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There’s no single solution to staffing your office if you decide to extend your hours. Staff plans and hours of operation vary widely. But Elizabeth Woodcock, FACMPE, does have one admonition: "Don’t be overstaffed. It defeats the whole purpose of having expanded hours unless you’re doing it simply to serve the patients," says Woodcock, an Atlanta-based health care consultant and director of knowledge management for Physicians Practice Inc.
In general, practices that have early morning or evening hours do not have a nurse on duty during their expanded hours, Woodcock says. Instead, most practices support one staff person in front and one in back. The easiest way to extend your hours is to find someone in your practice who wants to work outside of typical office hours and is willing to work at night, she says.
The next best solution is to rotate the responsibilities among existing staff. Or, you might consider making the position a multi-tasking position. For instance, some practices have used the night receptionist, whose job does not entail the same full workload as the day receptionist, to make patient collection telephone calls that can’t be made in the middle of a busy waiting room. The receptionist can check the patients in and spend the rest of the time calling on accounts. This means you aren’t paying staff to sit around, and it can improve patient collections, as well.
Practices that offer extended hours for their patients have come up with a variety of workable solutions. For instance, Bristol Street Pediatrics in Elkhart, IN, books appointments from 7 a.m. until 7 p.m. Monday through Friday and from 8 a.m. to 12 p.m. on Saturday. All employees work a four-day work week (35 to 37 hours a week) and have one full day off during the week, says Anne Cutler, administrator. The staff alternate Saturday morning work.
The doctor on call stays for the evening hours and sees whatever patients come in. On Saturday, one nurse practitioner and two doctors see patients. The six physicians in the practice rotate the weekend hours. One doctor who works the Saturday hours is the on-call doctor for the weekend. The other is the one who is on call Friday and Sunday nights.
The Hedges Clinic in Frankfort, IL, has a contract with a physician who has an independent practice and is willing to work its urgent care hours for a salary. The clinic operates after hours with a skeleton staff — a receptionist, laboratory technician, X-ray technician, and nurse. Urgent care hours at Hedges are Monday, Thursday, and Friday from 5 p.m. to 9 p.m., Wednesdays 2 p.m. to 9 p.m., and Saturdays 2 p.m. to 6 p.m.
Catawba Pediatric Associates in Hickory, NC, has six physicians, two nurse practitioners, and a staff of 56 who see patients for up to 80 hours a week. There are typically four providers at the Hickory office Monday through Friday. At 5 p.m., there is one physician and one nurse practitioner. The practice has a separate support staff for evening and weekend work.
Physicians rotate working nights and weekends. The on-call physician is responsible for working in the office. For instance, in winter, they have split weekends off. If a physician is on call on Friday, he or she is also on call on Sunday. In the summers, they rotate being on call and staff the office on Friday, Saturday, and Sunday. One auxiliary staff member stays at the front desk and has back-up until she can handle the patient load by herself, usually around 6 p.m. to 6:30 p.m.