On any given day in a busy medical practice, we are all subject to ever-increasing demands for same day care, refilling medications, scheduling procedures, etc. Busy physicians in private practice must continue seeing patients on the schedule and at the same time, we must be aware of the above patient requests and ensure that our employees are all working together for the common good of patient care. How best to keep this cycle moving in an efficient manner is a very challenging task.
In my practice, I am the only physician and I have two nurse practitioners (NPs) that work for me. The nurse practitioners have their own panel of patients; however, this panel is considerably smaller than my panel of patients. As a result, I rely on the nurse practitioners to be available to see patients who call for same day service and acute illnesses. Not only must I continue to care for the patients on my schedule, but I must keep my schedule flexible so that I am available to discuss patient care with the NPs and see any patients that they require assistance with. For almost eight years now, this practice has worked very well and has produced a very high level of patient satisfaction. As patients exit the office, they are encouraged to go ahead and make an appointment for follow-up care. However, some patients are reluctant to do so and after many weeks of procrastination, when they call back for same day care this typically results in an encounter with the NPs.
Each nurse practitioner and myself have one licensed practical nurse (LPN) that works with us to assist with patient care. I have one float LPN that is available for administering vaccines for walk-ins, allergy injections for same day visits, and fingersticks for INR measurements. I try to keep the daily schedule from resulting in excessive work, not only for myself, but for the nurse practitioners as well. This careful work balance allows each of us to feel as if we are staying busy, but at the same time, prevents any one of us from feeling as if we are pulling more than our fair share of the workload. This careful balance has produced a very high level of job satisfaction not only for me, but for the nurse practitioners as well.
The nurses are encouraged to pitch in and help out their co-workers when the patient load starts to increase. Since the NPs have a lighter schedule than me, I am able to use one of their LPNs, or the float nurse to assist with patient care or other responsibilities. While one nurse is getting a patient ready for me, another nurse is filling out physical forms or possibly preparing vaccinations for administration. The nurses all work very well together and this sharing of job functions has also produced a very high job satisfaction rate for each of my employees.
One must not forget the increased strain and stress of the clerical staff. I have two front desk employees that are busy with patient registration, check in and checkout, scheduling of follow-up visits, and patient referrals. During times when the patients are all placed in their rooms, if any of the LPNs have any downtime, they assist the front desk staff with scheduling or referrals. This has worked very well with also producing a very high level of job satisfaction for the clerical staff. Whether the patient sees me or one of the nurse practitioners, the nurses and clerical staff all understand that each patient does not belong to just one provider, rather each patient belongs to and is the responsibility of the medical practice.
It is very important for the physician to ensure that each employee is working efficiently, but not overwhelmed by the current task(s) at hand. Operating a primary-care medical practice can be a very challenging but rewarding occupation. Taking time to understand the duties of each of your staff members and provide the appropriate back up when needed is crucial to operating an efficient practice. A practice that operates efficiently will result in timely patient care, effective patient care, and ultimately will result in the most coveted outcome for a medical practice — a positive word-of-mouth recommendation. Patients can very easily spot an employee that is not happy with his/her job. When your employees are working well together, patients will perceive this and ultimately your outcomes will be positive as well.