Could Adding Staff Members Improve Your Practice? Strategic New Hires Could Sharpen Your Competitive Edge
JASON FLAHIVE, CPA
Many of today’s practices are adding new positions to their organizational charts to better serve patients and sharpen their competitive edges. Assuming you have a valid need for these hires, as well as the payroll and benefits capacity to compensate everyone fairly, this might be a good strategic move for your practice.
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Several roles could make your practice more efficient. One idea is to create a call center where trained staff handle general incoming and outgoing calls using prewritten scripts. By taking on tasks such as appointment scheduling and appointment reminders, a call center allows front office staff to better interact with patients in person while still handling more complex phone calls as necessary.
Some practices have staff members who take on a role like that of a host or hostess in a restaurant. This person immediately greets patients when they arrive and escorts them to the exam room. He or she should avoid answering any medically-related questions, but can offer patients calm reassurance of quality care. The “host/hostess” usually updates the tracking board or system that indicates which patients are in each of the exam rooms.
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Quality and compliance
It may be a good idea to create a “quality assurance director” to track metrics on problems and mistakes in the practice and develop processes to prevent missteps or recognize them earlier. Another idea is to add a risk and compliance officer, either by creating a practice position or engaging an external consultant. This individual would address issues related to billing, reimbursement and HIPAA compliance. They could also oversee and ensure compliance with Occupational Safety and Health Administration requirements, Clinical Laboratory Improvement Amendments of 1998 regulations and other health care regulatory areas — such as the self-referral Stark law and antikickback regulations.
Easing the burden on physicians
Many practices are adding nurse practitioners or physician assistants to examine, diagnose and treat patients, including prescribing medication. Doing so can free up physicians to focus on more difficult, complex cases and keep up with the latest research.
When hiring either a nurse practitioner or physician assistant, be sure to clarify how much and what type of supervision you or another physician will be providing. Also, establish which diagnoses should be immediately referred to the supervising physician.
Some practices — especially larger ones — are integrating pharmacists and pharmacy techs into their operations. This staff person not only dispenses medications, but is also involved in dosage management, prior authorization and other aspects of prescriptions.
Finally, as electronic health records (EHRs) have increasingly become part of medical practice, complaints have arisen that physicians appear more interested in their computer screens than their patients. Some physicians are sympathetic to these concerns — they find the need to update EHRs during patient visits distracting and disruptive to providing quality care. One solution is to hire medical scribes who accompany the physician during the patient visit and document everything that occurs. Of course, this needs to be balanced against the possibility that having an additional person in the room may make your patient uncomfortable.
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It Is complicated
Health care is an increasingly complicated business with many pressures. These include seeing more patients in a shorter period, increasing efficiency through advanced technology and dealing with an intense regulatory environment. Having a more well-rounded and skilled workforce may help you grapple with these challenges.
However, adding staff will cause you to incur some hiring costs, as well as higher payroll and benefits expenses. So, it is not a move to undertake without careful research and discussion with your physician partners and professional advisors.
The Team Beyond
KEVIN P. OMAHEN, CPA
The medical team in any practice often ranges from the nurse that brings patients to their room, to the physician that treats the patient and can even include specialists or technicians. However, nonmedical staff members and external support providers play integral roles in many practices’ operations. Here are a few examples:
- Office Manager
Look at this person as the quarterback of the team. This person oversees the entire administrative function of the office. Without an office manager, the physicians lose valuable time treating the patients by being consumed by administrative functions. For the best results, provide your office manager with regular performance reviews, including 360-degree staff feedback, so that you can objectively assess whether he or she is getting the job done.
- IT Specialist
Too many offices are using the office manager or physician as the IT specialist. However, serious expertise is sometimes required. If you do not have a dedicated IT employee, consider engaging an IT consultant to handle any sudden or recurring IT issues. The specialist can also work to ensure all of your data is protected.
- Insurance Agent
It is not just employees that you should consider in this evaluation, also think about the outsourced help. An insurance agent who understands your practice (and you) can help you find the right coverage at the right price. He or she should also understand the risks and issues associated with health care in your specific area, ideally providing immediate and personalized answers to your questions.
- Marketing Director
Marketing is an important component of any successful medical practice. Unless the size of your practice would prevent you from affording one, you should strongly consider hiring a marketing-focused employee or engaging an outside firm that specializes in health care providers. For many smaller, one- or two-person practices, the cost of a full-time marketing staffer or marketing firm is not feasible. Nonetheless, you still need someone to develop internal and external promotional and marketing activities, coordinate campaigns, and conduct analysis and follow-up.
Medical law is complex and constantly changing. It also varies from state to state. Having a reliable relationship with a health law attorney can help you set up compliant practices, minimize risks and resolve legal problems if they do occur.
- Billing Specialist
With a small easy to manage the practice, you may be able to keep billing in-house. However, engaging a third-party provider to handle billing may be wise because health care insurance has complex and ever-changing administrative and regulatory compliance requirements. Keeping up with the rules and regulations can be a full-time job and not every physician practice can hire or retain someone able to do it. It also is time-consuming and can eat away at the physician’s or other staff’s day.
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