business of pediatrics

How to Increase Patient Visit Volume

The fall and winter of 2020-2021 was unusual for pediatricians in that most offices experienced a drop in visit volume during what would have been an otherwise busy sick visit period. No one wants kids to be ill, but it’s a definite conundrum for pediatricians. If your practice has experienced a drop in patient volume, you’re in the right place. In this post, we’ll cover how and why visits dropped, strategies to increase volume, and why the worst of the pandemic-related visit drops may be finished.

Pandemic-Related Primary Care Drop

In the graph below you can see data from PCC practices spanning from late 2019 to March of 2021. The left side of the timeline demonstrates COVID-19 caused well and sick visits to drop dramatically. From April to November, well child visits outpaced sick visits, which is normally what you’d expect to see as kids get outside and are sick less often -- still, visits were down. The change in seasons brought some kids back to school in the autumn of 2020, and again as expected sick visits topped well visits.

pediatric visit volumeFor more data from PCC’s COVID-19 research, visit our Business Impact of COVID-19 page.

So if visit trends were not entirely abnormal why were visits still down for most of 2020 and into 2021? Some reasons are straightforward: kids who stayed home during lockdown measures in the U.S. could not get sick or infect others (as was the intention); the annual effects of flu on kids was decimated -- an early March 2021 Washington Post article cited only 1 pediatric death during the 2020-2021 flu season.

While pediatricians love to see a trend of healthy kids, this is not the complete story. According to PCC’s Pediatric Solutions Director Chip Hart, the data from PCC practices is showing the end of a period where kids not only weren’t getting sick, but parents avoided going to the pediatrician, too. Anecdotally, kids sick at home but who had access to virtual learning did not need a note from their pediatrician to return to school, so they didn’t call to schedule an appointment. While some kids got better on their own, others required ED visits, even as overall ED visits dropped as well.

This brings us to the spring of 2021, when COVID-19 vaccination is underway, a pediatric version is in development, and kids are slowly returning to school. Chip says that the end of this period of low visits could indicate a return to pre-pandemic levels of both sick and well visits as kids return to school, return to play outside, and as pandemic safety restrictions are lifted across states -- even if the data hasn’t quite caught up yet.

What does this mean for your practice? On the one hand, this graph and the information that supports it show that there can be many reasons for a single problem, and that there’s hope for a turnaround in the near future. What we know is that with visit volume down, your practice will need innovative ways to weather the storm.

5 Ways to Increase Visit Volume

1. Recall, Recall, Recall

This first strategy is tried and true. Before launching a recall initiative, your practice should tidy up your patient lists to make sure that your messages are getting out to the right families at the right addresses and phone numbers.

After that, you can begin your recall strategy, which will be unique to your practice. It could mean a dedicated front desk person calling through a list for a set period of time per day, or scheduled reminder emails and texts, or automatically scheduling well visits for a sibling when a patient comes in sick. Recall visits can improve vaccination and well visit rates, and offer valuable opportunities for physicians to note mental health changes, neglect or abuse, talk about food insecurity, and so much more.

2. Behavioral Health

If your practice did not offer behavioral health visits or did so occasionally before the pandemic, now is a great time to expand these services. Mental health is a huge concern for families and pediatricians responding to the pandemic and will continue to be relevant for years to come.

There are several ways to integrate behavioral health into your practice. Check out this blog’s mental health section to get started with resources.

3. Telemedicine

One of the first things practices did during the first wave of COVID-19 in the U.S. was to adopt telemedicine to offer care to patients when they could not visit the office. Telemedicine services are a great way to offer care in some circumstances, such as for behavioral health, controlled substance, nutrition, and lactation visits. It is also valuable to families with small children, who have kids studying at home, or who have an underlying health condition which makes an office visit anxiety-provoking or difficult.

Check out PCC’s COVID-19 Links and Resources page for more information on telemedicine, and learn how to  set up a vendor and properly bill for the visit.

4. Extra Services

Don’t forget the additional services that will help your practice meet its revenue potential as well as invite families into the office. Some examples include: 

  • Spring sports physicals, which are important opportunities for checking in with kids and teens
  • Fluoride varnish, which can help protect dental health if kids are also not visiting the dentist
  • Vision and hearing checks. Teachers in online classes may not detect vision or hearing issues the way they would in the classroom, so these checks may become more important to add at the pediatrician’s.

Be sure to visit our webinar on the 7 Pediatric Services That Will Save your Patients and Your Practice to learn more about these additional services and how valuable they can be.

5. COVID-19 Vaccines -- Maybe

Groups such as PCC, the AAP, and practices across the country are working with their state governments to advocate for pediatricians delivering COVID-19 vaccines. As vaccination experts, pediatricians are a valuable resource in this endeavor. 

You can prepare now for a mass vaccination service by studying previous flu clinic events, or planning for a drive thru clinic for another service, such as immunizations or well visits.

The news is not all bad -- Chip estimates that the nationwide drop in patient visit volumes is likely nearly over, and practices can begin recovering as kids return to school, return to outside play, and subsequently need a visit to the doctor for ills and spills. 

Preparing now for this recovery can help your practice financially, and get kids healthy and prepared for a pediatric vaccine when it appears. Mental health may be the largest issue to address -- learn how your practice can offer these services at any budget with our ebook below.

Integrating Behavioral Health:  A Guide to Expanding Access

Allie Squires

Allie Squires is PCC's Marketing Content Writer and editor of The Independent Pediatrician. She holds a master's in Professional Writing from NYU.