A patient in the wrong diary
Your clinic employs a podiatry assistant who handles routine nail care for patients a podiatrist has assessed as suitable, under your clinic's supervision and delegation arrangements. It frees your podiatrists for the work only they can do.
Then a patient whose circumstances mean your podiatrists want to see them personally books online into the assistant's diary because it had the earliest slot. Reception, in a hurry, moves another patient across to fill a gap. Nobody checked the notes. The assistant spots it on the day, or does not.
Why the decision does not reach the diary
- The podiatrist's decision about suitability is written in free-text notes.
- Reception cannot see it at a glance when booking.
- Online booking lets any patient choose any practitioner who offers routine care.
- Circumstances change, but nobody is prompted to review the decision.
- New patients have no decision yet, but can still be booked with the assistant.
The root cause is that a clinical decision about who can see whom is recorded as text, not as something the booking system can act on.
What wrong bookings cost
Patients seen by the wrong person, which your clinic's arrangements are designed to prevent. Appointments swapped on the day. An assistant put in an awkward position. Podiatrists' diaries full of routine work that could have been delegated, because nobody trusts the booking to be right.
| Patient status | Assistant diary | Podiatrist diary |
|---|---|---|
| New, not yet assessed | Not bookable | Bookable |
| Assessed as suitable for assistant | Bookable | Bookable |
| Assessed as podiatrist only | Not bookable | Bookable |
| Suitability review overdue | Not bookable until reviewed | Bookable |
How we build booking rules
- After an assessment, the podiatrist sets a suitability flag on the patient record in a click: podiatrist only, or suitable for the assistant, with a review date.
- The flag is stored in Cliniko, WriteUpp or your system where it supports custom fields or patient groups, or in a small linked table.
- Online booking only offers the assistant's slots to patients flagged as suitable. Others see podiatrist slots only.
- When reception books, the flag is shown clearly, and a booking that breaks the rule needs a podiatrist's override with a reason.
- The assistant's diary for the next day is checked against the flags each afternoon, and any mismatch goes to a podiatrist.
- As a review date approaches, the patient is booked with a podiatrist next time, or the podiatrist is prompted to review the flag at their next visit.
- The assistant can raise a concern from their appointment, which sets the patient to podiatrist only until reviewed.
Who is suitable for an assistant is a clinical decision made by your podiatrists under your clinic's arrangements. The system only makes sure bookings follow it.
Reporting helps here too. A simple view shows how much routine work has moved to the assistant's diary, how many patients are overdue a suitability review, and how often reception needed an override, which tells you whether the flags are being set and kept up to date.
What changes
Patients are booked into the diary their podiatrist chose. Reception sees the rule rather than guessing. Online booking follows it automatically. Reviews happen on time. The assistant works with confidence, and podiatrists hand over routine work knowing the booking will be right.
Is this a risk in your clinic?
- Suitability for the assistant is written in notes only.
- Online booking lets any patient book with any practitioner.
- Patients have been booked with the assistant who should not have been.
- Nobody is prompted to review suitability decisions.
- New patients can be booked straight into the assistant's diary.