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Who’s On First?


A major contributor to medical office inefficiency just might be the dreaded Everyone's-Job-But-No-One's-Responsibility Syndrome.

A major contributor to medical office inefficiency just might be the dreaded Everyone’s-Job-But-No-One’s-Responsibility Syndrome.

Sad but true, sorry. Many practices tout their teamwork and the fact that everyone pitches in, but when this happens on a regular basis, inefficiencies and compromised outcomes can abound. And while cross-training and supporting fellow team members is a good idea, sometimes people pitch in at the cost of completing their own duties. The result? When a problem emerges, it’s hard to pinpoint who did what.

Does your office clearly define the responsibilities for which each individual is held accountable? For example, if Mark is helping Jessica manage a sudden spike in billing calls when his real responsibility is data entry and electronic claims submission, you must ask yourself if he is the right one to assist her. Does he have the skill, the time, and sufficient self-accountability? Can you track this accountability? These are important questions to answer. Also:

  • Clearly define the primary tasks for each position. Assign a back-up for each position, and be sure that person is well-trained to deliver a consistent outcome as a substitute without compromising regularly assigned work. Be careful here. How you distribute the workload in your office is critical to efficiency and profitability. Mismanaging these assignments can lead to frustration, errors, uncertain outcomes, a never-ending stockpile of work, poor accountability, and a loss of supervisory control -- not a pretty picture!



  • Allow people to be called away from their full-time duties to assist co-workers no more than ten percent of the time. Otherwise, you’re asking for trouble. Of course, the exception to this is when a new employee starts or you have an unexpected absence, but the disruption should be temporary and its impact closely monitored.



  • Re-evaluate your office processes to determine if each step is truly necessary and whether such steps are performed consistently, regardless of who is doing the work. Perhaps you’ll find tasks you can eliminate, refine, or automate. Indeed, one of the best ways to streamline paper processes and obtain reliable, consistent, and trackable outcomes is, without a doubt, through automation. Explore opportunities to refine processes through automation or perhaps with additional training. The investment will result in more efficiency and long-term cost savings.



  • When developing job descriptions and assigning tasks, delineate the time demands to accomplish the primary tasks for each position to ensure you’re being realistic in your work distribution and your expectations of each staff member.



  • During annual performance reviews, examine the job description for that position and proactively discuss it with the employee. Find out if she is struggling with workload issues and if the job description and distribution of the workload needs to be further evaluated.

Evaluating the essential tasks in the office, distributing the workload evenly, and making sure the tasks are performed consistently among staff will promote teamwork in a way that makes sense.


Judy Capko is a healthcare consultant, speaker and author of the popular books, “Secrets of the Best Run Practices, 2006” and “Take Back Time, 2008.” Her focus is practice operations and strategic planning with an emphasis on patient-centered strategies and valuing staff contributions. She is a popular speaker at both national and regional conferences. Judy is the owner of Capko & Company, www.capko.com, based in Thousand Oaks, Calif. She can be reached at judy@capko.com.

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