Assembling a Spine Office Medical Team

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Slide 1


Nicola V. Hawkinson, DNP


Spine Fellows SymposiumAssembling Your Staff

The practice of medicine is by far one of the most important fields in which people can work. Taking care of peoples health is such an important profession that it should have only employees who take pride in their job and want to come to work each week


ObjectiveThe Business of SpineCommon MistakesRemember your roots and what you need to growAssembling your staffThe cost of hiring poorlyRunning your practiceThe future of the Spine PracticeWhat SpineSearch can do for you


The Business of SpineJoining a practice

Starting a practice

Building a road to success


Your Practice is Your BusinessBest PracticeConsistent ProcessEqual accessGood faith efforts

You need to know how it works!!


Common MistakesI dont have to worry about.. Staffing, they supply me with a secretary..Accounting, the practice has someone they have used for yearsMalpractice, the group has a policyBilling, the practice takes care of itMarketing/PR, the practice/hospital will promote meStaff education, they have been there for years


Three biggest office mistakesNot



Dont forget where you came fromOr where you are going..

Strategize your 1st years goal, and 5 yr goals (short & long term)Write them down and have a formalized process to record your progressRevisit your goals/progress on a quarterly basis to keep yourself on trackPutting goals in writing makes them more likely to be realizedDont be afraid to share goal with staffAssign goals to every team member regardless of positiongive everyone something to strive for


Lessons LearnedNo one will care more about your business than you doListen to those that work with youInvite patient feedback, they are your customersSpending a little extra time getting things correct in the short term will reap large rewards over the long term


Employ the right number of staffWhy do we have staff?So MDs dont have to perform nonclinical tasks which lowers physician productivity.This is key to remember because there is a tendency to view employees as a cost. When budgets get tight we fire employees, MDs do nonclinical tasks and income drops more creating a negative feedback loop.However employing to many employees can just as big a risk as employing to few


How to know the right number of staff?

Asses the task of each provider (for multi-physician practices) and staff.Is a physician being interrupted for patient phone calls?Does each physician need a full-time RN, NP, or PA?Are employees in their knowledge areas?Are you appointment schedulers working in shifts so the phones are continually being answered?Are accounts receivables staff seated where they can concentrate or at the busy front desk?Are accounts receivables going past their average collection times or for new practices past the industry averages?


Compensation: This is only part of the package!Study after study has salary low on the list of motivating factors. Higher on the list are the ability to balance personal and professional life, a sense of purpose and meaning of work, trust among employees and a good relationship with the supervisor or manager.Know your staffWhat makes them tick???Ask them What is important to you?


Now key attributes for different age groups and any other charactersitics that might differentiate the staff of your office

Some examples: Baby boomers often strive for public and peer recognition, promotion and control in addition to higher salaries. Workers born after 1969 tend to place the following above salary; positive mentoring experience, continual challenges, continuing education.Given choice of extra time off or a monetary bonus younger workers often prefer time off


Keys to success with exisitng office staff and hiring new onesDefine job rolesForm Mentor/protg relationshipsDevelop a strategic plan for employees


Define job roles:Most jobs in a medical office are self explanatory right? A biller bills, a receptionist answers the phone, a nurse sees patients and assists the MD. On the surface perhaps, but consider this example: One of your top secretaries schedules 10 new patients to be seen on Monday. No one tell the rest of the staff and when Monday comes all hell is breaking loose in the office by 0900. The secretary assumes that the office manager will tell the MD, the RN, and other administrative staff to have all documentation and to leave a little extra time between other patients to handle the large amount of new patients for that day. The Office manager assumes the secretary will tell everyone, the MD assumes some one will tell him, and the assuming goes on and on. Without clearly defined jobs you have a problem on your hands!


Define Job RolesThankfully, there is a simple way to solve this problem. Each person on your team needs a job description.Job descriptions help to Clarify roles and responsibilities everyone knows exactly what they are supposed to do. Increase morale because its clear what it means to do a good job and what it means to go above and beyond.


Define Job RolesA job description will rarely be a laundry list of every single task associated with a job.

As a business owner you are responsible for defining the roles of those who work for you but you dont have to go it alone. Invite those currently executing the job to provide feedback on what they think their job is and what it should be. This can be a very revealing exercise!

SpineSearch has a vast amount of experience in creating useful and efficient job descriptions both from an institutional setting as well as an office setting. If you would like us to assist in helping customize job descriptions to help maximize efficiency in your office do not hesitate to ask!


Define Job RolesIn most cases, job descriptions do not need to be overly complex especially if you are a small company. A good job description will Explain the major functions, duties and responsibilities of the job. Highlight the specific skills that are most relevant to the job. Explain what its like to work in your environment.

What position have your employees been assigned? Do they know?


Define Job RolesFacilitate the recruitment process because the job you are looking to fill is clearly defined so it is easy to explain to prospective candidates.

Define career paths within your company. Those more junior can see what it takes to execute a job more senior to their own. Impact the bottom line. When everyone performs the necessary tasks you can be certain patients are being properly serviced so theyll come back to you again and again!!!!


Form Mentor/protg relationships

Use your strong staff members to assimilate, train and mentor new staff until they are up to speed with proper procedures. Although many medical practice administrators have graduated from rigorous academic programs, few in any, have left those programs with the wealth of skills that are needed for successful health care management. This matter is further compocated by the fact that in most cases, the health care industry does no provide formalized corporate training for its managers or any other staff. Utilizing a well trained office manager or other higher level staff member to bring new staff members along the e proper path is critical to getting what you want out of a new higher


Develop a strategic plan for employeesWhere there is a problem, the decision-makers in the medical group must take ownership and commit to improve the issue. Have a strategic plan of action to presenent to the MD, partners, or board of directors depending on the structure of your organization. .


Develop a strategic plan for employeesAvoid the temptation to fix the squeaky wheel employees with small increases or changes without have an overall plan.

Strategic Planning require evaluation of many areas to review thoroughly before developing a plan of action. Practice evaluation should include areas such as number of staff, work turnaround time, and volume of work in objective measures as well as employee surveys to assess their ideas for improvements. This type of approach prevents what is frequently called the Band-Aid fix, which brings only temporary solutions and may actually make the problem more costly in the future.


Develop a strategic plan for employeesMany times employers will rush into an overall salary increase as a plan of action to decrease turnover. As I have discussed previously salary increase is frequently not the best action plan to prevent t employee turnover

Ask questions, speak with multiple staff members, develop a well thought out plan before you act!!In addition to a strategic plan for situations that arise in your practice I would highly recommend developing a set of standard operating procedures for your office.


Standard Operating ProceduresSOP'sWe can spend thousands or even millions of dollars building an office, buying medical equipment, purchasing sophisticated software, hiring powerful marketing firms that will perform every day exactly as we want. We can adjust and modify all equipment, customize the software, consult with all the PR firms in the world and we can have an information system that gathers important data about every patient & insurance provider that is seen. But if we cant employ a workforce that operates the office consistently and efficiently then the whole operation will fail.Full adoption of the standard oper