Conferences and vacations steal physicians away. It’s a perfect time for training, house cleaning and reducing overhead.

Throughout the course of a year, experienced administrators work hard to keep a healthy staffing cost ratio of about 30% of overall cash flow (i.e., about $300,000 in lay-staffing costs in a practice collecting $1 million annually).

But, that staffing cost ratio rises sharply whenever your physicians are at conferences or on vacation for a few days or weeks. When clinical staff have time on their hands, what should they do with that time? Without vigilance, even the most dedicated staff will take advantage of reduced work loads, and work slower or take longer breaks.

Those short-term time wasters have long-term financial implications.

When all of your doctors hit the beach or the ski slopes at the same time, it leaves the office desolate of patients but full of more staff than duties to perform. Some practices avoid this by limiting coinciding doctor vacation times but still find themselves with unproductive staff, perhaps because the practice has not set proper expectations that employees are to stay productive, for the most part, all the time.

ADDRESS UNPRODUCTIVE STAFF HABITS

Humans will be humans. If you do not reinforce productivity as an expectation, along with consequences if not followed, you will be disappointed by the results and negatively impacted financially.

Consider the following tips:

• Tell staff what your productivity expectations are and do so regularly. Discuss the difference between taking a five-minute breather after a wild clinic morning and hiding in an empty exam room with your smartphone for the last 15 minutes of each day.
• During performance evaluations, include the goal of productivity and searching out work to be completed when time allows.
• Make it part of your practice culture to help other departments when time permits. If scanning is behind and the clinic staff has time to help, encourage it.
• Teach managers to delegate more. We often see managers overwhelmed by work when they could appropriately share the workload.

GET ON THE PROPER LEVEL

To fix unproductive and unrequired staffing levels, consider the following:

• Require staff vacations to coincide with doctors’ vacations.
• Offer time off without pay if lack of available PTO (paid time off) is the issue.
• Save useful projects and assignments (see below) in a stack at the ready for these available opportunities. Some administrators keep an organized “quiet office duties” list in each department location and expect the staff to help themselves to the work. Others prepare and distribute the duties list as needed.

YOUR TO-DO LIST

Here are suggestions to keep staff busy when the clinic is quiet:

• Thoroughly clean exam rooms and lenses.
• Dust the optical department.
• Examine the office with a fine-tooth comb and fresh eyes. Remove signs and notes and clean up sloppy corners and electrical cord messes.
• Look at the dates on all reading material in the office. If you find Home & Garden from 1967, it has been there too long. Make sure the magazines look fresh, clean and uncluttered.
• Conduct cross training to enhance departmental functioning.
• Provide a “walk in my shoes” experience for employees. This across-observation of other departments should provide all staff with comprehension of how the whole practice functions, and ideally experience to help build teamwork. The goal is for every employee to know what happens in departments other than her own. This way, when patients ask questions, it is easier for an employee to respond with confidence. Call center and patient service front-desk employees who answer the telephone love spending time in the clinic, learning the basics of eye anatomy and care. Staff should feel more informed – not able to do the tech’s job.
• Dive into an extra recall effort. Data mine patients with specific diagnoses who have not been to the office in two or more years. Have your staff call them, rather than send a written reminder, for a more personal outreach and generally a better response.
• Check to see if you have the most current fee schedules for all the insurers you contract with. Compare them against your office charges to be sure you are not charging less than they are willing to pay. With the virtual disappearance of in-office visits from insurance representatives who kept the practices current on these fees, not having the updated information can hurt. Without them, you cannot be sure if your practice fee schedule is currrent so the practice could be losing reimbursement money it’s entitled to.
• Review your collections company’s processes and productivity. If you are not in regular contact with it and reviewing reports on a regular basis, you may become less of a priority to this company.
• If your inventories are not up to snuff, it is a good time to make them so. OM

Corinne Z. Wohl, MHSA, COE, is president of C. Wohl & Associates, Inc., a practice management consulting firm. Corinne earned her Masters of Health Services Administration degree at The George Washington University and has over 30 years of hospital and physician practice management experience. She can be reached at czwohl@gmail.com or 609-410-2932.

John B. Pinto is president of J. Pinto & Associates, Inc., an ophthalmic practice management consulting firm established in 1979. He is considered a leading author in this country on the business of ophthalmology. His latest book, “Simple: The Inner Game of Ophthalmic Practice Success,” available at www.asoa.org . Contact him at pintoinc@aol.com or 619-223-2233.