having managed a pediatric practice that was overloaded, unless it was urgent/emergent, we explained that each child needed to have their own appointment slot for routine visits so that the doctor could spend all the time she normally does giving each child her undivided attention. Then we went to the front desk and checked to see if an appointment slot was available that day, perhaps in the same hour. If it was, they were sent to the waiting room to wait about 15 minutes, if they wanted it. This way the formality was implied as to charges, charts, etc. >From a patient satisfaction/marketing side - we said: "MS. Jones, I know what a hardship it can be to chauffer kids around to doctors' appointments, etc.", "Let's see what we have available this morning ( afternoon) so you won't have to come back on another day." If it was late, we said: " Ms. Jones, I'm sure the doctor will stay a little overtime for you and keep the staff a little late to work you in so you won't have to come back. Just have a seat in the waiting room and I'll see what's available - I'll be right back". Only twice did a mother balk about not being seen immediately or concurrently in the first child's appointment, and most left saying "Thank you so much for working us in". Our internal patient satisfaction survey ad lib comments at the bottom of the page showed they appreciated it too. What better confirmation? PS. As always, collect the copay up front- even on these! Maria K. Todd HealthPro Consulting Consortium, Inc. Denver, CO ( )