How Can Understanding Patient Mix Help Improve Your Practice?
In the hustle and bustle of a typical breast imaging practice, so much time is spent just ensuring that we are performing the tasks necessary to serve our patients. Little time may be spent considering our practice’s “patient mix” and how that mix affects our daily activities. Such an analysis, however, is crucial to maximizing the efficiency and performance of our practices.
Breast imaging practices provide two essential types of activities for their patient population:
1. Screening activities, where mammography is used to locate signs of hidden breast cancer in those without overt signs of disease (asymptomatic patients), and
2. Diagnostic activities, where mammography is used to identify the presence of breast cancer in patients with some current symptom or indication of breast cancer (symptomatic patients).
"Patient Mix" is usually defined as the demographic and diagnostic characteristics of a given patient population. In the breast imaging field, our patient mix may vary by income, age, occupation, or ethnicity; or they reside in or are referred to us from various geographical areas. To further define patient mix, our patients are a combination of asymptomatic and symptomatic individuals. The proportions of asymptomatic to symptomatic patients that are serviced vary from practice to practice.
Usually, breast imaging practices will perform procedures for both asymptomatic and symptomatic populations. However, these populations have different needs and different outcomes they expect from their imaging experience.
Asymptomatic patients tend to view the breast imaging appointment as one of several proactive procedures they must take care of periodically to maintain their general health, like going to a physician each year for a physical check-up or a dentist every six months for cleaning of one’s teeth. These patients are expecting a quick and easy, “in and out” experience. They expect efficient and friendly service performed by knowledgeable staff. Screening patients are not expecting any bad news, and they typically don’t get any bad news—about 2-10 cancers will be detected out of every 1,000 asymptomatic screenings. As a result, a practice defining itself as a “screening practice” must be able to move large numbers of patients through the screening process efficiently to be effective.
Symptomatic patients, on the other hand, have already had some questionable symptoms or findings, and as a result are normally feeling frightened, vulnerable, and concerned about the potentially negative outcomes of their imaging experience. They will generally have many more questions and concerns about the imaging process and results than an asymptomatic patient, and have a greater need for communication, support, and compassion from providers. These patients will often feel stressed and need a competent and sympathetic provider to guide them through the steps of the diagnostic procedure. In a symptomatic population, screenings will detect about 20-25 cancers for every 1,000 screenings performed. Thus, a practice defining itself as a “diagnostic practice” must not only provide efficient, friendly and knowledgeable service, but must also employ staff with the appropriate training and skills to provide targeted supportive services to patients with negative findings in a compassionate environment. The patient must feel supported, well-informed, and must not feel rushed.
Thus, although a “screening” practice (servicing mostly asymptomatic patients) and a “diagnostic” practice (servicing mostly symptomatic patients) might have similar procedures, equipment, and staff, the needs of their target populations will be quite different and will require different operational responses. Depending upon whether you are a screening center or a diagnostic center, you will need to make different decisions about equipment purchases, patient flow, staffing mix, staff schedules, staff capabilities, training needs, physical space and layout, marketing plans, and other operational issues. It is challenging for a practice to meet the needs of both populations equally while maintaining optimal efficiency and performance, and it is thus useful to consider which type of practice you are, or wish to become.
The Leonides Coalition would like to learn more about how our members’ practices are organized, and how many “screening” versus “diagnostic” practices exist among us. We can then help each other identify and target our optimum patient mix in our locations to support our defined practices, and determine ways in which screening and diagnostic practices might be able to collaborate to reduce duplication of services, streamline patient care processes, and optimize patient satisfaction.
To kick off this process, we ask for you to provide the following information: What percentage of your practice’s patient mix is made up asymptomatic patients and symptomatic patients?
Once this data is collected, we can start to analyze which operational model (screening versus diagnostic) will best support the needs of each of our members’ populations. If our patient mix is equally distributed between asymptomatic and symptomatic patients, we may want to consider whether we would like to focus more on screening or diagnostics, and consider how to move towards changing our patient mix to support such a move.
Logix Drive is the Mammologix Client System
The Leonides Coalition
