What to Do When Medical Staff Call In Sick

It's flu season and your waiting room is packed. Your front-desk supervisor has just called in sick. Good luck. Unplanned employee absences can wreak havoc on your practice work flow, forcing everyone else on staff to shuffle priorities, cancel appointments, and postpone their own agenda while they cover for absent coworkers. While holes in your front line inconvenience other staff members, they can also adversely affect the patient experience and your bottom line.

Indeed, the most recent Unscheduled Absence Survey by human resources data provider CCH Inc., in Riverwoods, Ill., found that unplanned absenteeism costs up to $660 per employee, per year. It bears noting that the survey only measured direct payroll costs for paid, unproductive time. The true cost to businesses is far greater when lost productivity, impact on morale, and the expense of paying temporary workers are factored in.

"People are going to get sick and when they do, you need to make sure that customer service and quality of care are not compromised," says Heather Bettridge, a consultant with the Texas Medical Association and a former practice administrator. "You need to have a plan."

Be prepared

That begins with cross-training, says Margie Satinsky, president of medical practice consulting group Satinsky Consulting in Durham, N.C., and one-time managing director of a specialty pediatric practice. "You want to be sure you have at least two people who can cover for every job," she says.

Such training, however, should not be attempted ad hoc, says Satinsky. Managers need to identify backups for every position, and ask the person who does that job to train their coworkers well before they call in sick. Such directives yield a dual benefit. Not only are your employees likely to provide the best training for their own position, but the process of cross-training also helps to foster a sense of ownership and mutual respect.

When an employee does call in sick, it's your job to check in with their replacement throughout the day and assist as needed, adds Satinsky. "When someone is doubling up and doing two jobs on the same day, don't leave it up to them to figure everything out," she says. "It requires some discussion. Sit down with that employee in the morning and talk about how they're going to handle the added responsibility." And solicit their feedback on how it could work better. You may, for example, decide it's less burdensome to divide the sick person's tasks between two members of your staff.

Bettridge says you should also review the day's schedule to flag any complications that may arise due to the unplanned absence. "Look to see if there's anything problematic that day, and whether your peak times of the day are covered," she says. If your receptionist called in sick, you may wish to pull an employee from another department to help with check-in during the busiest part of the day. "By getting a feel for the big picture, you'll be better able to prioritize the things that have to get done today, over the things that can be held off until tomorrow," says Bettridge.

Get creative

Practices that employ more part-time workers, rather than fewer full-time staffers, are often most successful at plugging the holes when seats are vacant, says Betsy Nicoletti, a practice management consultant in Springfield, Vt. "Offices that have four part-time medical assistants instead of three full-time [medical assistants] have a little more flexibility in terms of scheduling," she says. So, too, do groups with multiple locations, from which practice administrators can shuffle employees as needed. "If you pull from other offices, make sure you've done your cross-training ahead of time, and make sure each employee rotates through every office during their orientation - so they know where they're going and they can meet the office manager and all the doctors," says Nicoletti.

You can no doubt function with minimal interruption when an employee is out for a day. But if she's fighting off something more serious than a cold, like pneumonia, it's best to bring in part-time help, says Satinsky. Establish a relationship with temporary agencies in your area. Or, better yet, seek out an ex-employee who either retired or left to care for their family. They may be interested in picking up a few hours for spending money. "These people are a great resource because they already know how your office runs," says Satinsky.

Establish good policy

Remember, however, that while cross-training and creative management can keep your practice on an even keel when sick days strike, that's only half the battle. The bigger goal is to reduce the number of last minute no-shows altogether, says Bettridge. Good policies help. "Make sure your employee manual specifically indicates that staff should contact their supervisor as soon as they determine they won't be coming in," she says, noting that should include a heads-up phone call the night before. "That gives management time to make appropriate accommodations."

You may also minimize the number of unplanned absences by offering a single pot of paid time off (PTO) per year, for use however your employees choose, rather than segregating the days allotted for sick leave and vacation. Indeed, employees who require an occasional personal day are forced to call in sick when you give them no other option. A 2007 CCH survey found that just 34 percent of people call in sick to work at the last minute due to "personal illness," while 66 percent are actually taking time off to deal with personal or family issues.

Practices that offer paid time off experience fewer of the disruptive "out sick" calls, since workers are free to schedule their personal days well in advance, says Bettridge, who notes a single pool of paid leave also discourages the abuse of sick days. "Policies that utilize PTO help incentivize staff to not use sick days unless they really need it," she says. That said, don't let the pendulum swing too far the other way. Presenteeism, in which employees who are under the weather show up and pose problems of contagion and lower productivity, can be even more costly to your practice. Encourage employees who are truly ill to remain at home, says Bettridge.

Lastly, managers should look for patterns to spot those staff who may be taking advantage of sick day benefits. You may notice that some employees never call in sick, while others call in every Monday morning after a holiday, or on Fridays during the summer. If you suspect an employee is abusing their days off, explain to them that you need the person in their position to be present and productive. Find out if there's anything your office can do to assist, and request a doctor's note if you must, but if they don't stop playing hooky, cut them loose, says Nick Fabrizio, a consultant with the Medical Group Management Association's Health Care Consulting Group. The impact on morale, when your dedicated employees have to pick up the slack for their coworker on a regular basis, is too costly to bear, he says.

Unscheduled absences can take their toll on a practice, disproportionately so at smaller offices where every employee is already juggling multiple jobs. To minimize disruption to patients and staff, managers must take steps to cross-train their troops and ensure their policies encourage professional behavior.

Shelly K. Schwartz, a freelance writer in Maplewood, N.J., has covered personal finance, technology, and healthcare for more than 18 years. Her work has appeared on CNBC.com, CNNMoney.com, and Bankrate.com. She can be reached via editor@physicianspractice.com.

This article originally appeared in the April 2013 issue of Physicians Practice.