Recently, we worked with an OB/GYN practice that had taken some big steps to reduce staff costs.  In particular, the practice was concerned about their long-standing process of providing new maternity cases a lengthy consultation with an RN — covering all the information a newly pregnant woman would need, and offering her a relaxed opportunity to ask questions.  Because the RNs were paid at $22-$25/hour, the practice manager and managing physician partner felt that these consults were an extremely wasteful expense.  They reasoned that the consults could be easily incorporated into the initial physician visit — adding 15 or 20 minutes to the visit, instead of paying for 30-45 minutes of RN time for the consult.

The maternity visit with an OB would be included in the patient’s global payment — no additional revenue would be generated by adding 15-20 minutes of physician time to the visit.  But, the practice reasoned, they would no longer be incurring the RN costs of $15-20 per consult — and, since the revenue was the same either way, the impact would be bottom-line positive, right?  Wrong.

What the practice failed to consider was the opportunity cost of tacking 15-20 uncompensated minutes onto the physician visit.  While the practice no longer had to pay an RN $15 to discuss pre-natal vitamins and exercise with maternity patients, the practice was giving up 15-20 minutes of provider appointment time — time which could potentially be billed out at much more than $15 if it were used for an additional patient visit.

 Provider time is a practice’s most precious resource — it’s the only means the practice has to generate revenue.  Using providers to do tasks that can be done by an RN or MA almost never makes economic sense for a practice.  Plus, taking higher level tasks away from your RNs and MAs deprives them of the satisfaction they get from those activities.  Keep everyone — especially your providers — utilized at their highest potential, and you’ll keep everyone more satisfied with their roles and your practice more profitable.

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