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The right medical practice staffing model doesn't waste any employee's time - or the patient's.
Does any of your staff waste time doing things
not in their job descriptions?

Whether you call it rightsizing, "highest and best-use staffing" or refer to it as a staffing ratio, every practice seeks to find its "sweet spot" – how many people it takes to run the most productive business. Like Goldilocks, practice administrators look for that "just right" model. Maybe you've already found it.

"Medical practices that are highly productive already understand the principles" of good staffing, says Marc Halley, president and CEO of The Halley Consulting Group. "They may not call it 'highest and best-use staffing' but that's what they're practicing." Halley will present the concept of highest and best-use staffing at the MGMA 2010 Annual Conference.

If you still seek that perfect model, here are some tips to keep in mind.

  • In your practice, there are three primary roles that affect productivity:
  1. The physician
  2. The clinical assistant
  3. The receptionist

    Halley says the rest of the practice, including administrators, are in secondary roles and should support the primary roles in meeting the needs, wants and priorities of referring physicians and patients.
  • In the highest and best-use staffing model, the primary roles do only what's in their job description and nothing else. For example, a physician should only practice medicine, not fill out paperwork or make copies, Halley says.
  • The clinical assistant has two important roles: 1. Ensure that the patient has a high-quality experience; 2. Drive and manage the physician's productivity by focusing on one exam room and one individual at a time. A 2010 MGMA e-Source article addressed how to approach this second role for nursing staff:

"When developing an optimal staffing model, consider the level of clinical decision-making you will require of staff (a factor often determined by how much physicians delegate), what types of professionals are most qualified for that clinical decision-making level and how you will use them.

"Generally, clinical staff consists of either licensed personnel (registered nurses [RNs], licensed practical nurses [LPNs], etc.) or nonlicensed personnel (medical, nursing and surgical assistants [MAs, NAs, SAs]). If your clinical model demands that staff make a lot of critical decisions and perform frequent medical procedures, you'll want more licensed professionals."

  • Your clinical staff can't focus solely on driving physician productivity and making critical decisions if they're on the phone with an insurance carrier or a pharmacy. To solve this common problem, more staff may be necessary. In fact, "many of the highest-producing practices in the country have more full-time-equivalent (FTE) support staff per physician than those who are producing at a lower level," Halley says. According to the MGMA 2009 Performance and Practices of Successful Medical Groups Report, the median total support staff FTE per physician is 5.24 for "better performers" versus 4.43 for "others."
  • Does best-use staffing ever mean downsizing? It could. Take a tough look around your office to see who's not so productive. If you don't want to lay off employees, try these six tips from MGMA Board member Nancy Babbitt, FACMPE. Or, consider ways to repurpose employees to make them more productive.

Are you stuck in a staffing dilemma? Share your experience in the comments.


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