Gaining efficiencies and production output is one of my favorite projects. I’m constantly looking for ways to streamline my practice. People often believe that they “obviously” need more staff as they grow in revenue (and hopefully net). Luckily for us, though, we can challenge that potential misconception. Here are the top ways I’ve been able to have fewer staff now than I did three years, ago and why it’s working:
- COVID reductions. How many of you realized that, when you lost staff during COVID and it was difficult to replace them, you didn’t need all of them after all? Yep, me too. And no, this was not at the cost of over-burdening other staff.
Take-away: When someone unexpectedly quits, take time to review what they were contributing to the office.- Can his or her duties be delegated to others?
- Could a previously full-time position be serviced by a part-time position?
- Could the work be done remotely? (Opening roles to remote work will greatly increase your applicant pool when do you need to fill a position.)
- Technology. We all have technology in our offices, but how we apply it varies from clinic to clinic. Do you connect all testing technology to your EMR for seamless data upload? Have you sent all data collection forms to your patients electronically ahead of their appointments for a faster check-in process? Think about how you could implement automatic ordering of trial contact lenses by scanning a bar code, or take inventory in your optical by using a scanning device that can count frames just by being waved over your stock. Even something as simple as running a monthly report from your EMR to verify orders that have not been processed, picked up or sent out helps with collections as well as the patient experience. We are constantly exploring new technologies and embracing the ones we already have that work well for our office. Don’t forget to analyze these systems on an ongoing basis, too, and cull any that are no longer relevant.
- Changing accepted insurances. This most obviously applies to vision insurances, but I’ve also decreased a few major medical “miscellaneous” insurances from which it was incredibly difficult to collect payment. We often focus on the plans that reimburse us, but I would also like to highlight the importance of the amount of staff time that is involved in working with these insurances, because I’ve found that this element is often left out of analyses.
Let’s break down what is involved in administering a vision plan patient in the clinic: A patient calls to schedule an appointment. Staff verify the plan, find out who the policy holder is and get all the other information needed. They may need to answer questions regarding how the plan works and what benefits the patient has. Then, once the appointment is confirmed, an authorization needs to pulled. This process is roughly the same for both new and established patients and takes approximately 15 minutes to complete.
The patient arrives for his or her exam. Assuming staff did a rock-star job of answering all questions, it’s smooth sailing for check-in and the exam. At the end of the exam, the doctor hands the patient off to the optician for the glasses/contact lenses conversation and what benefits their plan allows. Staff may have to run several scenarios for this patient, even if it’s just for glasses or contact lens purchases, to determine the better “deal” for them. This conversation is typically another 15 minutes that we don’t need to spend for private pay patients.
Once purchasing decisions are made, your staff must submit the claim for the exam, fitting (as applicable) and materials. Then, once you get paid, they need to enter in all the payments, write-offs and charge-backs, which could take another 15 minutes.
In other words, you have 45 minutes wrapped up in administration for and doing business with one vision plan patient. This doesn’t count the patients who can’t decide on glasses or contact lenses at the time of their visit and call back or return in person to go over everything again. Regardless of the range of reimbursements, that is staff time for which you must pay. Now multiply this estimate by as many vision plan patients you see per week. Even if you conservatively cut this time in half, you probably have the hours of at least a part-time staff member, if not full-time.
Take-away: I found that my staff has exorbitant amounts of down time now after I cut my last vision plan, which comprised approximately 35% of my patient base. Patient exams were also only down by 10%, so we ended up with just slightly fewer patients overall. Although I didn’t let any staff go when we dropped the plan, when one of my opticians left later that year and another part-time staffer followed (both for personal reasons), I didn’t replace them.
We also added virtual assistants, which allowed me to replace a more expensive front desk staffer with a lower-paid replacement as the responsibilities of that position decreased. As a result, my payroll is down 15% compared to the year prior. The best part? My office runs more efficiently now than ever before with less confusion and happier staff and patients.
Don’t discount what is (or isn’t) necessary for staff to do their jobs, but also take a moment to look deeper at the day-to-day activities of those staff members. Any gain you can find there is a gain to your bottom line and the success of your practice.
