Chapter 05: Lean Office Staffing


[Organizational Asset or Liability?] 

By David Edward Marcinko

By Hope Rachel Hetico

An overburdened, overstretched executive is the best executive, because he or she doesn’t have the time to meddle, to deal in trivia, to bother people – Jack Welch

Introduction Office Staffing

Every doctor in private practice knows the importance of their office administrator, or practice manager, to the operations and success of the practice. For example, one important person is the receptionist because, although patients may love you, they will consider your entire enterprise “rude” if not treated sincerely and with respect. If the office is large, then the receptionist, secretary or scheduling employee who answers the phone is just as important as you. Now, expand this scenario to appreciate how the entire medial office human resources [HR] continuum affects your business. HR may be a blessing or practice bane even without your knowledge.

In small offices, the receptionist and scheduling person often play dual roles and thus making the hiring decision even more critical. The receptionist needs to be top-notch in customer service and hiring someone with previous experience dealing with patients/customers might be the best approach. These front-line staff members directly bear the brunt of patients’ frustration and anger when the schedule is too tight to allow same-day service, or when they are told the laboratory results are not available, etc. So, you need to be sure to incent them, reward them, and tell them when they do a good job; or how to improve performance. Too often the front desk-staff are overlooked for extra training, or get smaller bonuses than the nursing staff or office manager because their pay is usually less. This may be a mistake. Treat them well and you’ll have less staff turn-over and your patients will appreciate the continuity of regular staff in your office.  

The first step in hiring personnel is to determine the number of employees needed and their office function.  Most practitioners choose to screen personnel independently.  Disqualifying characteristics include: poor communication skills, abrasive personalities, transportation difficulties or a lack of other specific qualifications. Miscellaneous recruitment sources include college placement offices, medical assistance schools, secretarial schools or local state unemployment offices.  Professional employment agencies are often good sources of potential employees for a busy practice but expect to pay a premium for the service. References and background checks may be performed though services such as:

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11 thoughts on “Chapter 05: Lean Office Staffing

  1. On Medical Practice Access Management

    This medical office access management product replaces the physician’s traditional patient data-gathering clipboard with a free easy-to-use wireless touch-screen device. Patient interviews are customizable and can be as short or as long as desired. The touch screen pad comes with a tracking device as well as multiple anti-theft devices. While not a substitute for clinician-patient dialogue, some patients more freely confide sensitive information to a computer, than a clinician (i.e. alcohol use, drug use, psychiatric evaluation, depression, etc.).

    A more structured clinician-patient conversation may be achieved by better preparing doctors, and informing patients, in advance of every visit.

    Dr. Marcinko

  2. The Micro-Medical Practice

    A blog reader once asked how his wife, a solo hand surgeon, should manage her practice and if she should have an office manager. He also asked what staffing ratios would be desirable for a hand surgeon’s solo practice. One proposed micro-practice business model can be fond in primary care.

    In this model, the physician has minimal, if any office help. The doctor meets the patient at the door, escorts him to the exam room, takes vitals (generally not needed in a hand surgeon’s practice), treats the patient; makes the office visit note, codes and bills. The doc does this all by herself, or with minimal help.

    An office manager is not part of this equation. Be sure to have a receptionist/medical assistant. The surgeon’s time is best used in the operating and examination rooms. The receptionist can answer the phones, schedule patients and answer questions. A solo surgeon may not require much more than this, especially related technology is used.

    For example, the assistant should be in charge of inventory ordering office and medical supplies. Consider a website with online patent scheduling, such as This may obviate the need for a receptionist, and/or free him up to help you in the exam room. Be sure to have a smart phone.

    For a complete package; visit Then, get a website with electronic medical record system with e-prescribing, interoperability and quality reporting functions [CCHIT certified]? Have patients enter their history through a web based application such as instant medical history Patients can enter their history at home, or through a computer in the office waiting room.

    Use email to convey results on x-rays and lab results. Get an answering machine for use during the day when you are in the exam room. Hire a medical biller and surgical coder to come in to code and bill. He/she should come in one or two times per week. One solution is to get online billing that you enter, and have the biller/coder come clean up the tough claims. Consider or

    Hire a bookkeeper to keep the books, and supply financial statements. Consider Quickbooks from the start to make it easy. The bookkeeper can do it virtually, or come in once per week or every two weeks. Hire a cleaning service it’s just gross to go in to a dirty doctor’s office! Be sure top check out all online services, and make sure they mesh together with your eMR!


  3. From MSN Careers

    “I work in a small doctor’s office with only one doctor. My office manager is very cool and participates in our slacking. When the doc or his wife are not around and we don’t have any patients … we make fun of the doc and his wife. When we make fun of our bosses, we really make fun of them and create scenarios that we act out, we raise our voices to impersonate them, and when we laugh, we laugh really loud.”

    “We also order food during lunch and eat it in the waiting room where we have a TV, computers and Internet (something that is not allowed during work hours). We snoop on the doc’s computer. We always catch him on the Internet so we like to see what he does on the computer all the time. Needless to say, we found porn in his favorites! Also, his wife forgets to sign out of her e-mail (don’t ask me why) but everyone uses the computers so we saw in her e-mail a message that read ‘Thank you for signing up to lesbian porn.'”


  4. US Supreme Court to Hear Medical Resident Tax Case

    A nearly 20-year-old legal dispute over whether medical residents are students or workers, for payroll tax purposes, is headed for resolution in the U.S. Supreme Court.

    The country’s highest court recently agreed to hear a case in which the Mayo Foundation and the University of Minnesota are challenging the Internal Revenue Service’s assertion that doctors in training, and the teaching hospitals that train them, must pay Social Security taxes on the residents’ stipends.

    The case, Mayo Foundation v. United States (09-837), is one in a long line in which the government and medical schools and hospitals have gone toe to toe, with hundreds of millions, if not billions, of dollars potentially at stake.

    Hope Hetico RN, MHA
    [Managing Editor]

  5. Professional Recruitment and Staffing

    Albrecht & Associates

    All Medical Personnel

    AM Resources Corp

    AmCare Physician Search

    American Medical Placement Services

    American Medical Services

    Atwater Consulting and Recruiting

    Barrett Group/ Mike Black

    Bay State Medical-Surgical (Mass)


    Borgess Health Alliance

    Born & Bicknell

    Breitner, Clark & Hall, Inc.

    Bronson Total healthcare

    Caduceus Physician Recruitment/Lee Brown

    Cambridge Group, The

    Canadian Medical Placement service

    Canam Physician Recruiting


    Cejka & Company

    Christie Clinic foundation/Central Illinois

    Christopher and Long

    Coast-to-Coast Recruiters

    Cobb George Executive Search

    Community Health Systems

    Community Health Systems, Inc.

    Cornerstone Resources

    Corridor Group, The

    Cross Country Staffing

    Daniel & Yeager

    Daniel Stern

    Danville Regional Health System VA

    Delta T Group

    Doctor’s Care Personnel Services

    Doherty Professional

    Durham Medical Staffing

    Durham Medical Staffing, Inc.

    EAI Healthcare Staffing Solutions


    EHL Employment House Limited

    EM Care

    EMS, INC.

    Ensearch Management Consultants

    Enterprise Medical Services

    Enterprise Medical System

    EPC Doc Hunter

    Fitzgerald Associates

    Fortune Personnel Consultants of Raleigh

    Furst Group / S. Barc

    Global Medical Search

    Goggio Kuenning & Associates, Inc.

    Golden Opportunities for Phsyicians

    Goodman Group, The

    Grace Healthcare System, NC

    Gutermuth Medical Services, Inc.

    H.I.S. Professionals, LLC

    Harris Kovacs Alderman Associates

    Health Concepts

    Healthcare Network USA

    Healthcare Resources Group

    Healthland HealthSystem

    HealthSearch USA

    Heidrick & Struggles

    Holmes & Narver

    Interim Physician Locums

    Interim Physicians Locums

    J&C Nationwide

    J. Morrissey & Company

    Jackson & Coker

    John March Associates/Maggie Allen

    John March Partners

    Joseph Goldring and Associates, Inc.

    JS Medical Group

    Kendall & Davis/Linde Healthcare

    LAI Worldwide Inc.

    LAI Worldwide Inc.

    Larrieu and Associates

    Larson, Katz and Young, Inc.

    Latter Associates

    Lee Calhoon & Associates

    Levison Search Group

    Locum Medical Group

    Locum Medical Group

    Lutheran Health Systems

    M&M Associates

    Manage Recruiters of Scottsdale

    Management Recruiters of Bethlehem

    Management Recruiters of Spokane

    Management Resources

    Marshall Group, The

    Marvel Recruiters

    MCA Medical Consultants of America

    Med Match Inc.

    Medical Directions

    Medical Doctor Associates

    Medical Employment Agency

    Medical Opportunities in Michigan

    Medical Personnel Providers

    Medical Search Institute

    Medicorp, Inc.

    Medicus Resource Group, Inc.

    Med-Pro Medical Professionals

    MedSearch Staffing Services, Inc


    MedStaff national Medical Staffing, Inc.


    MexXec USA

    Michael Mcgurn & Associates

    MK Recruiting Group

    Morton Plant Mease

    Motion Medical Solutions

    MRG Search

    MRI Charlotte

    MSI International

    Murphy Group, The

    National Health Partners

    National Health Services Corp

    Navin Group, Inc.


    NRI National Resources, Inc.

    Odell & Associates

    Olesky Assocaites

    Orwin Healhcare International

    Panther Enterprises

    Personnel Medical Resources

    PhyAmerica Physician Services, Inc.

    Physician Fit

    Physician Fit

    Physician Jobs.Com/Duggan

    Physician Placement Service of America

    Physician Search Group, Inc.

    Physician’s Agent/Jackson Copeland co.

    Pikesville Methodist Hospital, Ky

    Placement USA

    Pri-Med Healthcare – Locums (SLC, Utah)

    PRN Search

    Pro Search Associates

    Professional Plus, Inc.

    Providence Healthcare

    Psychiatric Resources

    Quiring Associates

    R.K. Howard & Associates

    RDS Medical Recruiting

    Saber-Salisbury & Associates

    Sacred heart Health System

    Scott & White

    Shear Healthcare Resources, Inc.

    Sherriff & Associates

    SHR’s Medquest

    Southern Illinois Healthcare

    Spencer Reed Group

    St Francis, Inc. Peoria, Ill

    Stuart Search Group

    Summit Health

    Susan Craig and Associates, Inc.

    Tamara Leake

    Team Health

    Tenet Health System

    Top Echelon

    Trapani & Associates

    Trinity Medical Group

    Trinity Regional Health System (Iowa)

    United Search Associates

    Universal Health Service

    Ursala Thomas & Associates

    Vantage Search Group

    Witt/Kieffer, Ford, Hadelman & Lloyd

    WorldWide Medical Services

    Hope R. Hetico RN MHA
    [Managing Editor]

  6. Waiting Room Time

    The average time patients spend waiting to see a health provider is 22 minutes, and some waits stretch for hours, according to a 2009 report by Press Ganey Associates, a healthcare consulting firm that surveyed 2.4 million patients at more than 10,000 locations.

    Orthopedists have the longest waits, at 29 minutes; dermatologists the shortest, at 20. And with each five minutes of waiting time, patient satisfaction sank significantly, the survey revealed.

    Christy Lodwick

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    You need initial traffic boost only. How to get it? Search for:
    Mertiso’s tips go viral

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