By Mark Wright, OD, FCOVD,
and Carole Burns, OD, FCOVD
Sept. 11, 2019
Staff members can help to provide a great patient journey through your practice, if you clearly define their tasks and responsibilities. Here’s a formula to evaluate a staff member’s performance and compute their true value in dollars and cents.
Technically, the doctor could do everything from answering the telephone, to helping patients pick out the frame for their glasses, to doing final checkout for every patient visit. Most doctors do not do this because it would mean that they would not be functioning at their highest level of education. As a result, doctors hire staff to help free up the doctor to function at the highest level possible.
How do you decide how many staff members to have and what they should produce for the practice? One way to do this is to create a map of the patient journey through the practice. To put this in business terms: first determine the work, then hire people to do the work.
A practical way to do this is to identify every time a patient stops in your practice. Identify exactly what you want from your staff and from the patient at each stop. For example, what do you want from your staff at reception when the patient stops at your front desk? Here are a few of the things you should want:
1) Greeting patients quickly within five seconds of crossing the threshold into the practice with a smile and a script (e.g., “Hi, Mr. Johnson. Welcome to our practice. My name is Mark Wright and I’m going to help you through your first steps today.”)
2) Thanking the patient for choosing us for their eyecare.
3) Offering the patient a gift with a smile (e.g., a chilled bottle of water).
4) Accurate identification of who the person is – this is a HIPAA requirement.
5) Verifying accurate payment/third-party information in the patient record and that the patient has been pre-certified (i.e., identification of plan rules and what is due today).
6) Confirmation of the reason for the visit.
7) Presentation of CareCredit.
8) Directing the patient as to what the next step will be and who will do it.
9) Making sure the next staff member who will interact with the patient knows the patient is here and ready as well as making sure no patient gets lost or forgotten in the reception area.
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Once you’ve identified the work products, then you can begin to think about the staffing necessary. One way that we’ve found helpful is to start with the end. Take 20 percent of the annual gross revenue of the practice. This is the maximum pot of money available to purchase your non-doctor staff.
Now that you know your financial limit, use a spreadsheet and tools like https://www.bls.gov/, www.payscale.com/, and https://www.salary.com/, to determine what staff members you need, how much you are going to pay each one and the total for everyone.
Another idea to utilize is that on average every staff member should generate $140,000 toward the overall practice annual gross revenue. Work the numbers backward, and a $1 million dollar annual gross revenue practice should have a maximum of $1M/$140K = 7.14 full-time equivalent (FTE) non-doctor employees.
(Take your current annual gross income and divide by $140,000 to find out how many FTE non-doctor staff members you should have. How close are you?)
Ask this question when thinking about hiring a new employee: How will hiring this new person add $140,000 to the annual gross revenue of the practice? Is this person a direct income-generating person (i.e.: optician) who should generate at least $140,000 or will this person free up a direct-income generating person to generate an additional $140,000?
Every staff member should have at least one clearly defined end product. An example is the staff member in charge of recall is responsible for getting established patients to return for care. The person in charge of marketing is responsible for the number of new patients. The end product must be something that is valuable to the practice and countable.
Not every staff member is productive. We have observed, over years of looking at many different practices, that there can be doctors and opticians who talk patients out of care while viewing they are helping patients. An example would be: “You really don’t need the single-use contact lenses the doctor prescribed, you can save money by going to a monthly lens.”
Is this staff member productive? Is this staff member helping patients?
Helping patients get the best care possible, while managing staff to make sure that care happens, is the essence of practice management. It’s not enough to just hope this is happening. We must measure to manage. What do we measure? The end products of each staff member. That gives direct insight into what is really happening in the practice, and that is how you judge the true value of each employee.