Offer evening hours

My practice is located in a small town economically dependent on textile plants. Two years ago, when the plants experienced financial strains, the workers faced rigid restrictions on hours, break times and time off, even for medical appointments. Patients quit returning to our office for routine appointments and began using the local urgent care center, even though it required higher co-pays.

To meet our patients’ needs, we began offering evening hours. Each physician (assisted by one nurse and one front-office worker) was assigned an evening, Monday through Thursday. On the day the physician was assigned to work an evening shift, he or she would start at our usual 8:30 a.m. but would stay until 8 p.m. instead of 5 p.m. To compensate for the increased hours, each physician went from having an afternoon off to a full day off each week, with the exception of any hospital rounds the physician might have, and each nurse and office worker who completed an evening shift received an afternoon off.

For the physicians, this change was remarkably liberating. With our previous schedule of an afternoon off each week, we often used the time just catching up on paperwork. A full day off meant real freedom.

The response from patients has been gratifying. We have 11 patient slots open each evening. With rare exceptions, they are almost always full.

Take your staff to lunch

In our hectic office setting, I find it hard to get to know each employee beyond a cursory salutation as we pass in the hall or meet at the water cooler. On a good day, I may find out what someone did last weekend or is going to do next weekend, but I often feel out of touch. To try to fix this, I’ve started taking a different employee out to lunch each week to try to get to know him or her better. I’ve found that this gesture enriches my relationship with the staff.

Seek performance feedback

Giving and receiving constructive, tailored feedback is key in developing an office where staff morale is high and patients are happy. Try these approaches to solicit feedback from your colleagues:

• Find a time that is good for both of you to talk.

• Ask “what if” questions, such as “What would you do if one of your patients became irate because you were running behind schedule?”

• Concentrate on a specific incident that lends itself to feedback, such as a team project in which you were the team leader.

• Ask longtime co-workers whether they see any patterns in your work style, including areas where you have excelled and areas where they have seen you struggle.

• End the discussion when it stops being productive.

Conduct fire drills

Don’t let your practice’s employees – or physicians – ignore the importance of fire drills. To make fire drills more realistic, seal off a stairwell or exit, have employees aid an elderly or wheelchair-bound patient as they exit the practice, or introduce other obstacles they might encounter during an actual fire. Give your key employees specific tasks, such as checking the building to make sure it is clear, leading evacuation groups, and contacting and coordinating plans with authorities. Conduct fire drills once a year in your practice.

Encourage staff to identify problems

Revealing problems in your systems and processes is the first step in making your practice run smoothly and with fewer errors. Instead of fearing the identification of problems, create an environment in which staff members feel comfortable reporting problems and know that their suggestions will be taken seriously.