How to Solve Your Medical Practice's Toughest Challenges

Kathy I. Moghadas, RN, CLRM, CHBC


October 11, 2017

In This Article

Physicians' Lunchtime and Personal Phone Calls

Another potential bottleneck is the issue of time for lunch. Over two thirds of the physicians reported that they take less than an hour for lunch, with 40% taking less than a half-hour. When that happens, particularly in a smaller practice, it is common to turn the phones over to answering services for an hour or even up to 2 hours during midday.

Cutting 2 hours of patient call-in time reduces patients' ability to access their clinicians. Usually, we see the paradoxical effect that when the phones are turned back on, the afternoons are fraught, with the administrative staff scrambling to return calls and take new calls.

Adding to this problem is that employers are putting pressure on employees to reduce the number of personal phone calls. We have witnessed problems with patients not being able to access their medical providers during their lunch hours.

Because the phone lines become overwhelmed with outgoing calls by the clinicians as well as clinical teams during the lunch hour, it is self-defeating to turn the telephones off during lunchtime. Email and patient portal access are still in its infancy, and as such, the main means of practitioner communication with their patients is the telephone.

Administrative Support Needs Are Changing

When asked what would help them, over one third (38%) of the physician respondents mentioned adding more clinical staff, such as nurses and physician assistants. The trend, though, is for less clinical support and more administrative support. Whereas the number of medical assistants or clinical assistants has pretty much remained the same over the past decade, we have seen the need for more dedicated administrative support personnel increase.

Ten years ago, a solo physician opening up a practice would routinely want to staff his office with a receptionist, an office manager/biller, and a medical assistant. Today, we see the addition of a dedicated billing person who should be certified in coding, as well as a person who is dedicated to handling referrals and scheduling with other physicians, in addition to that receptionist and office manager.

The fact that over one half of the respondents request and receive copayments and deductibles at the time of service (59%) supports the need for that additional administrative person to assist with upfront money collection. It also reduces the back-end chasing of patient payments by the accounts receivable department; this ultimately reduces the amount of outstanding accounts receivable in general and bills that are 90 days outstanding, which are all markers of successful practices.

Having less staff resources devoted to calling for collections, sending reminders, and having to perform multiple-cycle billing increases the value of the dollars you generate. A word of caution: Charging for cancelled appointments punishes the offenders but only works when the physician does not keep the patients waiting and the practice is not of a frequently rescheduling specialty, such as ob/gyn.


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