Staffing Your Medical Practice for Excellence

Front-office staff are the face of your practice - an expression of your practice's philosophy, attitude, and values. Therefore, it should be a top priority to hire and retain quality staff members for this position. In order to keep turnover and dissatisfaction down for administrative positions such as receptionists, phone operators, medical secretaries, and transcriptionists, you need to keep morale high.

This is a challenge because these positions can include high stress and low pay. Try something different - pay more for the right candidate. If you pay someone more than they think they're worth, they'll work up to that level. If you pay people less, they'll work down to that level.

One of the stressors for front-office staff is that many of the patients they interact with are unhappy simply because they're not feeling well. Although it can be difficult, this fact makes it even more important that front-office staff smile, make patients feel welcome, and convey a happy attitude. To lessen the likelihood of burning out the person at the front desk, rotate these staff members throughout the practice. As a result, you can enjoy the benefits of cross-trained staff as well as increased loyalty.

Here are some other ways to empower your staff and give them the tools they need to excel at their jobs:

• Promote professionalism. Treat your front-office staff with kindness and respect. Beyond a friendly hello in the morning, be sure your staff has the right equipment to do their jobs.  Keep equipment working and up to date.  Make sure staff knows how to use the equipment and make it convenient for them whenever possible. For example, if the receptionist needs to scan/copy patients' insurance cards, place the scanner/copier near her desk.

• Uncover weaknesses. Even with the best intentions, front-office operations are prone to kinks. At times, phones may go unanswered, patients may reach the exam room already dissatisfied, and these bumps can lead to sinking front-office morale and even resentment among staff members. A staff fallout can then affect patient flow, feeding an ongoing negative cycle.

Hold all staff to the same standards - the mini-max performance rule: "The minimum you get from one employee is the maximum you can expect from another in that position, in terms of performance."

• Phone fixes. Periodically use a chart to track incoming calls. Create a matrix with hours of the day along the right, and the reasons for the calls across the top - to schedule an appointment, talk to a nurse, refill a prescription, or get a referral. For one week every quarter, you can track the number and types of calls coming in at certain times of day. If you find you get numerous appointment calls in the morning, you can then staff accordingly. By tracking what's coming in, you can proactively plan for peak demand, rather than reacting to long wait times and angry patients.

Your phone company can provide you with additional information, such as the number of incoming calls, hang-ups, and busy signals. So if you discover after a month that 10 percent of callers get a busy signal or that 5 percent hang up, you know you need to improve your phone service by adding more lines, more people, or both.

You might also consider adding or tweaking your existing automated phone system. Program your automated system to play the greeting first, and then identify your practice. The first option should ask callers whether they want to make an appointment, and if so, transfer them to the operator. You can also include an option to hear directions to the practice or to refill a prescription. Although people are used to such phone trees, make sure it's clear, available, and friendly - especially for new patients.  And, remember to direct patients to your website for access to online services.

There should be no backlog of phone calls at the end of the day. Voice mail should be checked every hour. If there are too many voice mails to keep up with, you need to get someone, such as a float nurse, to provide extra help.  Use technology for the routine requests, so that your staff can use their talents to serve the patients.

• Consistently seek solutions. Be smart with staff resources - for instance, reducing phone-call volume by using a patient portal on your website. A portal is an interactive tool that can answer patients' questions, schedule appointments, deliver test results, process prescription refill requests, provide directions to the practice, and more to save staff a tremendous amount of time, while improving service to your patients.

One of the best ways to keep your front office streamlined is to ask staff for suggestions.  We think we know the answers as managers, but we're not doing it every day. You're also likely to get higher buy-in for staff to carry out their own ideas.

Rosemarie Nelson is a principal with the MGMA healthcare consulting group. She conducts educational seminars and provides keynote speeches on a variety of healthcare-technology and operational topics. Drawing upon her diverse experience, Nelson provides practical solutions to help medical groups succeed in their practices. She may be reached at www.mgma.com/consulting/nelson.