A reader asked me to comment on Saturday office hours, and all the staffing problems that it presents. Like so many areas in practice management, there is not simply a right and wrong answer to the question of having the office open on Saturdays. It's a decision that practice owners must make - and the decision to offer these hours could change over time.

Convenient hours (for patients) is a classic example of marketing. As such, I think the decision should be made based on whether or not the owner wants the practice to be in a growth mode. If you think you are in a growth mode, ask yourself how much of a growth mode? How badly do you want to build the practice? How quickly do you want gross and net revenues to grow? This question requires serious thought - and partners need to come to an agreement on it.

The rest is easy. If you are in a serious and aggressive growth mode - then the practice should be open on Saturdays. Fulfilling as many patient wants and needs as possible is the key to marketing. Hours such as 9 to 1 pm are usually sufficient to satisfy patients and it makes the office a little easier to staff and it avoids lunch breaks. On the other hand, if you are perfectly happy with your present patient volume then you may be able to simply be closed on Saturdays. Patients will adjust.

I have heard doctors say that Saturdays only bring lots of no shows anyway - but I do not find this to be the case. Saturday appointments in my office are the most demanded of all and we produce big income numbers on Saturday. Common sense tells me that people like to take care of errands and doctor visits on their day off from work.

Keep in mind that being open on Saturdays does not mean the doctor owner must work it personally. Consider these ways to provide some patient service and still let the doctor take the weekend off.

• When you bring on an associate doctor - have the new doctor take Saturdays, which will help fill his or her schedule
• Have the office open with technicians only for eyeglass pick up and adjustment
• Have the office open every Saturday with technicians on duty - but have the doctor only schedule patients every other Saturday.
• Some doctors do Saturdays in the winter but not the summer, or the office is completely closed every other Saturday. I prefer to not require the public to have to remember too much. I hate to have them make a trip to the office during usual office hours and find the door locked.

• My group practice has a large staff and we allow all staff to rotate Saturdays off. They work 2 and then are off 1. We give each person a schedule with "A, B or C" Saturdays, and then we mark each Saturday on the calendar as A,B or C. This does allow staff some Saturdays with family, and they can trade with a co-worker for a specific Saturday off if they need it.
• We require all full time employees to work Saturdays. You may need to "grandfather clause" a few if you are just starting Saturday hours and don't want to lose someone who simply won't make the change - but all new people should work it or they simply cannot be hired. I believe in fairness in all office policies and I try to apply as much as possible across the board.
• For not so large of a staff - consider part time employees, like students, who may be able to work every Saturday.
• If you have enough other good things offer in employment - salary, benefits, friendly environment, etc. you can find staff to work Saturdays.