Jarrod Shapiro, DPM Practice Perfect Editor Mountain View Medical & Surgical Associates, Madras, Oregon

When the business community talks about “controllable” versus uncontrollable costs, they mean the differences between the expenses a manager can affect, or manipulate, vs. those she can’t. Uncontrollable costs would include, for example, utilities, rent, or professional society dues. The classic controllable cost is labor. A manager can control this expense, for instance, by sending a staffer home early, thereby decreasing labor costs. But sometimes I wonder if labor is as “controllable” as we think it is. Let’s take our front staffers as an example. In significant ways, they’re both controllable and uncontrollable. It’s true when we say front staff can make or break a doctor.

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It’s not possible to watch over your front staff at every moment.  Preventing them from saying something wrong or unprofessional may not always be possible.  We have to leave a certain amount of control in their hands.  The front staff can either be a strong practice building asset, or a ticking nuclear time bomb.  We know from many surveys that poor staff interactions often lead to patients leaving physician practices. Remember, these are individuals with minds of their own, and sometimes your staff won’t use them.  However, as we’ll discuss below, there are ways to limit these risks. 

Additionally, it’s very difficult to find/hire that perfect front staffer. To whom do I refer? You know that person: friendly, bubbly, professional, smart, efficient, capable, and unflappable. Sounds like the best staffer for any position! The problem is, this person is very rare and often difficult to keep for long (they’re often upwardly mobile with active plans for future successes which may or may not include your practice). More often, we’re lucky to find a few of these traits in any one person.

Take the front staff at my office as an example.  My multispecialty practice has two primary front desk staff at both ends of the age spectrum.  The older of the two is confident and friendly, but incapable of performing the technical responsibilities of the job, making mistakes that sometimes have ramifications for me as the physician.  She also becomes easily flustered when too many events occur simultaneously.  On the other side of the spectrum is the younger of the front staffers.   Quiet, outwardly shy, with an inexpressive affect, she is capable of performing the technical aspects with authority and skill, never becoming upset when the stress levels rise, but lacking that all important customer service aspect.  I’d like to smoosh these two workers together! The insufficiencies of these two make for some potentially troublesome patient interactions.  Unfortunately, I have only minimal direct influence on the choice of staff at my practice (one of the limitations to working as an employee in a multispecialty practice).

So, what’s the good news then? The good news is front staff is not as “uncontrollable” as one might think.  With planning, attention, and follow-up, your front staff can be an invaluable part of the practice.  Here are a few suggestions and thoughts.

1. Consider what personal qualities you most value for a front staffer.  Is personable more important than technical skill?  Are problem solving skills more important to you?
2. Hire the best person you can for the position.  Perform a thorough interview of as many candidates as possible (which shouldn’t be hard considering the currently high unemployment numbers).
3. Keep clearly documented required skills and protocols in your practice manual so the staff knows what’s expected of them. Continually document successes, infractions, and deficiencies in personnel files in case it becomes necessary to take action.
4. Incorporate staff into decision-making processes when appropriate. An involved staff is a motivated staff.
5. Discuss openly motivational methods. What’s important to your staff? This differs between staff, and it isn’t all about money (which has been found to be a temporary motivational tool). Some staffers might prefer an extra vacation or personal day rather than more money.
6. Consider periodic training and skill updating. Many people will feel stagnant doing the same thing every day without changes. For example, my quiet front staffer could benefit from training to improve her people skills. Cross training may also improve staff morale while preventing stagnation in the daily grind.

It all boils down to motivation and training. If your front staff is well trained and enjoys their job, they’re more likely to treat your patients with the friendliness, respect, and professionalism that will keep your patients coming back time and again. Next to the doctor the front staff is the “face” of your practice. Make it a face patients want to see. Best wishes.

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Jarrod Shapiro, DPM
PRESENT Practice Perfect Editor
[email protected]

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