Medical Practice Management: Making the Most of Your Staff

How many people does it take to run a medical practice? Sounds like the beginning of bad joke, right? It can be, but in this case it is the beginning of how many practices hemorrhage money. When it comes to a straightforward family practice, a few simple tweaks can really change your bottom line, and your paycheck.

So how many people does it take to run an office? Assuming the team is properly trained and motivated and the right systems are in place … surprisingly few.  For a single physician clinic seeing an average of 30 patients per day (without any ancillary services), you should have three to four team members other than the physician in the entire clinic. Often times I see family practice clinics of this size with upwards of seven staff members (check-in receptionist, check-out receptionist, billing specialist, lab tech, two medical assistants, and an office manager). If you fit the bill of seven staffers for a single physician clinic, consider cutting your staff nearly in half. Here is what you need:

1. Office manager: In a practice that sees 30 patients per day or less, your office manager should be spending the majority of his or her time assisting with the billing. Your office manager should also back up the receptionist on the phones and check in/checkout. She/he should also be competent enough to fill in for the medical assistant when help is needed on the clinical side. The office manager should be the liaison between the physician and the staff for routine issues, such as vacation/sick days, tardiness, payroll, accounting, posting payments, etc. Remember if you give your office manager the responsibilities, you must also give her the authority to handle issues when they arise without interrupting you several times per day. One great hire for an office manager position is an RN with a clinic background; often times they are well-versed in the clinical side as well as the billing side of practices.

2. Receptionist: Your receptionist should be responsible for answering the phone by the second ring (you may elect to have an automated system to answer your phones. I believe a live person is best, but automated will work in a pinch), transferring those phone calls, checking patients in and out, and initiating the billing process at the end of the day. The receptionist, believe it or not, should at a minimum be able to help room patients and understand the flow of the clinical side as well.

3. Medical assistant: Your medical assistant(s) should be able to do their primary jobs quickly and accurately, and utilize communication to move the patients through the clinic quickly and anticipate the needs of the patient and physician. MAs should take vitals, height and weight, get a brief description of the reason for the visit, and walk the patients to and from the front desk/waiting room. The physician should never be standing around waiting on the next patient. In addition, your MA should be the backup for the receptionist and have an understanding of the billing side so they can fill in there as well. (Those types of fill-ins may be necessary when the physician is out of town or in the case of one and a half MAs on staff.)

4. Billing specialist OR billing company: Depending on the rates and benefits you can negotiate from your billing companies, it may be in your best interest to utilize a billing company rather than a live body in your office. The billing position is one of the few positions that I don't believe should habitually dual-role. You want your biller focused on your billing and revenue. Consider outsourcing your billing and hiring an additional part-time medical assistant if you feel the drag with fewer than four staff members.

If you haven't noticed the pattern already, I am going to spill the beans: Everyone in your clinic should be cross-trained and eager to jump in wherever and whenever it is needed. This is critical to the success of a practice of any size, but especially important when you are conserving overhead and running  a lean staff.

As you grow in patient volume or practitioners, it will become necessary to add additional staff members. Typically that begins with additional MA help first, then additional reception help, and finally (if you aren't using a service) additional billing help. 

What size is your practice (practitioners, patients per day)? How many on your team?