How to Create a Fair Wage Structure for Your Practice
Kelly Buchheit, CPA
Your practices’ wage structure can vary widely depending on whether your practice is new, with freshly hired staff, or is older, with staff that has been with the practice for many years. For instance, you may find your office in the awkward position of having a long-term medical receptionist who makes more money than a newly hired registered nurse. These apparent inequities can create resentment among staff and influence negative staff behavior. By utilizing a smart wage structure and policy, your practice can mitigate these risks.
Research and detail matter
Developing a fair wage structure requires adequate research and detailed job descriptions. For example, to determine appropriate pay scales for specific jobs, you may want to research websites, such as PayScale, Indeed and Randstad. Professional organizations also provide guidelines for pay scales, and many organizations take geographic variations of cost of living into consideration.
Maintaining detailed, up-to-date job descriptions on file enables practice managers to better understand each position’s job qualifications, experience requirements and responsibilities. All of these elements should play a role in the determination of a position’s fair compensation. Your practice should also allow room to “customize” pay if a particular employee’s expertise or duties surpass the bounds of his or her job description and bring extra value to the practice.
Benefits and perks help retain staff
It is also extremely important to consider the value of employee benefits, such as health insurance, paid time off and holidays, flexible scheduling and continuing education opportunities. You should also consider other, non-standard perks for employment, such as a casual dress policy, bonuses, trips or other incentives, as well as food benefits, such as pizza Friday or taco Tuesday. A strong suite of employee benefits can often be the determining factor for potential employees choosing your practice over another.
Compensation structures are key
After your practice has evaluated all of these factors, you can:
- Create a pay range for each position based on experience, education and unique skills;
- Decide on your practice’s level of pay transparency—typically, bonus programs should be transparent, but not individual salaries;
- Determine amounts for initial offers, starting with pay levels for basic skills and then adding soft skills, such as personality and emotional intelligence;
- Be willing to negotiate with potential and existing employees; and
- Get to know the Fair Labor Standards Act (FLSA) rules, which address minimum salary requirements for exempt and nonexempt employees.
These steps will go a long way toward helping you generate a fair wage structure and related policies.
Regular reviews keep staff involved and engaged
Finally, schedule regular reviews of not only each employee’s individual performance, but also of your salary and benefits packages. The results may require periodic adjustment based on inflation or the success of your practice, but if you are willing to do this, then your staff will understand that the success of the practice is directly linked to their success.
Improving the Efficiency of Your Practice
In today’s world, most business and medical practices do not suffer from being too efficient in their operations. In fact, many medical practices suffer from bottlenecks and redundancies that waste time and energy. These inefficiencies fall into several practical areas, such as the front office, back office and the physician responsibilities. Below are key areas to focus on in order to improve procedures and reduce waste.
Front office issues
The first area of focus is the front office, which is where patients experience their first interaction with your practice. The phone system, reception area and other front office functions need to be running smoothly and efficiently.
- Phone System
When the phone system is inefficient, patients become irritated and the completion of work by staff members is hindered. Consider how many phone lines you have and how many employees are responsible for them. Expecting an employee to staff more than two phone lines at a time may cause a slow-down. If you utilize a phone tree in your practice, pretend to be a patient and call your office to ensure that there are not too many options and that the options make sense.
In addition to the phone system, you should consider how messages and other communications, such as texts and emails are handled. Computerized systems can work well as long as there are methods in place to handle communications. For example, some practices color-code messages based on sender and message content—one color for sick patients and another color for pharmacy refills.
Many practices use paper intake forms. To improve efficiency, consider sending the paperwork ahead of time for patients to fill out prior to arriving at appointments. Even think about computerizing intake forms by utilizing laptops or tablets. Depending on the method used, make sure your practice has an efficient method for backup of data or storage of paper files.
- Appointment Confirmations
Confirming appointments definitely decreases the number of no-shows and is achieved through many different methods, such as automated phone calls, texts or emails. Many patients prefer an actual phone call, but the other methods should be used in conjunction with a call whenever only voicemail is reached. Studies show that phone calls one day ahead of time give too close of a notice, while calls approximately three days ahead of time are perfect.
Back office problems
Maintaining a well-oiled machine in the back office protects patient records and encourages practice growth through referrals.
Although electronic health records (EHR) and other programs permitting physicians to use tablets and pull-down menus may resolve many charting problems, other work is still required in order to maintain efficiency and accuracy of files. Staff members should ensure that tests results and referrals are recorded in patient charts prior to appointments. In addition, staff should prepare themselves for appointments by looking at charts for refills, screenings or preventive activities that may be upcoming for a patient.
- Tests and Referrals
Think about how your practice handles tests and referrals. Is someone assigned the responsibility of completing paperwork when tests are required? If particular tests are required on a regular basis, consider pre-printing order sheets. Implementing timelines laying out when tests or consultations need to take place can be helpful. These timelines should be communicated to staff members to enable them to better schedule appointments.
Although the front office and back office should run smoothly and efficiently, physicians are ultimately the ones responsible for setting the tone that encourages and maintains an efficient practice.
- Start Time
According to many consultants, a physician should strive to be at the office at least fifteen minutes prior to the arrival of the first scheduled patient. This gives the physician time to prepare for visits by reviewing paperwork, lab tests and patient histories.
To further increase the efficiency of your practice, consider making a structured schedule for duties and activities that you follow daily. Having a haphazard schedule becomes disruptive in a medical practice.
By focusing on increasing a practice’s efficiency, physicians can improve patient care and further profitability. Over time, this ultimately results in an increase in the satisfaction of both patients and staff members.