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Scheduling has always been difficult for pulmonologists, most of whom see patients in multiple locations during the day—but the problem seems to be growing more acute. In large part, this is due to growing demands on pulmonologists, including increases in prior authorizations, payer documentation demands, and peer-to-peer reviews.

One part of solving the scheduling crisis revolves around streamlining patient flow. Experts recommend gathering a considerable amount of data, including how many patients you see each day in your clinic, how much time you spend with each patient, how many of those visits are first-time patients, and which days are most popular for first-time visits. A thoughtful review of that data can result in identifying bottlenecks and finding ways to alleviate them.

Another step pulmonologists should consider is bringing their front desks to the next level with an advanced scheduling system. These systems include the ability to batch check eligibility, double book appointments, schedule resources by “first available,” and scan and attach documents to patient records.

A third way to improve scheduling is to block off sufficient time for documentation and admin tasks. Yes, it’s more time than you spent in the past, and it’s time you’re not spending with patients. But scheduling time to review patient information and to help your front desk secure necessary authorizations ensures patient care is never compromised, leading to better outcomes.

Pulmonology practices that have already implemented changes like the ones above and are still experiencing scheduling difficulties may want to consider adding advanced practice providers (APPs). Currently, there’s no set path to incorporating APPs—each practice must formulate its own workflows. Nevertheless, many experts believe APPs can increase patient access in specialty practices.

“Given the increasing demand for high levels of care in the United States, many larger health systems have already developed efficient procedures for integrating advanced practice providers into specialty care,” says Corinne Young, a family nurse practitioner with Colorado Springs Pulmonary Consultants. “However, smaller specialty practices may not know where to begin the process. And those who have brought an advanced practice provider on board may not know how to take full advantage of the skills they bring to the practice.”

Because there is currently no pulmonary tract for the APP workforce, training must be a major part of any program within a practice. For many, that barrier is worth scaling. Dr. Omar Hussain of Libertyville, Ill. says his practice hired an NP primarily to help care for shorter-stay, non-critically ill patients in the ICU (for example, patients receiving postoperative monitoring).

“We literally sit next to each other, and in the mornings, we make a game plan of which patients she will tackle first and which ones I’ll see first. When we’re called by the nurse for an ICU evaluation [on the floor], we decide in real time who goes,” says Hussain, adding that the NP has been “invaluable.”


  1. Greenhalgh, Tom. “5 Steps for Managing a Clinic Efficiently.” Pulmonology Advisor, 1 February, 2019. https://www.pulmonologyadvisor.com/home/topics/practice-management/5-steps-for-managing-a-clinic-efficiently/
  2. “How to Manage High Stress As a Critical Care Pulmonologist.” MPLT Healthcare, accessed January 2023. https://www.mplthealthcare.com/manage-high-stress-as-a-critical-care-pulmonologist/
  3. “Advanced Practice Providers Can Help Meet Increased Demand for Pulmonology Care.” CHEST, 20 October 2019. https://chestdailynews.chestnet.org/advanced-practice-providers-can-help-meet-increased-demand-for-pulmonology-care/
  4. Kilgore, Christine. “Advanced Practice Providers—An Evolving Role in Pulmonary Medicine.” CHEST, 8 December 2022. https://www.mdedge.com/chestphysician/article/259989/practice-management/advanced-practice-providers-evolving-role

Last Updated on February 2, 2023

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