Kenneth Hertz


Generally, the front-office staff is the first contact the patient has with the office, as well as the last. In these times of increased consumer knowledge, the customer service we provide can set us apart from our competition. 

But the front-desk staff is tugged in many directions: answering the phone, checking patients in and out, verifying current demographic information, collecting copays, calling to remind patients about appointments, dealing with pharmaceutical reps and other vendors - you get the idea. 

So what to do? Here are a few tried and true methods for improving your customer service in the front office:

 - Make sure that your staff receives sufficient training on using the practice management system, scheduling, reading accounts, phone manners, and customer service skills. And once is not enough. Training should be ongoing.

 - Create a distinct position to handle incoming calls, so that others on the front desk staff can focus on the needs of those customers actually in the office.

 - Make sure that your front-desk staff knows the answers to common questions, including office hours, directions to the office (including how to get there with public transportation), where to park, what insurance you take, and so on. If your office has an active intranet, post the information on that. If not, provide an answer book listing answers to the most frequently asked questions.

 - A mystery shopper can provide valuable feedback on the way things really work at your reception desk.

 - Try calling into your office’s main line to gauge how patients are treated. Also, spend a little time sitting in your own waiting room. See what the patients see, and hear what the patients hear.

 - Simple, huh? But so often skipped. Teach your staff to thank your patients. And while they’re at it, why not have the staff ask patients if they have all of their prescriptions, or if they have any questions that could be answered before they leave? That one step alone can save countless telephone calls later in the day.

 - This is the one that you should do to show that you notice the efforts of your front-desk staff. Take time to learn their names, chat with them, and acknowledge the contribution they make to the office. Your positive attention will work wonders, guaranteed. 

Bottom line: Never doubt the importance of your front-desk staff and the impact they have on your patient base. Keeping patients is far less expensive than securing new ones, and you need your front-desk workers to help keep them. With just a little effort and training to get the front office on board, you will have patients singing your praises and spreading the good word about the superb customer service at your practice. 

is a senior consultant with the MGMA Health Care Consulting Group. His special interests include operational improvement, practice analysis, strategic planning, and strategic marketing. He can be reached at 

This article originally appeared in the March 2008 issue of Physicians Practice.

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“Doctor’s office - please hold,” is not what anyone wants to hear when calling your practice, especially for the first time. Teach staff how to handle your calls properly.

Physicians Practice Pearls: The Value of First Impressions

You take your car in for service periodically. Maybe you even schedule a yearly physical for yourself. But be honest: Do we ever take the time to give our practice an annual check-up? Probably not. Every day we are so busy putting out fires and taking care of daily crises that we never take time for a basic check-up. The end of the year is a perfect time to do this. But how?

I suggest you take a broad view and drill down by asking questions, like this:

Was the practice's performance this year consistent with our vision, values, and mission?


What were our accomplishments? Our failures? What lessons can we learn from both?


How did our practice react to changes in the healthcare environment?


A practice is like a living organism. Did our practice grow this year, or is it dying? There is no "stayed the same."


What did we do to grow our practice? Were we successful?


How did our board function? Did we have participation from our physicians? Did we develop new leadership?


Are we a patient-centric practice? How do we know? And if not, why not, and how can we become so? 

Did we perform as a finely tuned orchestra, or as a cacophonous garage band?


Did we meet our financial goals? Did we even 

Do we have the right staff in the right positions doing the right things? What are the opportunities for improvement?


Did we work to improve our processes, and to increase effectiveness and efficiency?


Have we evaluated the manager and her performance? Have we set goals for the coming year? 

Have we analyzed the revenue cycle from start to finish?


Have we looked at each process to determine its level of effectiveness and efficiency?


Have we reviewed our data acquisition accuracy?


Have we analyzed our payer mix, contracts, and payer relationships?


Have we focused on our KPIs (key performance indicators) and benchmarked our practice against "best practices?"


Are we maximizing the features and capabilities of our practice management system? 

Have we checked our compliance documents within the last year?


Are we up-to-date on HIPAA training, OSHA training, etc?


Have we developed a matrix of all our insurance policies? Does our coverage still suit our needs?


Are our personnel policies and files up-to-date?


Are we current on employee evaluations? Do we need to re-evaluate our job descriptions?


When was the last time we analyzed our phone bill, to ensure that we aren't still paying for the five phone lines that we supposedly terminated three years ago?


How effective are our programs to build employee morale and recognize outstanding contributions? 

You get the idea. Be your own diagnostician; it's worth the time it takes. Evaluate the results and make appropriate plans for the coming year. Good luck!

Kenneth Hertz, CMPE, is a senior consultant with the MGMA Health Care Consulting Group. Mr. Hertz has 30 years of management experience within the healthcare industry and not-for-profit sectors. His special interests include operational improvement, practice analysis, strategic planning, and strategic marketing. He can be reached at 

You take your car in for service periodically.

Let's Get Physical

We must never stop learning. Sure, there are fires to put out and problems to solve every day, including unhappy patients, squabbling staff, difficulties with insurance companies, and the like. Nevertheless, you have a responsibility to yourself and your staff to continually grow and develop, both personally and professionally. But how do you find time to learn more about running your practice when you're in the midst of it all every day? 

Join your local- and state-level medical organizations.

 Also consider joining the Medical Group Management Association or the American Medical Group Association. Use these groups to network - one of the most robust methods for growth. Learn from your peers - not only how they have solved problems, but also 

 programs they've attended, books they've read, etc.

 Magazines, books, e-zines, Web blogs. Don't just focus on healthcare. Stay on top of business books dealing with issues medical administrators face every day, such as financial management, human resources, benchmarking, branding, and so on. Work in some face time with 

 Remember that staying abreast of what's happening in healthcare is important, but don't narrow your focus so much that you miss out on conventional business thinking.

Form a discussion group with your senior practice leaders.

 Circulate selected readings for discussion. Or, you could even develop such a program with other leaders in your community, tailored to whether you're a physician or an administrator. Meet once a month or once a quarter - whatever works for you - to swap information and ideas. Make sure you listen, 

 listen, as well as talk. Remember the cliché: "That's why we have two ears and only one mouth."

 There are so many opportunities today for physicians to learn and to share information with their staff. You can even download podcasts on subjects of interest and listen to them while commuting. (Read the 

," if you're unsure how to use such technology.)

Take care of your mental and physical health.

 Sound trite? Perhaps, but still valid and important. Take time for vacation and relaxation. You need it to recharge yourself. Get some fresh air, listen to music, put plants in your office, and talk to the goldfish. 

Personal and professional development is essential to growing a dynamic practice. Indeed, maintaining the status quo should not be an option in today's ever-changing business climate. Clearly, you want to make sure that you and your staff are always growing. It's a journey you should start today.

Journey to the Center of Yourself


Not every practice I work with has a budget (for shame). Even those that do often start with last year’s actual financial results, add a percentage, and poof! There’s the budget. So what’s wrong with that approach? It’s not realistic, and therefore, not helpful. Key issues change annually in every practice. You must take this into account, and aim for true, expected goals, rather than just maintaining as before, with a slight across-the-board adjustment. Here’s the right way to budget: 

 From that, create an operating plan that supports the strategy. 

 What are the providers expecting for compensation? How many providers will you have? Will their practice patterns change? Will one be transitioning to retirement? Will another now take two afternoons off per week instead of just one, as he did last year? Are you adding more staff? How will you handle raises? Are you adding Saturday morning hours? And what about the Medicare cuts? What new procedures will the practice do to make up for this shortfall? 

Make sure all physicians concur with the listed assumptions.

 Discuss them all in detail. This will greatly ease the actual budget generation. 

 Your practice’s needs surely shift with the seasons. Make your budget reflect this. Otherwise, it loses its effectiveness if it simply shows an annual figure divided equally by twelve. 

 Keep drilling down for details that you can list as assumptions. The more information you have the more accurately you can determine a “price tag” for the year. 

Scrutinize last year’s actual (not budgeted) numbers.

 You may discover bookkeeping errors, which, of course, you don’t want to carry over to the next year’s budget. For example, while reviewing the financial statements of one primary-care practice, I noticed that the costs for insurance seemed awfully high. The general ledger quickly showed me why: The bookkeeper had been posting payments for employees’ health insurance premiums to this category, but also any payments made to insurance companies for overpayments, patient refunds, and so on. Blindly transferring last year’s so-called “actual” figure for this category would have resulted in a gross inaccuracy. 

If you follow these steps and create an accurate budget for the upcoming year, bravo! But remember, your budget is only effective if you refer to it regularly. If your management software does not already provide it, create a monthly Actual vs. Budget spreadsheet report. These comparisons will reveal issues needing your attention. Make sure you generate this report by the 10th of each month, as financial performance information tends to reveal problems that have already occurred. Target and resolve issues quickly to keep your finances on track so you’ll achieve your goals for the year. Good luck! 

a senior consultant with the MGMA Health Care Consulting Group, has 30 years of management experience in the healthcare industry and not-for-profit sector. He can be reached at 

This article originally appeared in the October 2007 issue of Physicians Practice.

Here’s the right way to develop your annual budget.