As I write this, our economy continues to limp along at a snail’s pace. It seems every time we read some good news, it’s just a matter of a days before corresponding bad data rains on our parade. Whether it‘s the US employment figures, the debt crisis at home and abroad, the U.S. trade deficit or health care reform that’s got you down, the result remains that our confidence in the economy remains shaky.
Fortunately, we work in healthcare, one of the few bright spots in today’s economy. The boomers are getting older, people are living longer (not healthier), and we expect more to be insured, so demand for our services is growing at a pace exceeding our ability to provide the necessary care. According to the U.S. Bureau of Labor Statistics, Healthcare has added an average of 24,000 jobs per month over the 12 months prior to June of 2011. Compare that to employment statistics in Construction or Manufacturing and you’ll understand how remarkable that number is.
It’s not all roses in healthcare, however. Eye care professionals have real concerns about the near-term. The healthcare reform debate, Medicare reimbursement rates and the impact of the economy on discretionary spending have limited the upside and tempered the mood, even in healthcare. The mood of today’s Ophthalmologists would be best described as one of cautiousness.
The delicate balance that Ophthalmologists face (as does any small business owner) is the fine line between appropriately fueling your practice to maximize it’s revenue potential, without taking unnecessary risks and spending out of proportion with today’s economic environment. Ophthalmic practices are looking to cap or cut expenses without impacting its lifeblood, patients.
As a small business owner, I relate to the feelings of uncertainty that creep in when making decisions impacting overhead, and none of those decisions are more impactful than decisions affecting staffing. Keeping overhead manageable is important, and because there are lots of things out of our control, is it better to play it safe, and do more with less? That’s good to a degree, but in my estimation, when it comes to staff there is a shallow point of diminishing returns.
Nothing is more important than people. Nothing. The most significant decisions we have ever made at Local Eye Site have all revolved around human resources. Bad hires can seriously derail a business, and good hires can get it on track. At their core, every practice, and every business is defined by its people. People define its culture, and in turn the service it provides, and the feelings of its customers.
Back to doing more with less. Prudence is good; maximizing productivity of the resources you have is good. Making staffing decisions based purely on the short term bottom line is bad for business in the long run. Making an long term investment in highly trained and experienced people of good character to a large measure define your business, and enable you to separate yourself from your competition.
Let’s consider Technicians as a position that greatly impacts the experience and level of care that your patients (customers) have, and what they tell their friends. Do you hire experienced, highly trained and certified technicians? What does certification say to you about the level of commitment to career (and care) of the technician, versus the not-certified technician? Perhaps you hire “good people” that you will train? I would suggest that hiring good people is in fact very important, but those good people should also be experienced, well-trained, and committed to our their careers and our industry.
Tara McAlister, Manager of Staff Development at Charlotte Eye, Ear, Nose & Throat (CEENTA) in Charlotte, NC had this to say:
“Ophthalmic medical office practice productivity has become increasingly more important over the last several years with reductions in Medicare reimbursements and impending changes in healthcare. The most efficient way to control costs is to ensure that each task is performed accurately by personnel who are well qualified and trained in the latest techniques in ophthalmic diseases and conditions.”
Ms. McAlister knows that, especially in this economic environment, it pays dividends to invest in people that are highly trained and qualified. If you are going to maximize the productivity and quality of care from your human resources, it’s best to start with quality resources.
A study published in Contact Lens Association of Ophthalmologists in 2008 by Woodworth, Jr., C.O.M.T., C.O.E., et al set out to “compare ophthalmic practice productivity and performance attributes, as rated by employing ophthalmologists, of noncertified and three levels of certified ophthalmic medical personnel (OMPs).” 385 American and Canadian ophthalmologists assessed 14 desirable professional attributes and 10 practice productivity measures. OMPs were rated on attributes such as patient care, satisfaction and reduced patient complaints, doctor productivity, ability to work independently and be trained to perform multiple roles, good judgement, initiative, drive and revenue per patient.
Results showed that a statistically significant number of ophthalmologists believed that certified personnel showed more of all 14 of the personal attributes considered desirable compared to noncertified OMPs. The study concluded that “compared to noncertified personnel, the employment of certified ophthalmic personnel enhances the quality and productivity of an ophthalmic practice. Overall practice productivity is increased with certified ophthalmic personnel.” Finally, Woodworth et al stated…
“The most efficient way to control costs is to ensure that each task is performed accurately by personnel who are neither under - nor over-trained for the given task.”
William Ehlers, MD President of the JCAHPO agrees:
“A key to increasing ophthalmologist productivity and efficiency is delegating eye exam tasks to their eye care team, especially to certified ophthalmic medical personnel.” Dr. Ehlers continued “Canadian and U.S. studies have shown that certified personnel made the greatest contributions to productivity in key areas such as triage screening, trouble-shooting rapport, doctor productivity, and number of patients seen per hour. There is a growing recognition that certified personnel bring added value and a competitive advantage to their employers that increases their bottom line.”
As you consider how to best navigate the rough waters of this economy, be a good steward of your resources, but don’t cut corners on your people. Making an investment in quality human resources will ultimately increase your practice’s productivity, reputation, competitiveness and profitability. Happy hiring!
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Wonderful article and excellent points! In the middle of navigating these rough economic waters, the practice I work for implemented a new computer system to come into compliance this year with the government’s Electronic Health Record regulations. I am striving as a technician to remain sharply focused and attentive in my “face to face” interaction with each patient in front of me. Learning to quickly input the various pieces of my work up in the appropriate boxes within our EHR while avoiding the dreaded “back to the patient posture” is a challenge! The attributes referenced in the mentioned 2008 report (Contact Lens Association of Ophthalmologists in 2008 by Woodworth, Jr., C.O.M.T., C.O.E., et al) add so much to the overall experience we each give our patients, and increases the value a technician or assistant can bring to a practice. I explored what those specific 14 attributes were: “Credibility, reliability, competence, quality assurance, quality of patient care, knowledge base to make adjustments, increased skills (expertise), ability to work independently, broader knowledge base, ability to detect errors, ability to be trained to perform multiple roles in the practice, professional image, good judgment, and initiative and drive”.
The added skill needed to input the volume of information required with government certified EHR systems in 2011 and in the years to come will definitely affect future hiring practices. Will Human Resource departments with limited labor budgets now have to choose between hiring a speedy data entry type applicant, non-certified and willing to accept a lower base pay versus an experienced certified assistant or technician with many of these 14 attributes already well-established in their mindset? I strongly feel that if one’s eye care career is taken seriously, these attributes will naturally grow out of the commitment toward excellence in performing a certified technician’s job to a high degree. These qualities in a potential hire cannot be overlooked in an effort to cut corners; nor can they be expected to develop over a short amount of time after the hiring process. It takes years of experience and self-motivation to grow in these “soft skills” areas that complement the basic technical knowledge. Without my JCAHPO certification as a C.O.T., I might have accomplished the task of acquiring the skill sets required to be an adequate eye assistant. Yet it was through years of continuing education, recertifying and taking my work in the health field seriously to create a career for myself and increase what I personally can add to the practice. I agree; the value of people in this economy as well as the attributes those people possess cannot be overlooked, even in an economy running at a snail’s pace!