Finding and keeping great front office staff

Your front office staff are the face of your practice — an expression of your practice’s philosophy, attitude, and values. So it should be a top priority to hire and retain top-quality people to fill such roles as receptionists, phone operators, medical secretaries, and transcriptionists.

But it can be a challenge to keep these people and keep their morale high because these positions often include high levels of stress for low pay. So try something different, right from the start: Pay more for the right candidate.

If you pay someone more than they think they’re worth, they’ll work up to that level. If you pay people less, they’ll work down to that level.

It may not be as easy to keep the stress level low. One of the main stressors for front office staff is interacting with unhappy patients — people who are unhappy simply because they’re not feeling well. To lessen the likelihood of burning out the person at the front desk, rotate this throughout the practice. You’ll enjoy the benefits of cross-trained staff members as well as increased loyalty. And you’ll increase the odds that the person at the front desk will greet your patients with a smile, make them feel welcome, and convey a happy attitude.

Here are some more tips for getting and keeping top-notch front office staff.

Promote professionalism. Treat your front office staff with kindness and respect. Beyond a friendly hello in the morning, be sure your staff have the right equipment to do their jobs. Keep equipment working and up-to-date. Make sure staff know how to use the equipment and make it convenient for them whenever possible. For example, if the receptionist needs to scan/copy patients’ insurance cards, place the scanner/copier near her desk.

Uncover weaknesses. Even with the best intentions, front office operations are prone to kinks. At times, phones may go unanswered, patients may reach the exam room already dissatisfied, and these bumps can lead to sinking front office morale and even resentment among staff. A staff fallout can then affect patient flow, feeding an ongoing negative cycle.

Hold all staff to the same standards — the mini-max performance rule: “The minimum you get from one employee is the maximum you can expect from another in that position in terms of performance.”

Fix the phones. Periodically use a chart to track incoming calls. Create a matrix with hours of the day along the right and the reasons for the calls across the top, e.g., to schedule an appointment, talk to a nurse, refill a prescription, or get a referral. For one week every quarter, have the staff track how many and what kinds of calls come at certain times of day. If you find you get numerous appointment calls in the morning, you can then staff accordingly. By tracking what’s coming in, you can proactively plan rather than react.

Your phone company can provide you with additional information, such as the number of incoming calls, hang-ups, and busy signals. So if you discover after a month that 10% of callers get a busy signal or that 5% hang up, you know you need to improve your phone service by adding more lines, more people, or both.

You might also consider adding or tweaking your existing automated phone system. Program your system to have the greeting first, then the identity of the practice. The first option — after directing callers with a true emergency to go to the emergency room — should ask callers whether they want to make an appointment, then transfer them to the operator. You can also include an option to hear directions to the practice or refill a prescription.

Although people are used to such phone trees, make sure your message and directions are clear, available, and friendly, especially for new patients. And, remember to direct patients to your website for access to online services.

There should be no backlog of phone calls at the end of the day. Voice mail should be checked every hour. If there are too many voice mails to keep up with, you need to get someone, such as a float nurse, to provide extra help.

Constantly seek solutions. You can eliminate a lot of phone calls by using a patient portal on your website. A portal is an interactive tool that can answer patients’ questions, allow them to schedule appointments, deliver test results, process prescription refill requests, provide directions to the practice, and generally save staff a tremendous amount of time, while improving service to your patients.

One of the best ways to keep your front office streamlined is to ask the staff for suggestions. We think that as managers we know the answers, but we’re not doing the jobs every day.

You’re also likely to get higher buy-in from the staff if they’re carrying out their own ideas.

Rosemarie Nelson is principal, MGMA Health Care Consulting Group and blogs at Practice Pointers.

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  • Frank Lehman

    You said: One of the best ways to keep your front office streamlined is to ask the staff for suggestions. We think that as managers we know the answers, but we’re not doing the jobs every day.

    A great idea.

    But have you ever thought of asking your customers (ie. your patients)?

  • Ron Smith

    Staff, front and back, need incentives, not just training. We started profit sharing in 2010 and have an overwhelmingly low turnover rate in staff, and a high patient satisfaction rate. It hasn’t broken the bank at all. It hasn’t negatively affected any bottom lines.

    We also created a unique patient flow pattern by implementing some unique ideas. The nursing staff in the back rotate through the check-in window. We have a facilitator nurse that orchestrates all patient flow and coordinates with nursing care in the back. Each job is a little different and we have paid attention to those with different aspirations and talents. We look to puts staff into the positions they are stronger in and they are happier as a result.

    I don’t have an office manager. I have a practice manager. She even has the authority to call me on the carpet if I’m late or getting behind. As a physician, I must be as accountable to the rules that she and I setup, because I want the best experience possible for my parents and patients.

    I’m now in my 30th year and medicine is great. I remember about 15 years ago or better when I was so tired physically and emotionally drained. I was seeing 40 patients a day and leaving the office at 6;30. Now the only reason that I don’t leave by 5:15 or 5:30 is because I’m piddling around using some of my extra energy at the office where I’m seeing about 25 patients a day.

    There are ways to have a better practice if physicians can bring themselves to think beyond what they have done for years and years.

    Ron Smith, MD

    www (dot) ronsmithmd (dot) com

  • B. Andrews

    Thank you for your recognition of the importance of the front desk staff for the overall impression of the practice. From the patient’s perspective, everyone in the office IS the practice, and each member of the staff has opportunities to make the patient’s experience positive–or not. It’s not just a matter of scores and ratings: the overall experience can contribute to the therapeutic process. Patients who feel welcomed and validated will come back when they need care. And some will refer friends and loved ones to a practice they love.

    You include many savvy suggestions: paying decently, promoting professionalism, setting and upholding high standards for service and response, and addressing communication logjams.

    The idea of rotating staff through the most stressful tasks can be effective. An additional strategy is to give every staff member the tools to deal with unhappy patients in an empathic and helpful way. The Institute for Healthcare Communication (IHC), an independent non-profit based in New Haven, Conn. and active throughout North America, conducts a half-day workshop that teaches learners specific skills to make the practice experience impressive. I recommend you check out IHC’s Treating Patients with C.A.R.E. workshop.

  • Guest

    I work in sports medicine and do many referrals to orthopedics. Our current team physician needs to read this! We constantly hear from parents about how GREAT the doctor is but how HORRIBLE his office is. The phones never get answered. I get back line numbers and cell phones to his entire staff including him. Even HIS communication is poor- taking over 3 days to answer messages. He is losing patients, and it is a constant battle with me as I start to refer elsewhere & then here it from my boss for not sending them to “Our team physician”. I do not know how to talk to the physician about it as I have numerous times before and fear “nagging” him. I am sick of getting yelled at my parents for their phones never being answered and surgeries getting scheduled for multiple dates, no student insurance being filed etc. Being a team physician for a large 5A HS in Texas is a HOT commodity we have physicians lined up to take the reigns! One comes up after his surgeries weekly to see kids (NO charge) & offers his services for us during conference/playoff games. It is true though that no matter how good a physician one is… you need a GREAT office staff to help support it!