Rate Determining Step (RDS)

Patient Scheduling

The busier you get the tighter your schedule should be, the worst thing for your mental health and your ability to market your practice is spreading patients out throughout the day.  That is one of the most difficult aspects of practice to control, but it is imperative that you do it and do it right.  All patient decision making gets done at the Evaluation and Re-evaluation, that leaves the patient understanding that the follow-up office visits will be quick and to the point.  Believe me, patients don’t want their time wasted either, and those that want to chit chat at every visit will suck the life out of your practice.  You need to be able to be away from the office several times during the week and be able to walk in and have rooms waiting for you.  If you are working with no staff, that is a little more difficult.  Getting a part-time staff member during peak patient hours is the #1 priority of your growth plan.  A single chiropractor can easily see 8-10 patients per hour with 3-4 new patients or evals for the day. 

I also suggest condensing your mornings and broadening the gap in the afternoon.  That will give you the ability to meet lawyers or MDs for breakfast say at 7am, then be to your practice and ready for patients at 8:30am.  Then you will work 8:30-11:30am which you can easily see 30-35 patients in that slot.  You are out the door for a lunch meeting by 12 and back by 2.  The lunch can be at the MD office or the lawyer’s office and I suggest having the food delivered so it is there when you arrive.  I always prefer to meet and eat at their office so we eliminate travel time and maximizing the time that you can spend together. You can then be seeing patients at 2:30-6:00 which again will give you about 30-40 patient visits with no stress.  That totals 70-80 pts on the day with breakfast and lunch meeting times built in. 

At the end of the day, you can meet a referral source for a cocktail or coffee and be home by 7:30.   These times can all be changed on non-patient days easily, but you can see that time management on YOUR end is the rate limiting step to your success. Also, consider asking the lawyers (especially) to come to your office, that will save you lots of time and still get to meet one on one.

CONTINUED – There are major milestones in every practice that are limited or accelerated by the “rate limiting/determining step”. Remember that a “rate limiting/determining step” is defined as the following:

“In chemical kinetics, the overall rate of a reaction is often approximately determined by the slowest step, known as the rate-determining step (RDS) or rate-limiting step.”


This also applies to our offices and the RDS is something that you MUST, MUST, MUST pay attention to.  It is the #1 thing that needs to be monitored and changed as soon as you see it.  This is the one item that slows everything down and when eliminated, it will accelerate your growth.  Here are some RDS’ commonly found in practice.

YOU – your ability to train, delegate and manage

YOU – your ability to efficiently communicate with and treat patients

Phones – patients having to leave messages causing staff to waste time calling them back and playing phone tag – then adds minutes to every patient encounter and over the course of a year resulting in lost HOURS.

Marketing – you are too busy treating to have time or energy to meet MDs or Lawyers

Notes – your documentation is so behind and so bad that you are not able to get out of the office

Marketing – not having a consistent plan to reach out and stay in front of referrals sources AKA – Bimonthly Flyers, CE Lunches or cocktail meet and greets. These all need to be scheduled ahead of time.  Then you need to go out and fill those items inside your calendar.

I have solved EVERY SINGLE ONE OF THESE RDS’ and can help you.  Look at this list and add it to yours, look for the ONE thing that is the worst – let’s fix that TOMORROW and allow your practice to grow. 

0 replies

Leave a Reply

Want to join the discussion?
Feel free to contribute!

Leave a Reply