Reducing wait times in the physician office

There was an article in last week's Wall Street Journal about physicians trying to reduce patient wait times in their office. Here were the ideas and related advantages suggested in the article [with my commentary on each]:

1. Flexible "open access" scheduling...........Advantages-same day appointments, faster access to routine follow ups and new patient appointments; less waiting time in the doctor's office. [this benefits some specialties more than others but I agree with this recommendation. However, keep in mind you must keep open so much patient appointment slots each day to accomodate open access scheduling]

2. 24/7 access to the doctor............Advantages-Can always reach doctor on the phone; home visits if urgent. [this is called old fashioned customer service, which many medical practice receive a failing grade in. I suggest using a "triage" nurse instead of a physician to handle this duty]

3. Reducing or eliminating office staff............Advantages-Lower overhead allows doctors to afford longer, more meaningful visits. [this suggestion is ludicrous in today's practice environment - has this writer ever heard of THE RED TAPE OF MANAGED CARE?]

4. Practice Web sites............Advantages-Can download forms to fill out prior to office visit; ask nonurgent questions via secure email. [using a web site to help reduce practice administrative burdens has always been a good idea and I wonder why there is a large number of practices not doing this still]

5. Electronic medical records.............Advantages-receive alerts and reminders about follow up care. [forget about the advantages the writer lists here. The real advantage of a "paperless" office is the efficiencies it brings to a medical office. It is my belief all medical practices will some day have electronic medical records]