Wisely Spent Time
The billing clock stops ticking when the patient is no longer in front of me, but this doesn't stop family, nurses and other colleagues from talking to me about the patient when the patient isn't present.
If I see six patients a day and the nurse and I want to discuss medication management for pain reduction to accurately progress the patients, each small visit could take 10 to 15 minutes. This adds an hour or more to my day. If family members have questions regarding their loved one, this can add another hour to my day. When there's a care conference and the patient isn't present, I'm unable to bill for my professional presentation of how the patient is progressing with his care. So add another half hour to my day for each conference.
Where does all this unbillable professional service go? The employer eats the cost of it and that's not right. Basically we give our services away for free when we consult with family, nurses and other caregivers while the patient isn't present. To combat this, we could talk about patients while they're always present; however, there are some things family may not want to express in front of their mom or dad. We could pull the nurse into the patient's room and discuss the medication, but this diverts the nurse from completing her tasks.
If I were to see eight patients a day and have two care conferences, discuss case management with the supervising PT and pain medication management with the nurse while the patient isn't present, my productivity can easily dip to the mid-70s while I complete work in a nine-and-a-half-hour day. Maybe the answer is to decrease the caseload per day and definitely not to rate a therapist's skill and performance of a job based solely on productivity scores.