Woodcock & Associates: Changing the Way You Work

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Expansion — Without Expanding

Is your practice running out of room? More patient volume is a nice problem to have, but not if you and your staff are tripping over each other.

Expanding by renting or building more space might seem risky in these economic times. And banks continue to keep a tight grip on funds they previously loaned so easily. With the economy in a rough patch and the future of medical reimbursement more cloudy than ever, physicians need to get creative to find more space within the walls of their present offices. The good news is that getting more room without relocating or going deeper into debt may be possible.

See if one of these ideas works for you:

Add hours. Try starting an hour earlier (or staying later). Early morning or evening hours are terrific options if you practice in a group. You and your colleagues can operate in staggered shifts or share the early morning or late evening responsibilities. Office hours stretching from 7 a.m. to 9 p.m. would allow you to effectively double your current 9-to-5 capacity, but even a 20 percent addition of time could make a meaningful difference if patients go for it. Note: Many physicians find that early morning hours are more popular with patients than extended evening office hours. Patients can avoid commuting traffic, and still get to work on time.

Work through lunch. Ouch, you are probably saying, but if space issues are of a moderate severity, you can pick up an extra hour just by working through lunch. More comfortably, you could take a 30-minute lunch and extend the day by an additional 30 minutes on either end. Some physicians schedule patients who have histories of last-minute cancellations or no-shows for the noon hour. That way, either you get lunch, see some patients, or a little of both at midday.

Go elsewhere to see patients. Maybe you can go to some of your patients. Consider sending one associate to perform traditional house calls, or travel to a nursing home, or assisted living facility. If your practice manages the care of indigent patients, a community organization may make its space available for you and your staff a half day a week.

Make do with what you have. Do you have a room or two dedicated to supplies, old files or samples – or an exam room that you’ve shoved all of these items into for years? It’s time to clean house. Get rid of them (if you can) or store those items safely elsewhere, such as in a locked cabinet or, if applicable, electronically. Convert the supply or old records room into a space for seeing patients; it may be your ‘mini exam room’ but it can become a productive, revenue-producing space. Another candidate for conversion to an exam room should be the medical records storage room. Get more serious about culling inactive records for offsite storage. And while you are at it, push for the implementation of an electronic health record ­- practices find that it frees up significant space once devoted to storing paper charts. Finally, consider taking back part of your reception area. For a modest remodeling expense, you’ll have another exam room or two. Staff can room more patients for you to see instead of having them cool their heels in the reception area. You’ll likely see more patients, which will not only boost revenue but improve patient satisfaction.

Outsource processes. Regain square footage by relocating certain administrative processes elsewhere. Not every administrative task needs to be onsite. Maybe the business office staff and telephone operators could be placed in cheaper office space. Before doing so, consider how much you’ve been leaning on the non-clinical staff to pitch in during unexpected staff shortages. You won’t have that backup if they are offsite. Balance the costs of any moving and any high speed telecommunications links you may need with the office staff. If the savings is considerable, it may be worth it, even though you run the risk of losing a sense of the team environment.

Eliminate private offices. It’s sometimes a hard step to take but many practices are moving away from private offices for each physician. Instead, two or three physicians will share one office or a “bullpen” office will be established for all physicians. These shared areas are cost-effective and promote collegiality. Consider that most physicians spend less than an hour a day in their offices. That 18 to 22 hours a month makes for some pretty expensive floor space.

Get more cross-functional. Many procedure rooms sit empty for several hours a day, especially those dedicated to just one procedure. Cross-functional rooms will improve your efficiency immediately while making better use of floor space.

Before you spend the time and money to relocate, consider the alternatives. Temporary or even permanent fixes for your space shortage could be right in front of you. If you really are out of options, then it’s time to move. New practice space designed well can significantly improve productivity. Take a close look at what you have and what you need. Don’t hesitate to seek help from space-planning experts when planning a facility improvement or relocation.

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Woodcock & Associates: Changing the Way You Work