An analytical comparison of the patient-to-doctor policy and the doctor-to-patient policy in the outpatient clinic

Peter J.H. Hulshof, Peter T. Vanberkel, Richard J. Boucherie, Erwin W. Hans, Mark van Houdenhoven, Jan-Kees C.W. van Ommeren

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Outpatient clinics traditionally organize processes such that the doctor remains in a consultation room, while patients visit for consultation, we call this the Patient-to-Doctor policy. A different approach is the Doctor-to-Patient policy, whereby the doctor travels between multiple consultation rooms, in which patients prepare for their consultation. In the latter approach, the doctor saves time by consulting fully prepared patients. We compare the two policies via a queueing theoretic and a discrete-event simulation approach. We analytically show that the Doctor-to-Patient policy is superior to the Patient-to-Doctor policy under the condition that the doctor’s travel time between rooms is lower than the patient’s preparation time. Simulation results indicate that the same applies when the average travel time is lower than the average preparation time. In addition, to calculate the required number of consultation rooms in the Doctor-to-Patient policy, we provide an expression for the fraction of consultations that are in immediate succession; or, in other words, the fraction of time the next patient is prepared and ready, immediately after a doctor finishes a consultation.We apply our methods for a range of distributions and parameters and to a case study in a medium-sized general hospital that inspired this research.
Original languageEnglish
Place of PublicationEnschede
PublisherUniversity of Twente
Number of pages15
Publication statusPublished - Feb 2011

Publication series

NameMemorandum of the Department of Applied Mathematics
PublisherUniversity of Twente, Department of Applied Mathematics
ISSN (Print)1874-4850


  • Outpatient clinic
  • MSC-65C99
  • Health Care
  • Discrete event simulation
  • Queueing Theory
  • MSC-90B22
  • MSC-60K25


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