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How physicians can increase productivity at their practice by utilizing staff


Fees aren’t going up, but many of your medical practice expenses are. Look to greater efficiencies to eke out more from reimbursements.


Judy Bee

Working longer or faster are not good options and can have deleterious effects. In fact, a physician should only see as many patients as he or she can while maintaining high standards of service and clinical care.

Some physicians think they have to do everything. Not so. Getting the right help, on the other hand, can increase reimbursements and ultimately improve the financial state of the practice.

But to achieve this goal, most physicians need to organize their practice operations and staff.

Rule #1: Physicians should not do work that a lower-cost worker can do.

A physician should work at the highest level of licensure all the time. That means there must be others working alongside the physician who are working toward the same goal at the same rate. Using a registered nurse to room patients, take vitals, and clean specula is a waste of training and money. A medical assistant is trained to do those tasks and many more.

In a practice with three physicians and three assistants, it might be wise to hire one credentialed nurse to handle patient education, clinical call backs, and triage  to relieve the other two medical assistants and keep traffic moving and physicians on time.

In many practices, everybody does everything. This approach degrades production and squanders much of the strength of the team as it relates to skills, education, and judgement.

An orthopedist once told us that the perfect patient was “prepped, draped, and anesthetized.” Efficient physicians deserve to have a patient ready to be seen-all records available, and instrumentation/supplies within 30 inches-every time. That keeps the physician moving.

In some cases that might mean that one physician needs two medical assistants because the patient’s time with the physician is limited. A fracture care patient, for example, needs the cast removed, an x-ray, and the cast reapplied. If one well-trained assistant is doing the cast work, she cannot keep patient traffic moving. The physician visit is brief: evaluate the healing, give directions for the cast, and decide when to see the patient next.

Think about your patient volume and make decisions about whether more duties can be delegated to your assistants.

A word about education

Patient education is crucial for both treatment compliance and efficient productivity.  To assess your process, ask your front-office staff how many patients come to the desk after the clinical encounter with more questions. If the administrative personnel are trying to answer clinical questions, or if they are fielding numerous calls from confused patients the day after a visit, you know you have a problem.

One successful approach uses a well-trained staff member to reinforce a physician’s recommendations and answer other general questions after the physician leaves the examination room.

Use easy-to-understand literature, wall charts, and models. Teach your staff how to communicate with patients too. Let them shadow you to learn.

The intended result is better-educated patients with fewer incoming phone calls.

The use of “well-trained staff” implies an investment of time and patience from the physician to get staff up to speed.

Remember, the work needs to be done, but it doesn’t all have to be done by the doctor.


Judy Bee is a practice management consultant with Performance Practice Group in La Jolla, California. Send your practice management questions to medec@advanstar.com.


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