Turning Slacking Medical Staffers into Star Employees

When you walk by your billing staff's computers do you notice Facebook up on the screen instead of the billing software program? Are your front-desk staff chatting and giggling while the waiting room is crowded with patients? Is your scheduler still using paper forms even though you've introduced an EHR system?

If you answered yes to any of these, you probably have a slacking staffer - that employee who's in a rut and not working as hard as she should or is just plain lazy and unmotivated. Either way, you could be losing hundreds of dollars per week, plus hours of time that could be put to better use.

"The issue of slacking staffers is a big one because it compromises office efficiency and patient service. One slacker can bring down the entire team," says Judy Capko, a Thousand Oaks, Calif.-based senior medical practice management and marketing consultant who is author of the best-selling book "Secrets of the Best-Run Practices."

Lucky for you, getting a slacking staffer out of a rut and motivated is possible - and usually not too difficult.

Who's slacking and how

Slackers wear many faces.

There's the burnt-out employee who's taking long breaks, or the nurse who takes her time completing routine tasks. There's the bored, 25-year-old receptionist who spends big chunks of time on Facebook during a busy morning shift, or the billing coordinator who can't seem to get letters to patients in the mail quickly and easily.

For each of these prototypes, there are different causes of slacking.

Younger-generation workers under the age of 40, for example, are more likely to slack off when they're bored, says Capko. "They're extremely good at multitasking, so if they're not busy, they're going to go surf the Internet and do something that's less productive to you," she says.

For older employees, slack-luster behavior often comes with learning new things, such as high-tech EHR programs. "A lot of 50-year-olds say, 'I've been doing this for years, why do I have to change? EHR is a perfect example," Capko says. "Older generations say 'I can't believe we have to go through this,'" and end up wasting time by resisting changes.

But even a practice full of sparkly EHR enthusiasts can go slack in a practice environment conducive to burnout, says Susanne Madden, president and CEO of The Verden Group, a medical consultant group in Nyack, N.Y., who works with physician practices to improve operational efficiency. "There's only a certain amount of weeks, months, years where your staff can do the same things with smiles on their faces," Madden says.

And if an employee is burnt out, he's more apt to make mistakes. One example, says Madden, is the front-desk person who unintentionally forgets to double-check insurance eligibility because his mind is elsewhere. And in a world of increasingly higher copays ($20 or $30 a visit, instead of $5 or $10) the result of a simple slacker mistake could result in your practice collecting just 30 percent of what it needs in a day. Later, the billing department will spend hours figuring out why claims are being denied.

"When you're burnt out, you're not going to focus on the detail," says Madden. "There are going to be steps that are missed."

Check your own behavior

Before you start pointing fingers, cut your staff some slack and take a look in the mirror.

If you're not living up to the standards you expect, such as coming in on time and keeping personal calls to a minimum, employees might feel entitled to a little goof-off time outside of their regular breaks.

"When I look at a situation where there may be slacker employees, I'm also going to look at the manager too, and say 'Okay, how are you motivating people?'" says Madden. "You don't need to have a manager cracking the whip all the time. But I think it's really important for managers to be visible, to walk the floor, to actually be out there at the front desk."

Managers usually set the tone of the entire organization, from being visible to not goofing off or taking too much personal time during the day. That's why Lucien Roberts, associate administrator of business development at MCV Physicians, and a part-time consultant in Richmond, Va., suggests setting an example by treating all employees the same way when it comes to work performance, even if one is a doctor and the other a front-desk receptionist. "The double standard is a recipe for failure," says Roberts. "It's creating an expectation that 'if Dr. Jones does that, so can I.'"

Brandon Betancourt, administrator of Salud Pediatrics, a nine-person pediatrics practice in Algonquin, Ill., says that managers should show staff they're not afraid to do menial or undesirable tasks, such as scanning or sending letters. "There's a lot of 'lead by example,'" he says, adding that when a staff member slacks off or complains, he can respond by saying "I've done it, so it can be done."

Take preventative measures

Though there's no single way to guarantee a slacker-free office, there are a few things you can do to get more productivity out of those employees in a rut:

Set clear, consistent technology policies. With so many parents working at practices, not allowing cell phones could actually hurt retention, says Roberts, noting that a lot of parents like to talk to their children after school to know that they got home safely. Just remember that if you set policies for e-mail, Facebook, and cell phones, enforcement must be consistent. "You can't allow some to [use] Facebook and not others," says Roberts. "If you take a hard line and say 'no, you cannot use any technology,' I think that's going to put you at a recruiting disadvantage."

Hire fairly. If your pay rate for a biller is $18 to $20 an hour, and you hire a new guy for $25 an hour, chances are the other billers will become resentful, and use their lower pay rate as an excuse to do less work or take it easy, says Capko. "That word's going to get out," says Capko. Instead, she suggests telling your prospective employee something along the lines of "we think you're great and we'd love to have you on board, but we've set our pay structure competitively, and the value of the position based on our job description's responsibilities is set at $20… but we do have a great benefits package."

Be approachable and available. In addition to being more visible on a daily basis, consider meeting more frequently through staff meetings. Holding weekly, 20-minute, one-on-one meetings is probably too difficult to arrange for a busy practice, says Capko, but you can meet regularly with the whole staff to discuss big issues. Betancourt says that his practice has improved collection ratios since he started sharing data that shows the bottom-line numbers resulting from sending out collection letters to patients on a timely basis (or failing to do so).

Keep things interesting. Remember that if employees are in a funk, they could just simply be under-challenged. "Burnout happens when people are inappropriately matched to their job. Or performing the same tasks for a certain period over time," says Madden. But instead of giving them more work, give them work that matches their skill set, even if it's something small like creating the office's holiday card, she adds.

Whatever you do, taking action is the only way you'll get a slacker to change - or at least slack off less often. "If you notice slacking staffers early, you are paying attention," says Capko. "If you're really in tune with your employees, you'll notice one person having trouble, and you'll nip it in the bud."

Marisa Torrieri is associate editor for Physicians Practice. She can be reached at marisa.torrieri@ubm.com.

This article originally appeared in the April 2011 issue of Physicians Practice.