Covid-19 and it’s economic impact on private practices

Hello,

This is Ken DeRouchie, the editor of The Practice Solution Magazine. On March 11th, I decided that The Practice Solution Magazine needed to shift its focus to the COVID-19 pandemic and how it is effecting private practice. This is still an ongoing research project. 

Between March 11th and March 16th, our researchers interviewed practice owners from throughout the US by phone. We were asking questions regarding the impact that the virus was having on private practices in the Dental, Optometric and Veterinary fields. During that initial 5-day period, most of the practice owners who were interviewed said that they really hadn’t felt a change in business other than a few more cancellations and rescheduled appointments. They did express concern for the future, and uncertainty as to what would happen down the road. Some expressed a concern over the possibility of another big recession, others said that another recession was unlikely. By March 15th this started to change.

On March 15th, The American Veterinary Association sent a message to all of its members stating: 

AVMA is advocating for all veterinary hospitals and ambulatory practices to be considered essential businesses in any situations in which non-essential businesses are asked to close for COVID-19 risk mitigation. Veterinarians and our teams provide important animal and public health surveillance, deliver essential medical care for ill animals, and ensure that only healthy animals enter the food supply.

Veterinary practices can and should defer elective procedures to preserve medical supplies when circumstances call for that. However, veterinarians must also be able to continue to provide medically necessary care for our animal patients, especially during this time when Americans are spending increased time at home with their pets and ensuring the integrity of our food supply is critical. In doing so, and as needed, veterinarians can adapt our approach to ensure an appropriate level of biosecurity that safeguards the health of our animal patients and their owners.

The message goes on to say, “All healthcare professionals need to adopt strategies that will allow them to conserve PPE as much as possible, including veterinarians.

At this point Veterinary practices started offering telemedicine appointments, providing curbside check-ins, cancelling or rescheduling wellness appointments and other non-urgent appointments and started focusing on emergency patients only. 

Source: AVMA Email

On March 16th the American Dental Association made the recommendation for, “dentists [to] postpone elective procedures.” 

Their release states, “The American Dental Association recognizes the unprecedented and extraordinary circumstances dentists and all health care professionals face related to growing concern about COVID-19,” according to the March 16 statement from ADA President Chad P. Gehani. “The ADA is deeply concerned for the health and well-being of the public and the dental team. In order for dentistry to do its part to mitigate the spread of COVID-19, the ADA recommends dentists nationwide postpone elective procedures for the next three weeks. Concentrating on emergency dental care will allow us to care for our emergency patients and alleviate the burden that dental emergencies would place on hospital emergency departments.

Source: ADA.ORG

Also released on March 16th is a statement from the California Optometric Association.

“As the facts and situation around COVID-19 (coronavirus) continue to evolve, and in step with Gov. Newsom’s recent Declaration of a State of Emergency, including the call for all seniors over the age of 65 and residents with chronic conditions to self-isolate at home, the California Optometric Association is requesting the cooperation of all California optometrists and issuing the following guidance: The California Optometric Association strongly recommends that optometrists practicing in California voluntarily suspend nonessential or nonurgent optometry care for the next 14 days. As always, it is expected that optometrists will continue to be available as needed for emergency care and services. Optometrists are considered non-essential services under the governor’s guidelines.

COA does not make this request lightly, and it is being done out of an abundance of caution during this historic public health emergency. As health care professionals, we all have a role to play in “flattening the curve” in order to follow sound, scientific public health advice to help limit infections and slow the spread of the virus.

Sincerely,

 Jason Tu, OD

President”

The following day, March 17th, The American Optometric Association released this statement:

The AOA supports the Centers for Disease Control and Prevention (CDC) patient care guidance issued on March 17 and the efforts of state and local authorities as well as state boards of optometry to combat further community spread and a wider outbreak. Also of critical importance are immediate efforts to assure continued access to essential health care, including urgent and emergent care provided by doctors of optometry, and to reduce current and expected burdens on emergency departments.

Doctors of Optometry are frontline physician providers of essential care. Urgent care is defined as medical care provided for illnesses or injuries which require prompt attention but are typically not of such seriousness as to require the services of an emergency room. Emergent care is defined as medical care for conditions requiring prompt medical attention due to a sudden change in the eye or visual health. Based on the immediate health needs of a patient, doctors of optometry can and should use their professional judgment to determine the timing and course of care, including assessing patient expressed urgency, necessary preventative care and the monitoring and refilling of prescriptions.

After these statements were issued, things changed immediately. We’ve continued to interview practice owners all over the country and the answers have changed dramatically. Practice owners are becoming increasingly worried. Some have already had to lay off employees. Most are worried about the long-term impact to the economy, wondering if it’s going to be like the great recession in 2008. Quite a few of the doctors that were interviewed have talked about the increased safety protocols they have put in place, ranging from taking the temperature of everyone (including staff) that enters the practice, and not allowing anyone with a fever inside, to disinfection and sterilization after every appointment. 

One other overwhelming commonality we have heard is the concern for their employees, their patients and their communities and the practice owner’s resolve to help get them through this crisis. 

You, as a doctor and practice owner are a person of vital importance to your community. People look to you, as a medical professional, for answers. You need to remain strong and not play into the panic that is so pervasive in the media. Yes, this is a pandemic and it is a global crisis and there are a lot of people in fear of what’s going on. Educate them. Reinforce the CDC guidelines for safety, i.e.- Clean your hands often, avoid close contact, stay at home if you’re sick, cover coughs and sneezes, wear a facemask if you’re sick, clean and disinfect.

Also, communicate with them and help them get past their fears. It is up to each of us at this critical time in our history to lift each other up, comfort and ease each other. We can all make a difference. Be a beacon of sanity in your area.

As for you as a business owner, there are things you can do to make sure your business survives. For those of you that are taking a big financial hit, the HR 6379 section in the stimulus relief package will help.

Take Responsibility for Families and Workers Act.

Division I- Financial Services

Title 2- Assisting Small Business and Community Institutions

SEC. 202. SMALL BUSINESS FINANCIAL ASSISTANCE PROGRAM.

(a) “In General.—The Secretary of the Treasury shall establish a Small Business Financial Assistance Program under which the Secretary shall provide loans and loan guarantees to small businesses.”

Provisions of the massive stimulus bill which just passed Congress were designed with small business owners like YOU in mind. These elements of the bill make it possible for you to keep your staff fully employed for the next 8 to 10 weeks, even if your practice hours are significantly reduced or you’re shut down entirely.

Other things you should do include: Make sure you update the main page of your website, post on your social media, email lists, texts and let your patients and clients know that you are still open to see emergencies. 

You can also do Telemedicine appointments via skype/zoom or phone.

The AOA published an article on March 11th. In it they state, “The initial legislative response by Congress and President Donald Trump to the COVID-19 public health emergency and localized reports of community spread in the U.S. is a sweeping, $8.3 billion emergency aid package signed into law on March 6. The measure includes funding for lab tests, vaccine research and general outbreak response, including directives aimed at providing physicians with authority and reimbursement mechanisms through Medicare for remote and telehealth services to their patients.”

If you have questions about any of these things or would like advice on where to start or what to do next, you can call me at 800-695-0257 or email me at kderouchie@thepracticesolution.net and we can set up a free, one hour call to talk and I’ll give you some recommendations.

 

Stay vigilant and be safe. 

Sincerely,

Ken DeRouchie

Editor

Achieving Better Retention and Patient Satisfaction

Thriving successful practices have mastered the challenges of patient and client retention.

A question that needs to be asked, answered and fully understood is, “Where does patient or client retention start?”

The truest and simplest answer is: the point when the patient is procured!

You could say that patient procurement and patient retention are two sides of the same coin.

Let’s delve into this in a bit more detail.

A practice, in essence, has a systematic way of obtaining, onboarding, and treating patients and collecting payment for services rendered.

In amongst all of this is the human element or the patient or client themselves. This is where the complexities of patient retention begin and end.

The Key Points That Determine Patient Retention.

How a clinic addresses the human element is really the crux of succeeding in the challenges of patient retention.

Always keep in mind that underlying retention and patient satisfaction issues are usually issues with service, delivery, and the interaction with the staff.

There are several key points in any practice that determine the outcome of patient retention. This applies to new patients as well as existing patients. These are as follows:

  • Overall Clinic Environment and General Staff Interaction with the Patients
  • Front Desk – Patient Arrival
  • Patient Prep
  • Physician Interaction
  • The Front Desk – Patient Departure
  • Interim Period – The Time After the Patient Leaves Until the Time They Return.
  • Dealing with Patient/Client Upsets

Each of these elements, when properly set up and organized, will lead to a higher degree of patient satisfaction and will result in better retention and better reviews.

In the next article, there will be some tips and strategies to help improve patient retention and treatment satisfaction.

Overall Clinic Environment

Clients/patients know you first by the appearance of your space. Uniforms or staff attire should be impeccable and professional at all times. Waiting areas, procedure spaces and any office visible to newcomers should be kept neat and clean.

Outside the practice, use professionally designed signs and these ought to be kept clean of filth or debris. Restrooms also say something about your practice that may go unspoken but never unnoticed.

Dealing with Upset Patients/Clients

Are there clear strategies, procedures and precise policies in place to deal with people who are upset or dissatisfied with some aspect of the clinic or the service they received?

Is there a person in the clinic who is trained on these policies and designated to handle upset patients/clients?

Staff that come into direct contact with patients and clients should be trained to recognize signs that the person in front of them is not satisfied, and deal with them in accordance with clinic policies. This is particularly important to address before they leaves.

Is there a private place in the clinic where an upset can be addressed? Taking the person aside can make them more likely to open up than if you attempt to deal with the problem in a public space.

Are Surveys Being Used?

Perhaps the single most important tool to improve the patient experience is the survey.

This often overlooked but powerful tool, when used properly, can determine the exact course of action to take to directly improve retention and improve other aspects of the practice.

The use of surveys in a practice can also result in creating better promotional response in the acquisition of new patients. Other beneficial information can be derived from the use of surveys.

New and existing patients should be surveyed.

The actual subject of creating surveys and surveying is a rather involved technology. The entire subject of surveys would be impossible to cover in this article.

Ideally, there should be someone in the clinic who has at least a basic working knowledge of the technology of surveying.

Manners Matter

There is much more to manners than just being polite. This is very important, but there may be other factors to consider on the subject of clinic manners.

Are patients being communicated to in a way that makes them feel understood and acknowledged?

Be Aware of and Sensitive to Personal Beliefs and Concerns

Treat each patient as the unique individual they are. Every patient or client likes to be made to feel special and important. One method of doing this is to have staff review the schedule each day so they can refer to the patient/client by name.

Be sensitive to those who may have particular customs, beliefs and ideas about medicine and treatment. It is always better to ask than to assume! It would be very wise for a practice to survey their patients/clients to discover any important information in this regard.

Develop a culture in the clinic of compassionate care, patient importance and service orientation.

All of these things when done should add up to a patient or client who feels that they are important and appreciated. Doing so, addition to good retention may mean the clinic will also get rave reviews to boot!

Dealing With The Interim Period

In this age of digital advertising & social media, the average American sees 5,000 ads per day (2018). This leads to distractions and plenty of opportunity for competitors to capture your patient or client’s attention between the time they leave your office, and their next scheduled return.

Handle this by encouraging loyalty. Reward referrals, offer a reminder system of texts, email and phone calls, and keep your practice top-of-mind with a social media presence and email newsletters.

If you are a practice owner and would like free help with a particular employment concern or any other management topic, fill out the form on this page, and we will be more than happy to assist you. ^

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If you are a practice owner and would like free help with a particular employment concern or any other management topic, fill out the form below, and we will be more than happy to assist you (highly recommended).










Solution to the Most Distressful Staff Management Problems

I’m sure many of our readers are very familiar with The Practice Solution Magazine’s phone surveys. Our team of surveyors speak with doctors all over the country, 8 hours a day, 5 days a week. Given the nature of your busy schedule, we definitely appreciate it when you take the time to speak with our team. The information that you provide enables us to concentrate on articles of interest to you and your staff.

With that in mind, we have found in our recent surveys that one of the most distressing areas for most doctors is the managing, hiring and controlling of staff. Every person is different, and human interaction within small practices often times can be nerve-racking, volatile and frustrating. You have probably found that not everyone thinks like you do, cares as much about your practice as you do, or is as willing to work extra hours as you do.

We definitely recognize the frustration that can occur with losing an employee whom you have just invested thousands of dollars and hundreds of hours training. One of the most important things that you can do to bolster your practice is to ensure that all of your staff are fully trained and operating on the same page. The optimum team is one that knows what their specific duties are; how to do those functions without any difficulty; can do them without emotional issues getting in the way (in other words, strictly professional); and are aware of what the other staff should be doing.

When your staff are competent work is more efficient, morale is higher and the doctor can just be the doctor instead of the referee or babysitter.

If you implement the suggestions here, you will find at least some of your frustrations disappearing, and you may even get more support from your employees because they will have a better understanding of what you need as the practice owner, which will enable them to become more competent and professional.

It would be nice if employees never made any mistakes and always did a perfect job. But, we are all human, and mistakes or on-the-job errors are part and parcel of running a practice. That raises the question, what do you do when your staff err and how do you correct them? Here are some suggestions.

As part of this overall process you must have written job descriptions and office policies that clearly delineate what tasks a person is responsible for on their job and the overall working guidelines for the office. The reason these are so important is that you use them as part of your correction procedure. Unfortunately, very few practice owners have proper job descriptions and office policies in place.

For starters, if you need to correct a staff member, make sure you review any specific disciplinary policies you have issued so that your actions are consistent with these. For example, if your policy states that theft is an automatic discharge, you would not simply issue a reprimand to someone caught stealing.

The first level of correction is normally directing the staff member’s attention to whatever policy he/she violated, what was not done or what should have been done, all of which is delineated in their job description or in your written policies.

Have the staff member reread the policy and/or job description. Ensure that they understand it and clear up any confusions or misunderstandings. This is usually enough to handle the first offense.

On the second offense the office manager or practice owner should review the situation with the staff member and have them sign a copy of the policy that was violated as an attestation that he/she understands and agrees to the policy and/or job description. We then recommend for you to put a copy of the signed document in the personnel folder of the staff member and give a copy to the staff member to put in their staff binder. One can consider that this constitutes a warning.

On the third offense, we recommend that you do the following: give the employee a written warning, a copy of which goes in their personnel file. Sit down and discuss this situation with them; go over the fact that they’ve been corrected on this twice before; and tell them that, per office policy, continual violations could result in a suspension or dismissal.

Practice owners normally find that this type of action on a third offense either puts a stop to the problem or points out clearly that they have a real problem staff member on their hands and that proper actions, including excellent documentation, will need to be taken in order to suspend or dismiss the staff member for future violations.

What do you do with a staff member that you have corrected three times and who messes up again? You’ve already given them a written warning, discussed that continued violations could result in suspension or dismissal, but you still find them doing it again.

At this point you should check their production record (although you should have done that already as part of correcting earlier violations). Hopefully you have a simple statistical method to keep track of key production metrics for each staff member and the office as a whole so that you can monitor their productivity. If the person is an excellent producer (which is unlikely given that they keep messing up), you might consider the next step to be a suspension without pay for a certain number of days. If the person has a poor production record, dismissal may be in order.

Again, the importance of having proper office policies and job descriptions in place in order to properly deal with staff cannot be overemphasized. You can easily put yourself in a legal quagmire if you attempt to discipline staff without these in place.

We also strongly recommend that you check with a good employment attorney when you are looking at dismissing any problem employee to ensure that all of your legal bases are covered.

If you are a practice owner and would like free help with a particular employment concern or any other management topic, fill out the form  on this page, and we will be more than happy to assist you. Scroll to top

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If you are a practice owner and would like free help with a particular employment concern or any other management topic, fill out the form below, and we will be more than happy to assist you (highly recommended).











Profitable Communication Systems

One of the key elements in running a successful practice is the actual communication level of the practice.

This communication level is not just how people talk to each other. “How” is important, but there is more to it than just that.

It’s also not how many telephones, computers and email addresses the practice has. How they are used is what is important.

Think of communication as a series of systems or channels. These channels consist of not only the methods, but also the importance and reasons for interchanging ideas, information and knowledge.

These ideas, information and knowledge are the elements that keep the staff and patients in tune with what’s going on in the practice as it relates to them.

It is the quality of these communication systems that make or break a practice.

Let’s take a closer look at some of these communication systems.

The first is the methods and quality of how communications are delivered between the staff and the patients at an organizational service level. These communication channels can be in the form of verbal, policy, dispatch or memo, phone, intercom, emails, etc.

The next and maybe the most overlooked aspect of interoffice communication is the job description itself and how well each staff member knows it.

Often overlooked in job descriptions are the elements of what communications are required, necessary, and important relative to the jobs of other staff and the form these communications should take.

Check your office job descriptions and make sure that they include this vital information.

It is also important to include in an office manager’s job description procedures and policies governing the implementing and maintaining of office communications systems.

The question is, how well and how easily can communication be initiated, relayed and received in the practice and with the patients?

It can be proven empirically that the speed, flow and quality of how well communication can be initiated and received will distinguish a well-run and profitable practice from one that is struggling.

Understanding, implementing and maintaining high quality communication systems in a practice is vital to the success of the practice.

Smooth out the communication and watch your practice grow.

Fill out the form  on this page to read the outline on implementing profitable communication systems (highly recommended). Scroll to top

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Fill out the form on this page to read the outline on implementing profitable communication systems (highly recommended).










The Truth About Collections

Accounts receivable and collection percentages are a subject that we hear about frequently. Every doctor has a different idea about what a good collection percentage is as well as how to collect money for services rendered.

For example, I have talked to many doctors who feel obligated to let patients/clients go without paying. They feel guilty about trying to collect from someone if they feel that the person is in a financial hardship.

While this is quite altruistic, it is very short-term thinking. These doctors must also understand that they can’t continue to provide help to their patients/clients if they can’t afford to keep the doors of their practice open. Another fact that is not commonly known is that failing to pursue a bill and persevere in asking for payment can actually have a negative effect on the patient/client’s self-respect. People expect to be billed, even when they complain. While it can be uncomfortable to deal with objections, realize you are making it possible to help many more patients over the years – and that is worth mentioning to them, as well.

Failing to insist on payment for services rendered can also lower your own esteem, making it harder to collect the next time. If you provide a service, you should be compensated for it. Period. Unless you go into a situation knowing in advance that it is going to be a charity case – and there is certainly room for that in any practice as long as it is planned for – you should always insist on being paid for rendering that service.

Of course, this is great in theory, but being able to actually collect all monies owed is another story and requires good group coordination and effort. If you and your staff are trained on how to do this from initial contact through patient discharge, including having the proper policies in place with your staff and patients/clients, your chances of collecting at the time of treatment go up exponentially. We believe that you should be collecting 98% or better of what you are producing, minus insurance adjustments. If you are collecting less than 98%, you are losing net income out of your own pocket.

Here are a few other tips that may help you when dealing with the uncomfortable situation of a patient/client who is saying they cannot make payment:

  1. Believe it or not, smiling is one of the strongest tools you have to deal with uncomfortable topics. Frowning or looking worried can have a subtle but negative effect on the conversation. Smiling naturally in a friendly manner when it is appropriate to do so is the best method.
  2. Speak confidently, concisely, and firmly. Never apologize for your prices.
  3. Listen carefully, but also use silence to control the conversation. One of the most powerful things you can do in a conversation is state your piece…and then shut it. The silence will become uncomfortable for the person, and they will often try to fill it by giving you reasons why they cannot pay. Acknowledge those, and continue to gently insist that a solution is found to make payment.
  4. Stay calm, even if the patient/client gets upset. Your emotions should not give the person any excuse to take offense or try to wiggle around the main topic of the conversation.
  5. Focus on one thing only – the patient/client – when making the calls to collect. Do not multi-task, but instead, concentrate on the person in front of you. This makes them feel important to your practice (which they are), and shows a level of care that can make paying easier to face.

By using these tips, you can gain better control of your collections percentages and thereby the level of care you can provide to future patients/clients. Any staff who deal with collections in your practice should be drilled on a regular basis in how to handle objections, present payment requests, and demonstrate a genuine, caring attitude. Whether you are asking in person before the person leaves, or trying to collect over phone, text or email, these same points apply.

Staff normally dislike roleplaying, and it is too easy to avoid in the busy week. But the reason for the distaste is often only a few simple (and very easy to correct) mistakes on the past of the executive doing the drilling:

  1. Only correct one thing at a time. Letting people have wins is one of the most overlooked, and therefore most important parts of drilling. When your staff first start out practicing objections-handling, they may make many errors all at once. THAT’S OKAY. It’s a drill, not a test. Simply pause the drill, correct just one thing, and have them continue drilling until that one thing is handled. Then take up the next error.

Failing to balance criticism with praise. When staff do something right during a drill, pause and let them know. This reinforces what you want, and in fact can often be more powerful than any negative criticism you might offer. In other words, push the hardest on the thing you want more of.

If you are a practice owner and would like free help regarding collections or any other management topic, we will help you if you help us by doing a 15 minute anonymous interview regarding practice management. Fill out the form to your right, and we will be more than happy to assist you. (highly recommended)

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If you are a practice owner and would like free help regarding collections or any other management topic, we will help you if you help us by doing a 15 minute anonymous interview regarding practice management. Fill out form below, and we will be more than happy to assist you. (highly recommended)









14 Steps to Safeguard Your Practice from Embezzlement

Our research staff continues to find that embezzlement is an issue that is still prevalent in practices nationwide. Consequently, we are revisiting this subject to provide additional advice.

 Minimize the Risk

More than likely, you’ve heard the horror story about a colleague whose trusted employee embezzled money from his/her practice. To preclude this from happening to you, there are steps that you could take to minimize the risk of embezzlement.

­­­

We recommend that the following procedures become a part of your normal routine, as they will help to safeguard you from embezzlement. 

Handling Cash

  1. Make it your firm policy that you provide every patient/client with a receipt for cash payments.
  2. Cash handling and cash record keeping duties need to be segregated. Have one person collect patient/client portions over the counter and another person post balances. Have a third person make the bank deposits. As the owner, you must play an active role in monitoring sales and cash if you have too few employees to fully separate those three duties.
  3. Each month, compare the amount of cash deposited in the bank to the receipts and/or balances posted in your collections log. There could be some minor fluctuation, of course, but a significant difference for that month is a warning sign and should be investigated.
  4. Start a simple patient/client sign-in sheet listing patient names and the date signed in. Compare this on a daily basis to an over-the-counter-collections report (and day sheet or equivalent). Look for inconsistencies, such as patients/clients who are on the sign-in sheet but not listed on the day-sheet report. Spot-check by phone call to patients/clients who are reported to not have paid an amount due that day. This can be done as a “quality control” call to the patient/clients. Of the questions asked, one might be something like, “It’s our policy that all patients/clients who pay any cash on the day of service receive a receipt. Did you receive a receipt today for any cash you paid?” Put this policy in writing and IMPLEMENT IT. That will make it far more dangerous to attempt embezzlement.
  5. Make it a written policy that you conduct unannounced checks of petty cash and other cash accounts on a regular (bi-weekly or monthly) basis. Conduct those checks without fail.

Fill out the form on this page to read steps 6-14, they will provide you with the essential data regarding the proper management of your accounts receivable and other office records (highly recommended). Scroll to top

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Read steps 6-14, they will provide you with the essential data regarding the proper management of your accounts receivable and other office records (highly recommended).










Dealing with a Problem Employee

I received an email from a doctor having a staff problem. I replied to her and thought this might benefit some other people out there. Please see our discussion below:

Hi Ken,

As an employer, how can you tell your employee to stop his/her: gum smacking, not to laugh at the end of each sentence, to stop blowing her nose as everybody can hear it, to stop asserting herself on someone else’s conversation?

I have such a hard time saying something to my assistant about these issues. Everybody in the office is being affected, and I am not happy at all with her. I try my best to tell her what I would prefer from her as an employee, but it hasn’t worked.

Please help me.

Dr. S


My Reply

Dear Dr. S,

There are several things that can help you in this current situation and help prevent this from happening in the future. This is a bit of a lengthy reply due to the nature of your problem. Please take the time to read through this as I believe it will give you some insight into the problem and how to handle it.

The first, and probably the most important thing is to make sure that you have very detailed job descriptions and office policies in place. In your office policy manual, there needs to be written policies about acceptable and unacceptable employee behavior. When new employees are hired, they are given a copy of this policy manual, and they are to read and sign off on them. This lets them know what is and isn’t permitted in your office. They agree to this, and you now have legal recourse for disciplinary action and/or termination for non-compliance.

As new policies are written, a copy is handed out to all employees for them to read and sign off on. These signed agreements are added to their personnel files. These can then be referenced in regular employee evaluations, disciplinary actions, and if needed, termination situations.

If, however, you only deliver your requests verbally, you leave these requests open to interpretation. It is imperative to have everything in writing so that there is no room for interpretation.

The other underlying issue that I see here is hiring the right people to begin with. There are three steps here:

  • Attracting the right kind of employees,
  • Determining who to hire, and
  • Training them to do their job properly after you’ve hired them.

When you are looking to fill a new position, the wording of your ad/listing is key. Where you are advertising is also a big factor. Utilizing employment agencies that pre-screen applicants to your qualifications can greatly increase the quality of candidates that you see, weeding out the lower quality people ahead of time.Determining who to hire is a shot in the dark for most doctors. They read a resume, conduct an interview and take a shot. No one writes on their resume that they are chronically late, don’t take directions well and can’t get along with others. What you see on a resume is only what the applicant wants you to see. Similarly, all you hear in an interview is what they want you to hear. They say the right things or at the very least what they think that you want to hear in order to get the job.

After they are hired they stay on their best behavior until they get comfortable; then, they become themselves. Only then do you know who you’ve really hired.

You need a more objective way to screen and hire people so that you have a better idea of who they are, what kind of personality they have, their responsibility level, their aptitude and their work ethic. Corporations have been hiring people this way for years. Small businesses suffer through much higher turnover rates due to their lack of successful hiring techniques.

Personality tests, IQ tests, Aptitude tests are all implemented to get a feel for who a person really is and how they will fit into your practice and interact with the staff, more importantly your patients.

Once you have hired the right person, you need to make sure that you train them properly. This is where detailed and up-to-date job descriptions and office policies come into play. It is vital that you equip your new employee with the proper tools to do their job rather than throw them to the wolves and hoping they pick up the proper way to do things as they go.

Here is a policy regarding employee performance evaluations. Take a look at this as I think it will give you an idea of the kinds of policies that should have a place in your office policy manual.

To receive “an example policy regarding employee performance evaluations”, please fill out the form to the right. This example policy can help you better understand the exact types of policies that are most beneficial to have in your company’s office policy manual. (highly recommended). Scroll to top

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Fill out the form to receive a policy regarding employee performance evaluations (highly recommended).








Building a Successful Practice Through Efficient Hiring

To build the most productive and profitable practice, having stable staff who work together to accomplish the mission of the practice is vital. Knowing how and whom to hire is a key skill. To lose employees who may have seemed appropriate for your team when you hired them, yet were not actually a good fit once on the job, is an enormous hidden expense in a practice.

In fact, based on the typical costs of finding, interviewing, testing, training and getting a new employee fully functioning on the job, turnover costs can equal six to nine months of the position salary. If a job pays $3000 per month, your costs could be anywhere from $18,000 to $27,000 each time the position turns over. Therefore, it’s vital to know how to screen applicants properly in order to hire the best possible individuals for your practice and to avoid the stress and high cost of frequent turnover.

Checking References

Checking the references that a job applicant provides is an important—but often neglected—step in the hiring process. The quality of staff can make or break a practice; so, investigate carefully and hire only those whose backgrounds indicate competence and imply that they would be good employees.

Checking references is not always an easy process. In order to protect themselves from legal or privacy issues, many employers have become reluctant to voice opinions about a former employee. However, you should still do reference checks on any candidate whom you consider hiring, to gather any data available.

It’s best to check references prior to a one-on-one interview with the applicant, since you might uncover information that will eliminate that candidate beforehand and save you the interview time. If that’s not possible, check references after the interview, but before hiring.

Here are some questions you might ask references:

  • How long was _______ employed by you or your company?
  • Can you tell me his/her ending wage/salary?
  • Why is he/she no longer employed there?
  • Was he/she a loyal employee?
  • Was he/she dependable?
  • Do you feel he/she is honest?
  • Would you rehire this person?

Again, a past employer may not be willing to answer some of those questions. The key question is the last one, “Would you rehire this person?” This question is important to ask if the person providing the reference is very guarded or hesitant in giving answers.

Keep in mind that checking references is just one of several vital steps in the hiring process. Another important part is to determine the attributes your ideal applicant would possess.

Fill out the form on this page to read the rest of the article and receive our Hiring Interview Checklist (highly recommended). Scroll to top

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Read the rest of this article and receive our Hiring Interview Checklist that you can use to determine the characteristics of your ideal employee (highly recommended).








How to Deal with Canceled or Rescheduled Appointments

One of the most common problems doctors want help with is dealing with canceled or rescheduled appointments. If a doctor’s office has too much of this occurring it can wreak havoc on their daily production. Normally, when this is occurring it is a sign that the receptionist is not properly trained in scheduling appointments, managing the appointment book, or handling cancelations and rescheduling.

When you are getting a high volume of cancelations, you should ask yourself these questions:

  • Does your receptionist immediately reschedule a canceled patient/client?
  • Does your receptionist ask the patient/client to put the appointment in their calendar, phone, or day planner so they won’t forget?
  • Do you keep a record of the reasons behind cancelations for future reference and to implement any needed corrections?
  • Do you have any sort of policy regarding cancelations that is part of the “welcome to the practice” information given to patients/clients?
  • If you have such policy, do you enforce it?

Here are some other questions you should ask yourself as regards appointment no-shows:

  • What actions do you take when someone doesn’t show up for an appointment?
  • Do you call the patient/client after a certain length of time, e.g., 10-15 minutes?
  • Do you have any sort of policy regarding no-shows that is part of the “welcome to the practice” information given to patients/clients?
  • If you have such policy, do you show it to no-show patients/clients the next time they come into the practice?

The doctors we deal with are all asked these simple questions, and many more, when they are dealing with cancelations, no-shows, and reschedules. We recommend that you closely evaluate the management systems and training that you have in place with the staff members involved; then, fix or implement the proper procedures to reduce the number of patients/clients lost. This normally leads to increased production without any increase in marketing or staff expense, which, of course, leads to greater efficiency and net income in a practice.

If you would like more help dealing with canceled or rescheduled appointments or any other management topic, fill out the form to the right, and we will be more than happy to assist you.

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Screening Applicants

The Group Interview
Finding a new employee is a very time consuming process. To consolidate efforts and streamline the initial stage of the interview and selection process, have all of the applicants who meet the basic criteria come into the office for a group interview session. The purpose for this is that it consolidates the office manager’s efforts, giving you an opportunity to get a look at the applicants and screen out those whom you do not care to invest any more time in. The finalists from this segment will then be invited back for an in-depth individual interview.
Once you have collected all of the resumes from your advertising, go through them and screen out those that do not have the qualifications you are looking for. Take into consideration whether or not the applicant included a cover letter and whether that letter really communicates something about the applicant. Look at the experience, background and talents being conveyed in the resume and letter.
The First Interview
Phone those applicants that appear to be the very best and schedule them to come into your office to fill out an application. During this phone call you can rate their phone voice and composure and get a bit of a feel for their willingness. Make notations on the resume. Schedule all of the applicants for the same time, e.g., an evening after work or on a Saturday morning.
Make preparations ahead of time. Have packets of paperwork ready for each of your applicants. Their packets will contain an application, a questionnaire, a sheet that they will fill in with their employment goals and what their understanding of a practice is. They will also be asked to write a brief collections letter and sign an Authorization for Release of Information form.
When the applicants arrive, welcome them and deliver a brief statement (10 minutes or less) about the practice, its purpose/mission and the position. Then, direct them to the pre-printed packets handed out. Have them:
  1. Fill out their Job Application Essays.
  2. Fill out their Hiring Questionnaire. Asking them what your practice is about, its purpose, the position that they are applying for and a few negative and positive things about the position or practice.
  3. Write a brief letter to a client who has an overdue account (which gives you a good indication of how the person deals with others on sensitive matters).
  4. Sign and date the Authorization for Release of Information form.

As the applicants complete their forms, rate them on their appearance (1-5) and take them individually into a private office to conduct a brief interview (about 5 minutes for this first interview). This will give you a feel for the person.

Before your applicants leave, give them each a card for a complimentary exam at your office. (This is optional, but could garner a new patient even if not hired). Thank them all for coming in and let them know that they will be hearing from you within the next couple of days.

Fill out the form to the right and receive “Screening Applicants – Part II” (highly recommended). Scroll to top

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Fill out the form to continue reading this article Screening Applicants – Part II (highly recommended).