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Does your front-desk staff draw patients in - or turn them off?

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These employees can make or break a practice. So why do doctors hire too few people and underpay them?

Judging by the number of tasks you ask your front-desk staff to perform-greet and register patients, answer phones, schedule appointments, check coverage, collect fees-they could easily be your most important nonclinical employees.

And yet, in too many practices, front-desk personnel are treated as afterthoughts. Too often lacking the proper training and supervision, earning too little, and working amid barely contained chaos, they end up performing poorly and alienating patients.

But a smoothly running front desk isn't just good for patient relations-it's also hardwired to a practice's bottom line. "I tell my doctor clients, 'Your front-desk people have your wallet upside down in their hands, and they can let money fall out quite easily,' " says Keith Borglum, a practice management and marketing consultant in Santa Rosa, CA.

Do you have too few people doing undoable jobs?

Let's start with staffing. If you're a solo practitioner running a moderately busy practice, you can probably get by with just one person to handle the full range of front-desk tasks, including phones and checkout. "This person can probably process 30 patients a day before the wheels start to fall off," says Judy Bee, a practice management consultant in La Jolla, CA.

If volume in your practice increases-because, say, you've hired a nurse practitioner who also sees patients-you'll need to add another front-desk staffer, someone you can use in one of two ways: to answer phones exclusively or to take over either the greeting or checkout functions. If the latter, require that she share telephone duties with her colleague: Person A answering one line, Person B the other.

If yours is a larger practice, how you organize front-desk operations is critical. "If you have a badly organized work environment, you simply can't tell whether you have good workers or not," says Bee. "They might be perfectly fine if they weren't running around like their hair is on fire."

Too often, Bee says, the people working at the front-desk are expected to do too many tasks, making them disorganized and frantic. In a busy four-doctor practice, for instance, where volume may easily exceed 130 patients a day, a well-organized front desk should comprise:

Ideally, each of these employees should be cross-trained to take over someone else's responsibilities in a pinch.

Not every successful practice follows this model, however. At Beavercreek Family Medicine in Dayton, OH, for example, there's a designated receptionist for each of the practice's four physicians-someone who handles all front-desk tasks for him, from scheduling to checkout and everything in between.

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