Does Your Practice Have Adequate Staff?

It’s hard to believe that anyone would deny the pandemic was responsible for an impact on revenue and staffing issues, including both layoffs and resignations. It brought about face mask and social distancing protocols, a surge in telehealth and fewer face-to-face visits. Yet, can we also blame a virus for a sudden lack of communication skills, inefficiencies, diminished customer service and inadequate staff?

If you have put on your patient shoes and visited a medical office recently, you may have noted differences in how the office functioned pre- and post-pandemic. Many of the in-office preventative measures put in place (reluctantly, but necessarily) have removed the “norms” that patients have come to expect. Patients didn’t like the changes, no one does, but under the bright light of reality, most understood and accepted. That is, until those changes resulted in poor customer service.

My friend went to her doctor for an annual physical, delayed thanks to COVID-19 by almost two years. She shared with me an unacceptably negative experience and the reason she now seeks a new practitioner.

“Used to be I’d call to make an appointment and after one or two rings, the receptionist would answer and schedule a convenient time. Now, I call and either no one answers or after many rings, I am connected to the answering service who then directs me to call back again because `someone must be in the office.’ I call again – nothing. Lately, it seems to take two days to reach someone in the office.” (Strike 1!)

“Used to be I’d arrive for my appointment on time and head right into the office. Now, I must call from my car and wait to hear that it’s okay to come in. I called. Again, no answer. I waited and called again. This time, surprise! Andrea, their long-time, well-trained, experienced RN, answered the phone and in a rushed voice (not like her) instructed me to ‘Come right in.’  I could tell she was under pressure”. (Strike 2!)

“Used to be there was a receptionist and two nurses moving patients along. I’d walk through the door to a friendly greeting. Now, it is just Andrea, a generally happy face of the practice running back and forth. No one else to help. Apologizing that she is all alone, she rushes me in and leaves, scrambling to cover all stations – front desk, rooming and setting up patients, cleaning, answering phones, making appointments, taking blood pressure, blood work-up, patient updates, discharging duties, collecting copays, etc.” It’s no wonder phones aren’t being answered. How many patients went elsewhere? (Strike 3!)

“Used to be I had the doctor’s full attention when he entered the treatment room; now I share time with his portable computer getting rolled all around the room. He was quiet (to a fault), reluctant to look me in the eye, and his touch was tenuous, I couldn’t imagine him concluding whether or not I actually had a heartbeat. True, his lack of attention and communication skills were never exceptional, but now worse than usual. I find I put more trust in Andrea than I do in him. In spite of her circumstances, she made every effort to keep things running smoothly. A hero in my eyes and the reason I’ve stayed with this doctor, until now.”  (uh, Strike 4?)

Let’s face it, there are a lot of factors at play, affecting all businesses. But I wonder…does the reason that a successful pre-pandemic practice spirals downward have to be because patients do not “feel the love”? Patients (like my friend) will leave a sinking practice and a doctor who appears unaware of operational inefficiencies in search of an office that recognizes qualified, pleasant staff are very much the mark of a successful one. Moreover, it can be just as disconcerting for patients to watch and feel the effects of reduced/scattered service as it is for the conscientious, qualified staffer, desperately trying to maintain professionalism, while keeping the office afloat on his or her own.

We all recognize that early in the pandemic, patient visits evaporated; employee layoffs followed as part of an ugly reality. However, we are slowly climbing back into some degree of normalcy and patient load is bouncing back. It is a mistake to assume that bargain basement staffing continues to be a reasonable way to run an efficient, productive, successful practice.

How many staff are right for your practice? One way is to determine your payroll ratio. A typical benchmark can range from 22 to 25 percent of gross revenue (although that will vary depending on efficiency output). Look at your finances, pay close attention to what your patients tell you and monitor the effectiveness of your work processes. These will help you decide how many staff you can afford – and how many you cannot afford to do without.

Ms. Homisak is the President of SOS Healthcare Management Solutions in Federal Way, WA.  She completed a Health Coach Training Program from the Institute of Integrative Nutrition, and received certification as a Holistic Health Practitioner from the American Association of Drugless Practitioners.