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The four scheduling models, and which one actually protects your clinic hours

Block, wave, modified wave, or open access. Each fails differently, and the failure decides whether you finish on time.

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For doctorsDoctor sideUpdated Aug 2026

In short

Every scheduling model is a bet about variance. The question is not which is fastest on a good day, but which one absorbs the case that runs forty minutes over.

The four models

Indian OPD clinics run one of four scheduling patterns, usually without having chosen between them. They differ in who absorbs variance: the doctor, the patient, or the schedule itself.

Four outpatient scheduling models compared on variance handling and failure mode
ModelHow slots are filledAbsorbs a long case byFails as
BlockEveryone told the same arrival timeMaking patients waitA full waiting room and no way to triage it
Individual (wave off)One patient per fixed slotRunning late, cumulativelyA clinic that finishes ninety minutes over
Modified waveTwo or three at the top of each hour, then singlesCatch-up time inside each hourOnly if the overrun exceeds the hour
Open accessSame-day booking, minimal advanceSame-day demand matching capacityUnpredictable days, and no follow-up structure

Why modified wave usually wins

It is the only one of the four with slack designed in. Individual slots have none, so a single overrun propagates through the entire session and every subsequent patient pays for it. Block scheduling has slack but spends it entirely on patient waiting time.

The number to watch is not utilisation

A clinic at ninety-five per cent slot utilisation has no capacity to absorb anything, and one complicated case turns the afternoon into an apology. The metric worth tracking is finish-time variance against scheduled close — because that is the one your staff experience and the one that decides whether follow-ups get booked.

Questions we get asked

Which appointment scheduling model is best for an Indian OPD clinic?

Modified wave suits most OPD settings, because it is the only common model with slack built into each hour rather than borrowed from patients or from the doctor’s evening. Individual slots look tidier but have no absorption capacity, so a single long consultation runs late through every subsequent appointment.

Why does high slot utilisation make a clinic run late?

Because utilisation and resilience trade against each other. A schedule filled to ninety-five per cent has nothing spare to absorb a case that runs long, so the overrun has nowhere to go except into the next slot and the one after it. Some deliberate slack finishes the session closer to time than a fuller schedule does.

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