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Physicians
Practice's
Ask an Expert
is a question and answer forum featuring
leading practice management experts who may or may not be
employed by Physicians Practice. We receive, on average, 170
questions per month from physicians, office administrators
and others. Have a question about the operation of your practice?
Visit www.PhysiciansPractice.com.
Your question will be answered within three business days.
Q.
How do I figure
out how many staff I need and what kind of staff to add?
A.
The Medical Group Management Association offers averages for
number of support staff per full-time equivalent physician
by specialty. However, keep in mind that the benchmark for
others may not be the benchmark for you. That's because your
support staff is there to support the physician, the revenue
generator. The number of staff generally reflects the pace
at which the physician sees patients. Keep these factors in
mind:
Volume
— How many patients are coming through the practice?
Complexity — How long is the average
patient appointment?
Services — Does the practice provide
imaging services? Laboratory? Other ancillary services that
consume staff time?
Efficiency — Can a medical assistant
help the physicians in the practice to be more efficient?
Does the practice have an experienced biller who can complete
tasks quickly?
Technology — Does the practice employ
technology that speeds things up or slows things down? Does
it need more people to work the technology than it would without
it?
Space — Are you in a large space
that requires your staff to take time to transport patients
from the reception area to the exam room, or is it a smaller
office where patients can find their own way?
Q.
The
front office never knows what the back office is doing and
vice versa. How can we improve communication?
A. Begin
each office session with a team briefing with the physician
and clinical assistant. This should be a mandatory, 5-minute
prep briefing about that day's workload to address such items
as what challenges may impact patient flow. These sessions
help make sure everyone is prepared. Keep 3x5 cards or use
a designated whiteboard for staff to write up points to address
at the next briefing. There are all kinds of communication
tools that may help, too. Larger practices depend on lighting
systems. Some practices are now using pagers, as well. Also,
make sure your office is arranged to facilitate easy communication.
For example, don’t put the waiting room between the front
office and the physicians.
Q.
What
should my overhead rate be?
A. Overhead
rates are largely dependent on specialty. In surgical specialties,
it may be as low as 30 percent; while in primary care, overhead
can be as high as 60 percent. That's because surgical specialties
can use the hospital’s resources (operating room nurses,
for example) and thus maintain a relatively small staff, but
primary care groups bear all of the costs of an office. However,
the percent of total costs for any practitioner, regardless
of specialty, is typically 50 percent personnel expenses and
50 percent operating expenses. That is, out of $100,000 in
total practice costs (excluding the physician’s compensation),
$50,000 is spent on personnel and $50,000 on operating expenses.
The goal is to have as low an overhead rate as possible. You
would rather spend 40 cents on operating costs for each dollar
collected than 50 cents. Remember, though, that overhead needs
to be considered as a ratio of costs to revenue. You can't
just focus on cost reduction because by doing so, you may
simply reduce revenue, leaving the overhead rate unchanged,
or worse, even higher.
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