Here are four tips for successfully managing staff at orthopedic practices.
1. Control overtime expenditures. Although overtime is sometimes needed, it can also be a major driver in staffing and labor costs for practices, says William R Pupkis, CEO of Capital Region Orthopaedics in Albany, N.Y.. If practices are experiencing routine spikes in the number of overtime hours, they may need to try a few approaches to reduce this expense. Scheduling issues often are drivers of overtime costs, especially if a practice or a physician is not prepared for a flux of patients, Mr. Pupkis says. "It is the responsibility of management to provide support to the physicians. If he or she is unable to manage it, then we must do so in their stead," he says.
Using shared human resources employees, such as front desk staff, to relieve FTEs is one way Mr. Pupkis' practice has offset some of their overtime costs and has helped to support physicians in seeing their patients. Another concern is that many staff members may come to depend on the extra income generated by overtime hours and may not react well when told this income will be cut. "This can be another aspect of overtime that can backfire," Mr. Pupkis says. You could end up losing a valuable employee. Remember, you lose the good employees first because they can get a job anywhere, and most probably for more money.
2. Ask staff for cost-saving ideas. Employees at the Institute are actively encouraged to share their ideas for cost savings and are used to gauge proposed opportunities. Actively soliciting employees for process improvement ideas has reduced costs in a number of areas at the practice, including costs associated with the use of disposable coffee cups and photocopies, says Les Jebson, executive director of The University of Florida Orthopaedics and Sports Medicine Institute in Gainesville. "As our costs continue to rise and our compensation and collections flattening — it is simply not an option not to actively solicit and incorporate solutions for working more efficiently, without compromising quality."
3. Train staff now for future efficiency. Employees with downtime present a great opportunity to enroll them in training courses that hone their skills and make them more efficient in the long run, according to Cynthia Dunn, a practice management consultant with the Medical Group Management Association, based in Cocoa Beach, Fla. When she advises practices, "one of the biggest problems I see is a lack of training," Ms. Dunn says. "Staff are not equipped to do what they need to do. Let's train our folks to utilize the tools we give them."
Coding and reimbursement courses, available from professional associations and in several on-line offerings, often cost less than $200 and are sometimes available for free through insurance companies, according to Shannon Doyle, an MGMA consultant based outside of Denver. He adds that now may also be a good time to get staff trained in reporting quality indicators for pay-for-performance initiatives. Current incentive payments are relatively low but both private insurers and Medicare are gearing up for more extensive incentives, he says.
4. When changes occur, explain the reasoning. In any organization, Dennis Viellieu, CEO of Midwest Orthopaedics at Rush in Chicago, says, you will run into people who resist change, especially extreme overhauls like implementing an EHR or dealing with regulatory changes. The trick to dealing with resistance, which could hurt productivity and profitability, is helping your staff understand why the change is happening in the first place. "You have to be able to communicate down to the folks that are on the front lines and let them know the benefits and value of the new application," he says. "If the reason doesn't make sense, they're not going to be on board."
Mr. Viellieu says practices might run into difficulty from staff members who feel a change is making their jobs more difficult. An EHR, for example, provides a formidable obstacle during implementation, when physicians and nurses are trying to treat patients and learn a new software system simultaneously. "They might say, 'This is keeping us from doing what we need to do,' " he says. He recommends acknowledging the difficulties your staff is having and then pointing out the eventual benefits. "Implementation is always the most difficult time," he says. "You have to stress the benefits that you won't get if you allow them to talk you out of it."
1. Control overtime expenditures. Although overtime is sometimes needed, it can also be a major driver in staffing and labor costs for practices, says William R Pupkis, CEO of Capital Region Orthopaedics in Albany, N.Y.. If practices are experiencing routine spikes in the number of overtime hours, they may need to try a few approaches to reduce this expense. Scheduling issues often are drivers of overtime costs, especially if a practice or a physician is not prepared for a flux of patients, Mr. Pupkis says. "It is the responsibility of management to provide support to the physicians. If he or she is unable to manage it, then we must do so in their stead," he says.
Using shared human resources employees, such as front desk staff, to relieve FTEs is one way Mr. Pupkis' practice has offset some of their overtime costs and has helped to support physicians in seeing their patients. Another concern is that many staff members may come to depend on the extra income generated by overtime hours and may not react well when told this income will be cut. "This can be another aspect of overtime that can backfire," Mr. Pupkis says. You could end up losing a valuable employee. Remember, you lose the good employees first because they can get a job anywhere, and most probably for more money.
2. Ask staff for cost-saving ideas. Employees at the Institute are actively encouraged to share their ideas for cost savings and are used to gauge proposed opportunities. Actively soliciting employees for process improvement ideas has reduced costs in a number of areas at the practice, including costs associated with the use of disposable coffee cups and photocopies, says Les Jebson, executive director of The University of Florida Orthopaedics and Sports Medicine Institute in Gainesville. "As our costs continue to rise and our compensation and collections flattening — it is simply not an option not to actively solicit and incorporate solutions for working more efficiently, without compromising quality."
3. Train staff now for future efficiency. Employees with downtime present a great opportunity to enroll them in training courses that hone their skills and make them more efficient in the long run, according to Cynthia Dunn, a practice management consultant with the Medical Group Management Association, based in Cocoa Beach, Fla. When she advises practices, "one of the biggest problems I see is a lack of training," Ms. Dunn says. "Staff are not equipped to do what they need to do. Let's train our folks to utilize the tools we give them."
Coding and reimbursement courses, available from professional associations and in several on-line offerings, often cost less than $200 and are sometimes available for free through insurance companies, according to Shannon Doyle, an MGMA consultant based outside of Denver. He adds that now may also be a good time to get staff trained in reporting quality indicators for pay-for-performance initiatives. Current incentive payments are relatively low but both private insurers and Medicare are gearing up for more extensive incentives, he says.
4. When changes occur, explain the reasoning. In any organization, Dennis Viellieu, CEO of Midwest Orthopaedics at Rush in Chicago, says, you will run into people who resist change, especially extreme overhauls like implementing an EHR or dealing with regulatory changes. The trick to dealing with resistance, which could hurt productivity and profitability, is helping your staff understand why the change is happening in the first place. "You have to be able to communicate down to the folks that are on the front lines and let them know the benefits and value of the new application," he says. "If the reason doesn't make sense, they're not going to be on board."
Mr. Viellieu says practices might run into difficulty from staff members who feel a change is making their jobs more difficult. An EHR, for example, provides a formidable obstacle during implementation, when physicians and nurses are trying to treat patients and learn a new software system simultaneously. "They might say, 'This is keeping us from doing what we need to do,' " he says. He recommends acknowledging the difficulties your staff is having and then pointing out the eventual benefits. "Implementation is always the most difficult time," he says. "You have to stress the benefits that you won't get if you allow them to talk you out of it."