There's no one-size-fits-all approach to a strong staffing model. That's one lesson Kimberly Gooden has learned during the more than two decades she has spent as practice administrator at Dermatology Consultants, P.C., a practice with three locations in the Atlanta metropolitan area. "Physicians are happier when they are able to utilize their staff in a way that's more efficient for them," says Gooden, who manages seven physicians, five physician assistants, and 79 support staff. "We do try to make sure that they have as much autonomy as possible, as long as it is efficient." Some of her physicians, for instance, prefer working with the same medical assistant throughout the day, while others enjoy switching assistants as they change exam rooms.
But it's not just physicians' preferences that require Gooden to take a flexible approach to her staffing model. When the practice implemented an EHR last year, Gooden hired more medical assistants to assume some duties as scribes. And when the practice became part of an independent practice association in which patient satisfaction plays a major role (if patient satisfaction metrics are too low the practice will experience monetary penalties), Gooden began using patient satisfaction reports to identify areas that needed improvement and to train staff to move customer service to a higher level. For instance, staff is focusing more on interactions with patients while escorting them back to the exam room during appointments.
Gooden's practice is not the only one experiencing big changes. Many of you are encountering new technologies, healthcare reform initiatives, and shifting reimbursement models. Just like Gooden, it's critical to assess your staffing model and priorities to ensure your staff continues to meet your changing needs.
That's where a staffing analysis comes into play. It's one of the most effective ways to determine if your practice has the right number of employees, and if your staff is doing the right things. We asked medical practice consulting experts to share some of their favorite staffing analysis strategies.
Prepping and planning
As with any major project, an important first step of the staffing analysis is to determine who will lead the project. While the office manager or administrator is the natural choice, Kenneth Hertz, a Medical Group Management Association (MGMA) principal consultant, says practices should encourage other staff members to get involved. "This is an opportunity to take some people in your practice that really shine, that have great promise, and to give them an opportunity, with coaching and mentoring, to really significantly help the practice and to get everyone involved," he says. "Maybe we need a front-desk person, maybe we need a billing person, maybe we need a clinical person, maybe we need a medical assistant or [a licensed practical nurse] or [registered nurse] ... We need to get them together and say, 'Look, this is what we're trying to do: We're not as efficient as we need to be and can be, and we'd like to get everybody to work together on this.'"
While physicians should not be in charge of conducting the analysis (this would be an inefficient use of their time), they should be aware of the project, its purpose, and its progress. This will help secure physician buy-in after you've completed the analysis and it's time to take action, says healthcare consultant Deborah Walker Keegan.
Once leadership and physicians are onboard, be open with staff about the project. Since they may equate "analysis" with "layoffs," encouraging transparency will help keep rumors and fears from escalating, says Richard Crici, chief executive officer of RJ Crici Consulting, Inc. "I don't think it would be a good idea to mention the fact that we're not cutting jobs, or we're not doing this to cut jobs, because you may in fact conduct this analysis and then it may lead you down that road," says Crici. "The better approach would be to say, 'We're conducting this staffing analysis because we want to make sure that we've got the right people, in the right places, with the proper tools to be as efficient as possible.'"