Now that I've got you thinking like a healthcare economist lets quickly review the change we're proposing to the model we use to engage our patients and clients:

Old Patient Engagement Model vs. New Health Engagement Model


As you continue reading this post and begin to fully grasp the immense total economic cost of scheduled appointments (a.k.a. synchronous engagement) with patients start considering how this shift might be implemented in your own workflows.

The Cost of Inefficient Care

According this a study of over 1,500 managerial and administrative professionals by scheduling software company Doodle, the average time to schedule an in-person meeting or conference call is...


Wait for it...

32 minutes per meeting!


If you think about the standard time-draining tasks associated with scheduling, like emailing back-and-forth, missed phone calls, etc. this number probably won't be particularly shocking to you.

It's worth noting that Doodle points out that their specialized scheduling tool cuts scheduling time in half, so just for fun I’ll make reference to how using a tool like theirs (or Calendly which we use at Nudge) would impacts our numbers at the end of this post.


Okay, we now know that it takes approximately 32 minutes to schedule an in-person visit.

Let’s use that number to calculate how long it would have taken Dr. Steve’s Office Admin to schedule in-person sessions with each of his patients from the experiment.

Remember from his experiment that Dr. Steve provided value to each patient via nudges in a single morning (well under 4 hours total to provide value to 85 patients).

For this quick calculation, we'll take his 85 patients and multiply them times 32 minutes to schedule each in-person session.

85 patients X 32 minutes = 2,720 minutes?


That's too many minutes for me to wrap my head around so let me translate it into how many days it would take Dr. Steve's Office Administrator to schedule all of these visits on average if he worked on average between 8-10 hour days and only did scheduling...

2,720 minutes = 45 hours and 20 minutes / 9 hour avg workdays =  . . .


Wait for it . . .

5 days (1 entire week) of scheduling!


To continue with our fictional scenario, let's say we've wrapped up the week and Dr. Steve's Office Admin is maybe a little ornery, but he got the job done and everyone got scheduled for this week. 

But at least these appointments aren't a huge time-drain for our practitioner, right? We haven't wasted any of Dr. Steve's time yet after all.

Let's take a look at the implications for these scheduled sessions on Dr. Steve's end.


Inefficient Patient Visits Costing Health Practitioners Time And Money

Note that in real life Dr. Steve runs his Lifestyle Medicine Program within a concierge cardiology practice, so in reality he spends significantly more time with each patient when they come in for a visit than I will use in this fictional account.

To be a little more objective I'm going to use the average length of a primary care visit from this Health Services Research (HSR) study, which came out to 17.4 minutes. I acknowledge that (hopefully) most of you spend more time with your clients and patients than this, or at minimum provide a much better experience than the average primary care visit, which I would describe as "mostly unpleasant" at best.

My goal here is to provide a modest estimate of time spent with the patient to make this applicable to a wide range of practitioners, so let’s say Dr. Steve spends an average of 17.4 minutes meeting with each of his patients, whether it's over the phone or in-person.

85 patients X 17.4 minutes = 1,479 minutes

That's again, too many minutes for me to wrap my head around, so translating that into hours tells us Dr. Steve will be spending. . .

24 hours and 39 minutes with his patients in these sessions.

Now let’s see how long it would actually take to get through all of these patient visits assuming the Office Admin managed to schedule all of these sessions consecutively at 30 minutes intervals (i.e. 17.4 minutes with the patient, and then 12.6 minutes for Dr. Steve in-between each patient to prep for the next one).

85 sessions X 12.6 minutes between each session = 1,1071 minutes, or 17 hours and 51 minutes inbetween patients, plus the 24 hours and 39 minutes spent with patients comes to a grand total of. . .

42 hours and 30 minutes to get through all 85 patient visits.


In other words, Dr. Steve, our practitioner didn't escape the scheduling time-drain at all.

In fact, he is facing an almost identical situation to his Office Admin who spent a full week of work-hours dedicated solely to scheduled patients.

If Dr. Steve did nothing but see his patients, prep and maybe squeeze in lunch, he'd be spending a full week of his worktime dedicated to his 85 patients visits.


So to quickly recap, using an asynchronous patient engagement strategy (a.k.a. nudges) Dr. Steve spent a total of 3 hours and 40 minutes providing in-context, personalized coaching feedback to his 85 patients (and that time includes 3, 5-minute breaks he took in the process).

Dr. Steve's Office Admin spent exactly zero time helping him engage these patients.

If instead Dr. Steve wanted to provide value to all of these patients in scheduled visits, he would have spent 42 hours and 30 minutes providing value to his patients, or nearly 1 full workweek dedicated solely to scheduled patient visits.

Dr. Steve's Office Admin would have spent 45 hours and 20 minutes scheduling those sessions, or right at 1 full workweek dedicated solely to scheduling patient visits.


Total work hours to engage each patient via scheduled visit:

[Practitioner Plus Office Admin]

87 hours and 50 minutes


Total work hours to engage each patient via nudges:

[Practitioner Plus Office Admin]

3 hours and 40 minutes


In other words, it requires approximately 24X more work-time to meet with a patient in-person than it does to provide them value by sending them a personalized nudge.


Let me be clear that I am not equating the value a patient derives from an in-person visit with the perceived value of a quick personalized message that's the length of a tweet.

That would, of course, be preposterous.

What I am suggesting, however, is this:

What if you replaced just one in-person session per year with 24 personalized nudges sent to each individual you work with throughout the year?

Would that provide a better overall experience and more perceived value to your clientele if they got a personalized nudge from you once every two weeks from you?

I can guarantee it would. And it wouldn't cost you any extra time.

Better yet:

What if you replaced two in-person sessions per year with those 24 personalized nudges spread throughout the year?

Now take that extra full week of work-time you just won back for yourself and go on vacation.

Or better yet, you can send those personalized nudges from a beach somewhere while you soak up the sun.

After all this innovation in the way we engage patients isn't ONLY about creating a better patient experience, it's also about creating more time, more freedom and a better quality of life for the health practitioners who make health happen for their patients and clients.


Enjoy the journey my friends, you deserve it.