Carol Stryker

Of all the resources necessary to run a practice and care for patients, a physician's time is the only one that is irrevocably limited. While a practice can increase its capacity for patient care by adding a physician, the sole way for an individual physician to increase productive capacity is the more effective use of her time.

The bad news for maxed out physicians is that improved effectiveness requires thoughtful analysis of the status quo, as well as a willingness to make changes. The good news is that almost all of the analysis can be outsourced or delegated, and the changes improve the environment for patients and staff as well as the physician.

Here are six ideas for increasing physician capacity.

Tips to Improve Physician Productivity

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Some small changes at your practice can improve physician productivity, thus improving the environment for everyone.

How can a physician improve productivity and reliability, mitigate legal and financial risks, improve patient satisfaction and quality of care, and get home at a decent hour? An essential part of the answer is effective staff management, which is a big challenge in any business.

It is even more challenging for physicians because:

A provider is generally either out of the office or in an exam room with the door shut, so she has limited opportunity to observe office/clinic operations.

There is a wide gap between physicians and staff in regards to education, training, perspective, and job function.

Physicians would much rather focus all their attention on patient care.

Here are three elements of effective staff management. Each requires time and energy. Some require financial expenditures. Well done, however, they yield high returns - like any good investment.

Effectively manage medical practice staff

You may have noticed that there is a lot of overlap in the suggestions. The overlap is a very good thing. It means that, done intentionally, everything done to enhance one capacity enhances at least one more. For instance, an operations manual supports training, operational consistency, and management by system. In terms of cost, an operations manual can be expensive. In terms of value, it is a big bargain.

The physician does not need to provide this management directly, but she must provide for it and require it. Training, tools and systems can develop organically or with the help of a consultant. A nurse or medical assistant can provide most of the direct supervision and leadership, provided she is visible, actively engaged, and respected.

Not all of this can or should be developed and implemented at once. Attack the most critical areas first and build on successes. The truth is that the support for effective management is always a work in progress.

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Three elements of effective staff management that can lead to increased productivity and profitability and happier patients at your practice.

Telephone Etiquette Tips for Medical Practice Staff

Patient frustration and anger are generally the result of unmet expectations. It follows, therefore, that the fundamental task in improving patients' satisfaction is to manage and then meet their expectations. How your practice handles telephonic communication with patients provides four excellent examples.

Please note that none of the suggested strategies add any cost; most increase staff productivity, and some mitigate risk.

The principles presented apply to every interaction between human beings. Being aware of your patients' expectations, explicitly moderating them as necessary, and keeping your service promises is the key to increased and sustained patient satisfaction.

Meeting patient expectations is the surest way to increase their satisfaction with your practice. Telephone management is a good place to start.

Five Telephone Etiquette Tips for Medical Practice Staff

One of the most interesting things to me about physicians is their ability to make quick decisions.  Any problem directly in front of them will have their full attention for as long as it takes to observe the situation, pull information from their personal databanks, and process both.  My best guess is that this is a skill ingrained during their training.  (What does MD stand for?  MAKE A DECISION!) 

As necessary and effective as this problem-solving method can be, it does not solve physicians well in the management of non-medical tasks and issues.  A recent personal trip helps illustrate.

An important high school reunion for my husband was to be held outside Washington, D.C.  He responded immediately to the invitation, mostly because he only had to click "yes" and "send."  It was also easy to arrange a hotel for the visit because the Reunion Committee had made that just as simple.  That's where things sat for several months.

Several weeks before the event, we carved out some time on a Friday night, when we were both tired and frazzled, to make our airplane reservations.  We added some days after the reunion, but neither of us had more than a vague notion of what we would do with the time.

Time flew by and we were both overwhelmed with what needed to be done to avoid leaving anyone in the lurch while we were gone.  We had plane tickets and a place to sleep the first four nights and nothing else except structured plans for the reunion. 

Here are just some of the sub-optimal things we experienced after:

• It took quite a long while to decide on a rental car company, mostly because I was making arrangements for the next day and did not know the area.  I was doing it on my phone and did not have the benefit of a map for context.

• After a hard day of driving, we arrived at Kitty Hawk, actually Wright Brother National Memorial, just as its gates were being locked.  That meant the unexpected need to spend the night and visit the memorial the next day.  Who knew they actually lock up national parks?

• Not leaving Kitty Hawk until noon, we didn't arrive at Charleston, S.C. the next day until about 8 p.m.  This meant we disrupted plans with friends for a mid-afternoon arrival. Driving through Charleston during rush hour and later through some remote and poorly marked areas well after dark made for another very long, hard day.

•  The plan was to pick up the Blue Ridge Parkway at Ashville, N.C. and check out the foliage.  We got there just as the visitors' center was closing and learned that lodging was going to be a problem.  We ended up sitting in the parking lot at dusk, looking for a room.

• We did find a room, but it was thirty miles south and pretty substandard.  It was noon the next day before we got back to the Ashville visitors' center.  Basically, we'd lost close to a whole day.

• We had such a good time that we decided to keep the car an extra day.  That meant calling the rental company.  Unfortunately we were in a part of the parkway that has no cell service.  I had to beg a landline from one of the concessionaires.  After working my way through the rental company's automated answering system, it told me it was too late to extend the rental through the automated system.  I had to start over again and ask for an operator.

• We returned the car to Reagan National and took the Metro to a stop near our next hotel.  When we asked them to come pick us up, they said it would be half an hour because the driver was on a run to Reagan.   It had not occurred to us that we could be fetched there, but all we had to do was ask to find out.

• None of the bumps in the road individually did serious damage to what turned out to be a great trip. 

• All of them taken together wasted a lot of our limited time and increased our costs.

• The snags could all have been avoided with just a little bit of prep time on our part.  The benefits would have significantly exceeded the effort expended.  We just did not carve out any pre-trip planning time.

A medical practice is far more complex, and the costs and frustration are monumentally larger.  This means the effort to plan ahead and deal with things in context is even better spent.

Doctors are used to making quick decisions, but when it comes to some tasks, you have to think ahead. Prep time is your friend. 