Chris Kresser: I’ve never seen patients more than three days a week, if I recall. I’m trying to remember back to the beginning. It’s possible I did three and a half days, but right from the beginning, I knew that I wanted to be a research-based clinician. I already had my blog and my podcast going, which is how I built my practice in the first place, and I knew I wanted to continue that. I just knew that I didn’t want to be a full-time clinician, so I, from the beginning, didn’t set up my practice that way. I think eight new patients was the maximum that I ever did with this case review model, and one of the benefits of the case review model is that because it’s more in depth than a typical new patient visit, you can charge a little bit more for it, and so you don’t have to take as many new patients to make ends meet. Certainly if you don’t have any other sources of income, like passive income, and you’re just starting out, you may want to work more than three days a week seeing patients. You may want to work four days or maybe even five days, although I wouldn’t recommend that if you do want to develop sources of passive income because then if you’re working five days a week with patients, you’re going to have very little time to develop that passive income and grow your practice. So I would strongly recommend limiting to four if you can.
In terms of number of new patients per day, again, if you’re just starting and you don’t have any established patients at all, you can take more than eight new patients because all of your time is going to be initially for new patients, but you have to make sure that you don’t take so many new patients at one time that the wait time for your established patients starts to become really long. I wish I had a formula for you for this, but it’s really kind of a trial-and-error process. I have found myself that for what I do now, which I’m down at this point to six days a month in the clinic, so I have every Tuesday and every other Thursday, and that’s kind of a minimum for me. And I’m not taking any new patients now, but previously when I was working eight days a month, which was every Tuesday and Thursday, I was doing six new patients a week. I would do three hours of new patients in the mornings on Tuesdays and Thursdays, so that would be six case reviews, and then my afternoons were for existing patients. I couldn’t do any more new patients than that because if I did, the wait time for existing patient follow-up appointments would be too long. It’s already probably a little too long, but I didn’t want it to get longer than that. Now that Amy is on board, though, that has helped a little bit because some of my new patients do follow-ups with her because they can schedule them a little bit sooner than they can with me.
Amy, when she first started, her maximum patient hours per week was 24. She set that up, I think, by doing about three and a half days in the clinic so that she wasn’t doing three eight-hour days. And then, I think, she has mostly done about eight new patient visits a week, sometimes less and sometimes a little more, depending on the patient flow.
So, yes, it’s a very different model than conventional medicine. You’ll be seeing fewer new patients, and you’ll also be seeing fewer established patients because, I think, it’s pretty hard to get much done in a 15-minute follow-up appointment. I used to do them, but I stopped doing them because I just felt like it was not enough time to have a productive appointment.