than the notice period is an exception that the manager approves.

The list. When a session is cancelled, reception needs every affected patient on one screen with phone numbers, and a message that offers two alternative times. Calling starts with the patients booked soonest. A patient who learns about the cancellation at the door will not rebook.

Count cancelled sessions per doctor each quarter. A doctor who cancels one session in five is costing the clinic more than their fill rate suggests.

Lateness is a rota problem too

If a session is scheduled for 5pm and the doctor arrives at 5:40 every week, the session really starts at 5:40 and the first three patients wait for nothing. Compare the scheduled start with the time the first patient was actually seen, per doctor, over a month.

The fix is rarely a confrontation. Usually the scheduled start is wrong for that doctor's hospital commitments, and moving the session by half an hour removes the problem. Where the lateness is unpredictable, book the first slot of the session as a short follow-up that can absorb the delay.

Slot lengths per doctor and per service

One default slot length for the whole clinic guarantees that some doctors run late and others sit idle. A first consultation in neurology and a dressing change do not take the same time, and two doctors in the same specialty do not work at the same pace.

Set the length per service and allow an override per doctor. After two months, compare booked time with actual time and adjust. Also decide each doctor's rule for walk-ins and overbooking: how many extra patients per session, and in which slots. A rule set in advance is better than a negotiation at the desk every evening.

Fill rate decides which sessions stay

For each session, fill rate is booked slots divided by available slots. Read it per session over eight weeks, and trends appear:

• Sessions above 85% with a waiting list need more hours or a second doctor
• Sessions between 50% and 85% are normal and may need marketing or a better time
• Sessions below 50% for two months need a decision: move the time, merge two sessions into one, or stop

Then look at what a session costs. A room, a nurse, reception time and electricity are spent whether four patients come or fourteen. A low-fill session with a doctor on a percentage can still lose money for the clinic, because the fixed costs do not shrink with the doctor's share.

Publish only what is real

Online booking, the WhatsApp bot and the reception screen should all read from the same rota. When a session is cancelled or moved, it disappears from every channel at once. The usual source of double bookings and angry patients is a schedule that lives in one place and is advertised from another, such as an image of the weekly timetable posted on Instagram three months ago.

Start this week

1. Write the weekly template: every session with its doctor, room, hours and services.
2. Draw the room-by-hour grid and mark the empty blocks.
3. Calculate fill rate per session for the last eight weeks and list the sessions under 50%.
4. Compare scheduled start with first-patient-seen time for each doctor.
5. Put visiting consultants' terms in writing, including the minimum to run a session.

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