Staff Management

2 Staffing Changes Saving Me 4 Hours+ Daily

Dr. Dune with a patient in her practice. Dr. Dune says that getting the right staffing support has made a huge difference to her ability to provide a high level of care while growing her practice.

By Barbara Dune, OD

Dec. 14, 2022

A great staffing challenge is time management, from your own perspective as practice owner and from the perspective of your employees. Are you making the best, most efficient use of their time? Here are a couple staffing changes that freed up at least four hours a day for me and my team.

Use of Virtual Assistant as Scribe
In September 2022, we added a virtual assistant through Hello Rache, a placement agency for remote workers. This virtual assistant, who is based in the Philippines, serves as my scribe. We use Google Meet technology to provide her audio access to the exam room. We keep the camera off to further patient privacy, and because I did not feel that much, if anything, would be gained from our virtual assistant having eyes on the patient.

I was able to evaluate multiple candidates for the job, just as I would if hiring for an in-person position. The individual I chose for this hourly, contract position has a background as a pharmacist, so she is familiar with medical terminology and drug names. This meant there was much less of a learning curve for her than there would likely have been for a new scribe with no healthcare experience.

The scribing she does enhances my time with the patient, allowing me to focus more on the patient and less on note-taking. It also frees up significant time for me each night. I was regularly staying awake until 2 a.m., or later, updating my patients’ health records with information from the previous day’s appointments. My new scribe has her own login credentials to our cloud-based EHR, and is able to input notes directly into the patient record while I am talking to the patient in the exam room.

I then review and sign off on the notes at the end of the day, and then she takes care of the rest. The most I have to do now is add a clarification to the notes if there is a point the scribe requires additional information on, and upload any images I have taken. This process takes me no more than around five minutes per record compared to the three hours, or more, I used to spend each night finalizing and uploading notes

Our EHR allows us to assign “tasks” to patient files, so our virtual assistant is able to work with me and my in-office employees seamlessly, as we can easily alert each other to work or clarification needed in a patient file.

In addition, our scribe also does back office work, freeing up my in-office staff to focus on patient work.

Our virtual assistant scribe is paid $9.50 per hour, with the agency billing only for the hours she has worked, which usually comes to around 36 hours weekly. That adds up to $300-$360 per week. She operates on a month-to-month contract basis, which can be terminated at any time by her or by us, with no long-term commitment.

I recommend that before you hire, or contract with, a virtual assistant, you have them do a trial run of whatever tasks you would like to assign them. In my case, I had the virtual assistant, when she was a job candidate, scribe for me for an hour to see how well she did.

Hired In-Person Medical Assistant
Patient education makes a huge difference to how well patients comply with treatment plans, and therefore, patient outcomes. When the patient has good outcomes they are better off and remember the doctor who gave them such an improvement in their life. With so much at stake, I never want to give short shrift to patient education. I also want to make sure I am not negatively impacting my efficiency or keeping the next patient waiting.

I found just the solution I was looking for when I hired a medical assistant whose primary responsibility is educating and following up with patients at the end of appointments to ensure correct implementation of the treatment plan I have prescribed. I provide an initial explanation of the diagnosis and treatment plan and then I call the medical assistant into the room to provide additional information and to answer further questions the patient may have that didn’t occur to them when speaking with me. This prevents the patient from leaving the office and having it occur to them on the drive home that they forgot to ask me about something they wanted more information on.

In addition to her work with patients in the exam room following their time with me, our medical assistant does follow-up calls with patients to see if they are following through on doing what was prescribed. For example, she asks how the at-home dry eye treatments are going and if the patient was able to get the eye drops I prescribed from the pharmacy, and if they have been taking the drops as prescribed.

I am also training the medical assistant to provide the in-office treatments we offer to our patients, like TearCare and BlephEx. These are important parts of our dry eye treatment, and frees me up to see an additional patient while this treatment is occurring. Each treatment takes about 20 minutes, time I can use to do a follow-up appointment.

An additional advantage of our medical assistant is that she is fluent in Spanish, which is her first language. We have a high volume of Spanish-speaking patients with limited English language skills, so our medical assistant plays an especially important patient education role in these cases.

Our medical assistant is paid $15 per hour and, in addition to providing comprehensive patient education that improves treatment outcomes, she saves me about 10 minutes at the end of exams in which a diagnosis with treatment plan has been made. My practice has a medical eyecare focus, so that adds up to as much as an hour per day, or more, of my time.

Like our virtual assistant scribe, I had our medical assistant do a trial run before hiring her. I had her come in for a day to see how well she could do the work and how well she interacted with my other staff members. I let her know that this was part of the interview process, and paid her a small stipend for the day that covered her travel expenses as a thank you.

Barbara Dune, OD, of Serenity I Care in Hartford, Conn. To contact her: 




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