Don't Let Overtime Take Over

I'm often asked how practices can control overtime pay. It's so expensive.

To set the stage: Overtime pay is one and one half times the regularly hourly rate, not two times or more. It is paid for hours worked in excess of 40 in a defined workweek -- say, from 7:00 a.m. Monday until 6:59 a.m. the following Monday. Holiday, vacation, and sick leave do not qualify as hours worked and therefore do not result in overtime pay.

Salaried employees are exempt from overtime, but a salaried employee must qualify for administrative or professional exemption status -- usually 80 percent of their time has to be spent doing specific administrative or professional work. Any "comp" time granted for overtime must be given in the same week, which will then be recognized as normal pay.

So, how can you control the costs related to overtime? Here are some ideas. It's not intended to be a complete, comprehensive list. Hopefully, though, it will spark some creativity on how you can better manage overtime in your practice.

• Make it up on the back end. If two hours of overtime occur on Monday, give two hours of comp time later that week. Track work hours closely to ensure no surprises on Friday. Develop a flex-time strategy.

• Manage lunch breaks so that employees are not eating at their desks while answering phones and so on. Instead, give them time away from the work place. Some practices allow an hour, others 30 minutes; decide what's best for your practice.

• Stick to your schedule. Make patient activity fit within the 40-hour week. Then start and end clinic sessions on time.

• Do only today's work today. If there is work that can be put off, then put it off. This is not procrastination; it is putting priority on work.

• Expect some overtime and deal with it. Flu season is soon upon us. Some clinic days will be very busy and it will be necessary to stay late. Just plan for it in your budget.

• Review the workload of each employee and her ability to accomplish the level of work expected. About 25 percent of work performed is re-work or unnecessary work. Take a serious look at work habits and patterns in terms of efficiency.

• Supply needed tools. Ensure that adequate systems, procedures, and tools are available so staff can get their work done quickly. Eighty-five percent of the problems with staff are system problems, not those of the individual employee.

• Identify patterns of overtime -- certain days of the week, certain doctors' and employees' habits -- and address what the pattern is telling you about work performance, either good or bad.

• Offer job sharing for key jobs by using two part-time employees to fill one position. For example, you may have two individuals over 65 who have experience as receptionists and who each want to work, but not full-time. Let them set their schedule as to who works when, ensuring that you are covered during your business hours, five days a week.

Owen Dahl, FACHE, CHBC,

is a nationally recognized medical practice management consultant with over 24 years of experience in consulting for and managing medical practices, and he is the author of

Think Business! Medical Practice Quality, Efficiency, Profits.

He can be reached at odahl@houston.rr.com or 281 367 3364.