Chapter 05: Lean Office Staffing

BASIC OFFICE STAFFING AND HUMAN RESOURCE MANAGEMENT

[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: www.references-etc.com

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10 thoughts on “Chapter 05: Lean Office Staffing

  1. On Medical Practice Access Management
    http://www.Phreesia.com

    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
    http://www.MicroPracticeSolutions.com

    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 http://www.AppointmentQuest.com. 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 http://www.MicroPracticeSolutions.com. 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 http://www.MedicalHistroy.com. 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 http://www.MedicalOfficeOnline.com or http://www.EZClaim.com.

    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!

    William

  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.'”

    http://msn.careerbuilder.com/Article/MSN-2200-Workplace-Issues-What-We-Do-When-the-Boss-Isnt-Looking/?sc_extcmp=JS_2200_home1&SiteId=cbmsnhp42200&ArticleID=2200&gt1=23000&cbRecursionCnt=1&cbsid=38ff0cd137954f558466966a2d91b9a5-320834658-RK-4

    Vanessa

  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.

    http://www.insidehighered.com/news/2010/06/02/supreme

    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
    http://www.BusinessofMedicalPractice.com
    [Managing Editor]

  5. Professional Recruitment and Staffing

    Albrecht & Associates
    http://www.albrecht-assoc.com

    All Medical Personnel
    http://www.allmed.com

    AM Resources Corp
    http://www.medical-search.com

    AmCare Physician Search
    http://www.amcare.com

    American Medical Placement Services
    http://www.resourcecenter.com

    American Medical Services
    http://www.americanrecruiters.com

    Atwater Consulting and Recruiting
    http://www.healthyjobs.com

    Barrett Group/ Mike Black
    http://www.thebarrettgroupinc.com

    Bay State Medical-Surgical (Mass)
    http://www.recruit-doc.com

    Booth-Yellin
    http://www.booth-yellin.com

    Borgess Health Alliance
    http://www.borgess.com

    Born & Bicknell
    http://www.bornbicknell.com

    Breitner, Clark & Hall, Inc.
    http://www.breitner.com

    Bronson Total healthcare
    http://www.bronsonhealth.com

    Caduceus Physician Recruitment/Lee Brown
    http://www.jobs4med.com

    Cambridge Group, The
    http://www.cambridgegroup.com

    Canadian Medical Placement service
    http://www.cmps.com

    Canam Physician Recruiting
    http://www.richnet.net

    Canon-Brower
    http://www.canon-brower.com

    Cejka & Company
    http://www.cejka.com

    Christie Clinic foundation/Central Illinois
    http://www.christieclinic.com

    Christopher and Long
    http://www.christopherandlong.net

    Coast-to-Coast Recruiters
    http://www.cjnetworks.com

    Cobb George Executive Search
    http://www.cobbgeorge.com

    Community Health Systems
    http://www.chs.net

    Community Health Systems, Inc.
    http://www.chs.net

    Cornerstone Resources
    http://www.cornerstoneresources.com

    Corridor Group, The
    http://www.corridorgroup.com

    Cross Country Staffing
    http://www.crosscountry.com

    Daniel & Yeager
    http://www.daniel-yeager.com

    Daniel Stern
    http://www.danielstern.com

    Danville Regional Health System VA
    http://www.drhsi.org

    Delta T Group
    http://www.delta-tgroup.com

    Doctor’s Care Personnel Services
    http://www.doctorscornerpersonnel.com

    Doherty Professional
    http://www.dohertyprofessional.com

    Durham Medical Staffing
    http://www.durham.com

    Durham Medical Staffing, Inc.
    http://www.napr.org

    EAI Healthcare Staffing Solutions
    http://www.eai-healthcare.com

    System/Ariz
    http://www.evrhs.org

    EHL Employment House Limited
    http://www.e-h-l.com

    EM Care
    http://www.emcare.com

    EMS, INC.
    http://www.emedserv.com

    Ensearch Management Consultants
    http://www.ensearch.com

    Enterprise Medical Services
    http://www.enterprisemed.com

    Enterprise Medical System
    http://www.enterprisemed.com

    EPC Doc Hunter
    http://www.dochunter.com

    Fitzgerald Associates
    http://www.fitzsearch.com

    Fortune Personnel Consultants of Raleigh
    http://www.fortune-ral.com

    Furst Group / S. Barc
    http://www.furstgroup.com

    Global Medical Search
    http://www.grobal-medicalsearch.com

    Goggio Kuenning & Associates, Inc.
    http://www.goggio.com

    Golden Opportunities for Phsyicians
    http://www.home.sprynet.com

    Goodman Group, The
    http://www.goodmangroup.com

    Grace Healthcare System, NC
    http://www.gracehcs.org

    Gutermuth Medical Services, Inc.
    http://www.gutermed.com

    H.I.S. Professionals, LLC
    http://www.hispros.com

    Harris Kovacs Alderman Associates
    http://www.hkainc.com

    Health Concepts
    http://www.healthcareconcepts.com

    Healthcare Network USA
    http://www.hnusa.com

    Healthcare Resources Group
    http://www.shrtmedquest.com

    Healthland HealthSystem
    http://www.healrtland-health.com

    HealthSearch USA
    http://www.healthsearchusa.com

    Heidrick & Struggles
    http://www.heideck.com

    Holmes & Narver
    http://www.hninc.com

    Interim Physician Locums
    http://www.interimhealthcare.com

    Interim Physicians Locums
    http://www.interimhealthcare.com

    J&C Nationwide
    http://www.jcnationwide.com

    J. Morrissey & Company
    http://www.jmorrissey.com

    Jackson & Coker
    http://www.jcnationwide.com

    John March Associates/Maggie Allen
    http://www.johnmarch.com

    John March Partners
    http://www.johnmarch.com

    Joseph Goldring and Associates, Inc.
    http://www.jobprofessionals.com

    JS Medical Group
    http://www.jsmg.com

    Kendall & Davis/Linde Healthcare
    http://www.kendallanddavis.com

    LAI Worldwide Inc.
    http://www.laix.com

    LAI Worldwide Inc.
    http://www.laix.com

    Larrieu and Associates
    http://www.ruonline.net

    Larson, Katz and Young, Inc.
    http://www.ikli.com

    Latter Associates
    http://www.latter-associates.com

    Lee Calhoon & Associates
    http://www.calhoon.com

    Levison Search Group
    http://www.levisonsearch.com

    Locum Medical Group
    http://www.locummedical.com

    Locum Medical Group
    http://www.locummedical.com

    Lutheran Health Systems
    http://www.lutheranhealth.org

    M&M Associates
    http://www.md-jobs.com

    Manage Recruiters of Scottsdale
    http://www.mrihealthcare.com

    Management Recruiters of Bethlehem
    http://www.mrbethlehem.com

    Management Recruiters of Spokane
    http://www.mrspokane.com

    Management Resources
    http://www.managementresources.com

    Marshall Group, The
    http://www.callmarsahll.com

    Marvel Recruiters
    http://www.marvelcons.com

    MCA Medical Consultants of America
    http://www.mcadocs.com

    Med Match Inc.
    http://www.medmatchinc.com

    Med_Employ.com
    http://www.med_emply.com

    Medical Directions
    http://www.medical-directions.com

    Medical Doctor Associates
    http://www.mdainc.com

    Medical Employment Agency
    http://www.drjean.net

    Medical Opportunities in Michigan
    http://www.mimom.org

    Medical Personnel Providers
    http://www.medwebusa.com

    Medical Search Institute
    http://www.msi-intl.com

    Medicorp, Inc.
    http://www.medicorpinc.com

    Medicus Resource Group, Inc.
    http://www.medicusrg.com

    Med-Pro Medical Professionals
    http://www.medpro-search.com

    MedSearch Staffing Services, Inc
    http://www.medstaffing.com

    MedStaff
    http://www.medstafflt.com

    MedStaff national Medical Staffing, Inc.
    http://www.medstafflt.com

    MedWebUSA
    http://www.medwebusa.com

    MexXec USA
    http://www.medxecusa.com

    Michael Mcgurn & Associates
    http://www.mmachiropractors.com

    MK Recruiting Group
    http://www.mkrecruiting.com

    Morton Plant Mease
    http://www.mpmhealth.com

    Motion Medical Solutions
    http://www.betterjobs.com

    MRG Search
    http://www.mrgsearch.com

    MRI Charlotte
    http://www.mricharlotte.com

    MSI International
    http://www.msi-intl.com

    Murphy Group, The
    http://www.jobstofill.com

    National Health Partners
    http://www.nhpartners.com

    National Health Services Corp
    http://www.bphc.hrsa.gov

    Navin Group, Inc.
    http://www.navingroup.com

    Net-Temps
    http://www.net-temps.com

    NRI National Resources, Inc.
    http://www.djob.com

    Odell & Associates
    http://www.odellrecruits.com

    Olesky Assocaites
    http://www.olesky.com

    Orwin Healhcare International
    http://www.orwin.com

    Panther Enterprises
    http://www.seanet.com

    Personnel Medical Resources
    http://www.pmrcareers.com

    PhyAmerica Physician Services, Inc.
    http://www.coastalphysician.com

    Physician Fit
    http://www.physicianfit.com

    Physician Fit
    http://www.physicianfit.com

    Physician Jobs.Com/Duggan
    http://www.physicianjobs.com

    Physician Placement Service of America
    http://www.physician-placement.com

    Physician Search Group, Inc.
    http://www.physiciansearch.com

    Physician’s Agent/Jackson Copeland co.
    http://www.physiciansagent.com

    Pikesville Methodist Hospital, Ky
    http://www.pikesvillhospital.org

    Placement USA
    http://www.placementusa.com

    Pri-Med Healthcare – Locums (SLC, Utah)
    http://www.locums.com

    PRN Search
    http://www.med-employ.com

    Pro Search Associates
    http://www.pro-search-associates.com

    Professional Plus, Inc.
    http://www.profplus.com

    Providence Healthcare
    http://www.practicelink.com

    Psychiatric Resources
    http://www.psychiatricresources.com

    Quiring Associates
    http://www.web.iquest.net

    R.K. Howard & Associates
    http://www.montrose.net

    RDS Medical Recruiting
    http://www.rdsmedical.com

    Saber-Salisbury & Associates
    http://www.sabersalisbury.com

    Sacred heart Health System
    http://www.sunbelt.com

    Scott & White
    http://www.sw.org

    Shear Healthcare Resources, Inc.
    http://www.shrmedquest.com

    Sherriff & Associates
    http://www.sherriff.com

    SHR’s Medquest
    http://www.shrmedquest.com

    Southern Illinois Healthcare
    http://www.sih.net

    Spencer Reed Group
    http://www.spencerreed.com

    St Francis, Inc. Peoria, Ill
    http://www.osfhealthcare.org

    Stuart Search Group
    http://www.stuartsearch.com

    Summit Health
    http://www.summithealth.org

    Susan Craig and Associates, Inc.
    http://www.candocs.com

    Tamara Leake
    http://www.locums.com

    Team Health
    http://www.team-health.com

    Tenet Health System
    http://www.tenethealth.com

    Top Echelon
    http://www.staffing.net

    Trapani & Associates
    http://www.webdoc.com

    Trinity Medical Group
    http://www.trinitymed.com

    Trinity Regional Health System (Iowa)
    http://www.trinityqc.com

    United Search Associates
    http://www.hnusa.com

    Universal Health Service
    http://www.practicelink.com

    Ursala Thomas & Associates
    http://www.physicianjobsuta.com

    Vantage Search Group
    http://www.vantagesearchgroup.com

    Witt/Kieffer, Ford, Hadelman & Lloyd
    http://www.wittkieffer.com

    WorldWide Medical Services
    http://www.wwmedical.com

    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.

    http://www.fiercepracticemanagement.com/story/five-tips-cut-patient-wait-time/2010-10-19?utm_medium=nl&utm_source=internal

    Christy Lodwick

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