Management Essentials

Making Your Practice Run Like Clockwork

By Farrell “Toby” Tyson, MD, FACS

We all have been taught that time is money, but who knows this better than you? Your employees, of course. They are constantly aware of every minute of every day: when they punched in, how long their break lasted and when they punched out are all engrained in their psyche. This can be both very beneficial in a practice and very destructive.

One simple way to help manage your employees' time is through the use of computerized time clocks and software. The days of manual punch cards have come to an end. The amount of time one spends just trying to calculate the accrued time when there are no missed punches or mistakes is cost-prohibitive.

Most practices have at least moved up to a semi-automated system that uses swipe cards, but these are still fraught with error. How often has one employee grabbed the wrong card to punch out for lunch only to have the true employee then use the card to punch out, but in the process they have now actually punched back in? When both employees come back from lunch, both will be punching out for lunch if they use their appropriate cards. This benign error has now just made a nightmare for calculating times. The time and salaries now spent to rectify this problem multiple times in a pay period could easily pay an additional salary.

Stopping “Time Bandits”

Where a card swipe system really becomes detrimental to a practice is when collusion among employees comes into play. This is usually accomplished by employees swiping in and out for other employees, thus generating pay for unworked hours. This can become extremely expensive when overtime is involved.

The advent of specialized time-clock software with biometric scanners such as fingerprint readers has helped to simplify timekeeping in a practice. The use of fingerprint scanners removes the problem of using the wrong swipe card or swiping for others. The other major benefits of advanced software lie in the flexibility and programmability of the software.

Many employees try to work the system by punching in early and punching out late in order to build up overtime or force the boss to let them go home early on Friday to avoid overtime. This misuse of time is inexcusable. An ophthalmology practice has hours of operation to best serve their patients. In order to do this, staff is hired to work those hours. If staff starts dictating their own hours by punching in at their discretion, the system falls apart and patient care suffers.

Most new time-clock software allows punch-in times to be programmed so that employees can only punch in on or after the scheduled start time. To allow for some flexibility, most will allow for rounding of punches; if someone punches in five minutes before the hour they will be rounded up to the top of the hour. The same can be accomplished when punching out.

Lunch breaks can also be a thorny issue in many practices. Legally, employees working a full eight-hour day must take at least a 30-minute lunch. Many employees conveniently forget to punch out for lunch and then state that they “worked through lunch.” Time-clock software can be programmed to force a lunch period if none is punched if a full day is worked. This policy, of course, needs to be fully explained to staff and documented in your employee handbook. Remember, a well-rested and nourished employee is a more productive one.

Improving Your Cost Accounting

Time-clock software also allows you to track resource utilization. Many practices, especially those with an ASC, have employees that float from one department to another during a pay period. Most time-clock software allows employees to be set up with different “job” functions so that if they are working in the clinic one day and the surgery center the next, the software can track the salary costs based on financial department. This can also be used to track hours of attendance at after-hour training meetings.

All of these “job” codes can have different overtime calculations associated with them. These aspects of the software really help sort your payroll costs between your different departments and locations of service.

Through a minimal investment of capital in a current time-clock system and software, you will not only save on payroll costs but will also save a lot of headaches. The added productivity of the clinical staff, as well as your human resource manager, will allow your practice to prevail. Remember, you and your friendly competitors are all granted the same amount of time in the day — it is how you use it that makes the difference. OM

Farrell C. Tyson, MD, FACS, is a refractive cataract/glaucoma eye surgeon at the Cape Coral Eye Center in Florida. He may be reached at tysonfc@hotmail.com.