Many practice managers do anything to keep staff busy — lest doctors see them “doing nothing” and start to believe they’re overstaffed.

It’s admirable to want to get the most from the team, but obsessing about staff utilization to the point of burdening them with unnecessary tasks is a pitfall.  Here’s an example: recently we worked with a practice that had very busy phones — it was a psychiatric practice, and more than 80% of the calls were about prescriptions, and needed to be handled by the prescriptions nurse.  The practice had experimented with a phone tree that allowed these patients to connect directly to the prescription nurse — cutting down patient wait times substantially.  But, once they did this, the front desk was somewhat less busy since they no longer needed to answer these calls and put them on hold while hunting down the prescriptions nurse (or taking a message for her).

The doctors at the practice were concerned about the perceived ‘down time’ — even though patients were being processed more attentively at the front desk, and with less waiting.  So, they rationalized that the phone tree should be disabled, and that the front desk should answer all calls first, then forward them as needed.  Once the receptionists began answering every phone call — often putting them on hold while dealing with the patient in front of them — they certainly seemed less ‘idle.’  But, patients in the office waited longer to be checked in, patients on the phone had to wait to be connected to the prescription nurse (or her voicemail), and the front desk environment was much more stressful.

Worst of all, this artificial burdening of front desk staff meant that all staff were now perceived to be fully “utilized” — i.e., no one was available for additional projects or important additions to their job content.  On our visit to the practice, one of the first things we noticed was that the front desk was doing a poor job of collecting co-pays (routinely billing them instead of collecting them at check-in).  Naturally, we urged the practice to work on this — to which the manager responded, we’ve tried, but the front desk is so busy, we can’t do it without more staff!

If the practice hadn’t been so obsessive about avoiding even the smallest bit of staff downtime, more capacity would have been easily available for the (much more important) task of properly collecting at the front desk.  And the same thing holds true for other needs that come along in the life of a practice — whether that’s the ability to take a little extra time on the learning curve for a new EHR or PMS, to consider ways to improve patient intake forms, to educate patients about a new portal or reassure them about a referral to a specialist.  A little bit of downtime needn’t be considered wasteful — it could instead be thought of as a small reserve of resources your practice can use to take advantage of future opportunities to grow and operate better.


Laurie Morgan

Laurie Morgan

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Laurie Morgan

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