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Introduction
Ancillary services are defined as procedures required prior to visiting a physician. These procedures are important because they assist the physician to accurately assess the patient's condition. For examples, an x-ray helps an orthopedic surgeon to determine injuries or musculoskeletal system conditions. Some outpatient clinics require patients to have ancillary services a few days prior to the physician visit to avoid additional waiting time. Others prefer both ancillary and physician services to be done in one visit since most ancillary services are computerized and the results can be communicated within minutes. This article presents a method for the latter scenario and focuses on how to determine and schedule ancillary services. Furthermore, if the patients' ancillary services can be identified and considered when the appointment is made then the first consultation time with the physician can be eliminated to improve patient access to care.
Problem statement
Waiting time in outpatient healthcare has been a long-recognized issue. Ancillary services, such as x-rays before the physician visit adds waiting time. Many researchers have tried to find better ways to schedule appointments because physician treatment-time varies, but ancillary-service variation's impact is overlooked. Some clinic staff define the appointment time as the physician visit time. Some ask or schedule patients to come early for ancillary services to prevent physicians from idling. However, coming in too early for ancillary services adds to the patient's waiting time. There is not a clear distinction between arrival and physician visit time, so it becomes difficult to proactively account for ancillary service time in scheduling systems. When considering ancillary services, it is important to define how long the ancillary service should be so additional waiting time is not generated. Inconsistent ancillary services lead to a compounding effect on waiting time. Many clinic staff have scheduled ancillary services independently regarding patient and physician schedules. Scheduled ancillary service time, therefore, should be based on patient flow generated by the physician visit to minimize patient waiting time. Considering ancillary service in the current scheduling system requires identifying whether ancillary services are needed for a patient. Clinicians are able to determine quickly whether a patient needs ancillary services when communicating with patients. However, this information is not normally transmitted to the scheduler. Proper scheduling should include the time...