Every small medical practice has a certain number of staffing decisions it will or will not make throughout the years. Staffing costs take a toll on budgets, but an under-staffed or overworked practice can suffer from poor patient care and revenue losses. Finding the right balance is important, but even more so is recognizing when to bring someone in-house and when enough support can be gained without the full-time, permanent costs.
Many practice owners staff reactively; they hire when the situation becomes overwhelming, when there is a sudden resignation, or when they realize things are falling through the cracks. Yet practices with a long-term approach to successful operation consider staffing proactively, not just for the sake of getting through a current situation but also for future growth and changes down the road.
What Traditional Staffing Costs Are Unaccounted For
When small practices assess what it costs to hire someone, they consider salary and benefits. Yet the true cost of onboarding someone new in a medical practice far exceeds what anyone considers on paper. For example, how much time do medical staff need for training? From weeks to months, depending on specialty and situational nuances of the practice.
How much time do current staff members need to assess training needs vs. what they’re doing to divide their attention elsewhere? Slower processing times, errors, patient service disruptions are all common as everyone takes their foot off the pedal to welcome someone new.
What about compliance needs? New hires need to understand HIPAA regulations, office procedures, and day-of procedures that are often specialty-specific and not learned overnight. For every senior staff member who takes time out of their day to explain to a new hire what they should know – as long as they’re even there – that’s another time cost most practices fail to account for.
Where Outsourcing is More Cost-Effective
Some functions do not require hands-on presence (when done by generalists) and are best handled by specialists in alternative settings. For example, billing – often an extensive web of insurance needs and coding requirements – fails in many ways for small practices who don’t have sufficient time on their hands to devote to it.
Instead, many small practices have revenue cycle issues that benefit from an assessment of outsourced billing help. Outsourced billing assistance boasts specialized expertise in programs developed on their end that would take years or months to replicate within a small practice’s walls and can increase/decrease based on practice volume at the time.
It’s essentially recognizing what specialists need physical presence in order to help versus what can simply follow procedures without any proximity.
The Full-Time Determination
Every small practice instantly assumes they need full-time employees for every aspect of their practice. However, this often means while things are slow, they have too many employees but when things are busy, they don’t have enough. The full-time billing expert may have more capacity than a practice ever generates for themselves on a part-time basis; yet no part-time role has been compelling enough for someone to meet.
The beauty of external support services is that the practice is only paying for what’s needed – for work – as opposed to salaries based on fixed criteria regardless of what’s needed at that time. This is especially true for practices undergoing growth spurts, seasonal lulls, or transitional periods where it’s uncertain whether or not there will be enough work.
The issue at hand with full-timers is that their fixed costs become ongoing even if the practice revenue cannot support it one month out of the year (or during a recession).
The multiple part-time positions required for increased coverage are too time-consuming and redundant instead of bringing in temporary support.
Specialization versus Generalization
Small practices rely upon many support personnel; those who answer phones are often scheduling appointments, doing insurance verification and answering coding questions. While it’s nice to have everyone trained well enough to pitch in wherever they are needed; that’s not always the best scenario for complex tasks.
Coding and billing requires specialization; something someone can get decent at doing (a receptionist who also handles coding) but not good enough to handle complex claims, appeals and negotiations with outsiders on behalf of the patient.
More often than not this leads to less revenue than if someone had been hired outright; a complex problem that exceeds the price of billing worth.
The question is whether or not it pays to train medical staff to become specialized or just use outside experts who already have the experience.
The Scalability Factor
Those small practices who want to grow need solutions that are scalable. Paying full-time employees from the start brings fixed costs that do not grow at the same rate as revenue does. Often there are situations where practices need more than one person can provide but don’t need two separate part-timers’ worth.
External help supplies better answers because they can scale without needing a commitment from permanent employment. As volume increases at the practice, volume increases for support needs as well. If growth doesn’t happen, however, no one is stuck in salary commitments that could ruin their business.
The same is true about those temporary spikes when there’s an influx of patients (seasonal needs, COVID spikes or vaccines) or vacation days go unfilled; external support can lend hours without having to create hassle around overtime or temporary hiring processes that complicate everything.
Quality Control Management
The big fear many practices have about utilizing external support are quality control and management considerations. If staff is in-house, they can see firsthand who’s doing good work and who isn’t; they can manage them better than if they’re outside forces.
However, communication needs to be looked at differently but qualities that are easily measurable mean they can be held accountable as well as those who focus only on those projects.
Those successful practices who benefit from external support provide adequate communication paths (best methods for communicating questions about billing), updates along the way so processes aren’t unnecessarily long (where applicable) and performance metrics which allow management potential that every other employee has access to.
More often than not outsiders provide better work that’s more efficient since they’re used to doing things only in their realm instead of trying to juggle here and there.
The Practice With Most Intentional Staffing Wins
The most successful small practices realize staffing decisions need an intentional approach instead of a reactive one. They assess their true workload needs, determine where it’s best to have physical presence and assess what it’s really costing them versus hidden costs and opportunity costs otherwise.
They factor in future growth and how different staffing solutions will either hinder or help facilitate their growth opportunities down the line. A practice looking to scale becomes outsmarted by flexible support during heavy growth until things stabilize; THEN proper staff can be brought in once workload patterns emerge.
It’s all about meeting staffing solutions where they are instead of relying on traditional means without acknowledging the current situation or future appeal. Staff decisions help keep things running smoothly while maintaining budgetary allowances.