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    Blocked clinic flow can be analogous to a beaver dam

    Analyzing root cause of poor clinic flow sheds light on poor front desk, technician relations


    “Beaver dams are built to provide ponds a means of protection against predators (coyotes, wolves, and bears) and to provide easy access to food during winter. Dams modify the natural environment in such a way that the overall ecosystem builds upon the change. While this can be a very positive change--beaver dams can also be very disruptive. Flooding can cause extensive property damage. But on a whole, dam building can be very beneficial in restoring wetlands. While beavers can create damage, part of the problem is one of perception and time scale.”1


    Having grown up in a rural community in western Massachusetts, all the children--and dogs--were very aware of beaver dams.

    We kids looked at the dams as forts to conquer and sit on during the day as the beavers swam aggressively around trying to keep us away.

    The dogs often looked at the dams as areas to conquer so they could capture the beavers. Unfortunately, they usually spent their days unsuccessfully stalking the beavers, and more often, being bit or chased from the water by a pair of angry buckteeth. The only reward our English setter ever achieved for hunting skills was “horse blue antiseptic,” which would be applied to the ill-timed teeth marks all over its body. And the next day--the dog would be right back there to try again in vain.

    I never thought after I entered the field of ophthalmology that I would give beaver dams much thought again--but here we are analyzing the clinic flow in these terms.

    In this day of electronic health records (EHRs)--where the ultimate goal of an EHR was to ensure our clinic lives went quicker and would be less bogsome-- clinic flow has never been slower.

    These very systems have actually decreased production time, increased expenses, and decreased physician, staff, and ultimately patient satisfaction, due to the “dams” which have been erected.

    What was once a theoretical benefit of the dam is now causing chaos all the way downstream.

    Front desk, technician animosity

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