Article Date: 8/1/2010

The Ebb and Flow of Staff Workloads
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The Ebb and Flow of Staff Workloads

It's time to update staffing models that are based on practice dollar volumes.


We all seem to have days when we find even our most dedicated staff person playing solitaire on the computer because no patients are in the office, and most of the "busy work" on their to-do list has been completed. Of course, the next day you feel as if a bus load of patients all show up at 2:15, and you could have easily used four additional staff members.

Staffing for the inevitable ebb and flows of patient care is challenging. Here are two concepts that can help with this challenge.

Beyond the classic model

The classic model of staffing hinges on the dollar volume of a practice. For example it's reported that on average, practices have one staff member for about every $150,000 of collected revenue. The two problems with this approach: First, it's a report of how things are, not necessarily how they should be. Second, the number is an average. If your practice aspires to generate a higher net by reducing staff costs, instead of shooting for the middle-of-the-bell curve, you should attempt to achieve a higher value than average. Or, if you designed a high patient volume/low revenue-per-patient practice model, you might never achieve the average — nor should you try.

Instead, try this approach. Conceptually, regardless of how your practice is configured, you'd like every patient who enters your practice to be tended to as soon as they approach the front desk, or in a more Utopian practice, immediately greeted as they pull into your parking lot.

Throughout their journey in your office, it would be ideal if patients always had a connection with a staff person or doctor. The result would be a more efficient experience for the patient, which should translate to a very satisfied patient — and, therefore, typically higher revenue per patient. Simply, if you attend to patients' needs every step of the way, they should be happier, and, therefore, more comfortable spending money in your practice than before.

So, in addition to measuring revenue per staff person, measure the amount of time the patient spends in your practice. Also, look at how long the patient waits to be seen at each "station stop" (check in, pretesting area, exam room, frame selection, check out), and look for trends. You'll typically see that the longer the delay is at any "station" (due to lack of staff), the less the patient spends in your practice. If the trends are solid and continuous, it's time to hire more staff.

Schedule carefully

The second concept: Take a careful look at how you schedule appointments. In a goal to maximize existing staff resources, make sure your staff is controlling your appointment book instead of your patients. So, rather than saying to a patient, "When would you like to come in?" teach your staff to offer appointment slots that will maximize office flow and reduce chaos. This certainly takes time, training and templates (that should be based on the data you collect from above), but it's well worth the effort. One caveat: Be sure to avoid limiting desirable time slots available in your quest of trying to maximize your template, as doing so may alienate patients.

A better chance

If you control the appointment book, you have a better chance of achieving your template and ultimately reaching your goal of your patients being tended to sooner and more efficiently — something that will lead to higher revenue. OM


Optometric Management, Issue: August 2010