When You’ve Run Out of Space: Alternatives to Moving Your Practice
from Practice Update, Summer 2007
By Elizabeth Woodcock, MBA FACMPE, CPC
I recently had a physician say that he no longer had enough exam rooms to see all of his patients. He had already set up a meeting with a real estate agent to discuss his options for relocating. Before you spend the time—and the money—to leave your existing space, consider your alternatives. If you’ve run out of space, there are some options to explore for a temporary or perhaps even a permanent fix.
Expand your hours
Scheduling your first patient at 6:45 a.m. means you’re in the first exam room seeing the patient at 7 a.m. Although you may not have thousands of parents chomping at the bit to come in that early, you’ll definitely have a few delighted early risers that are grateful to get their child’s appointment in before they head to work and school. Early morning—and evening hours—are terrific if you practice in a group, because you can operate in shifts: 7 a.m. to 2 p.m., and 2 p.m. to 9 p.m. Without breaking for lunch, this can fully double your current 9 a.m. to 5 p.m. capacity. Shorten the shifts, and work additional days, if necessary.
Work through lunch
If your space issues are limited, you can pick up an extra hour just by working through lunch. One creative physician who needed space scheduled all of his patients with a history of no-shows during 12 to 1. If they showed, he saw them. If they didn’t, he had lunch!
See patients out of the office
Instead of bringing all of your patients to your facility, determine if there is a way to go to them. Prevalent in the distant past, home visits are returning to popularity. Although it may not behoove you to see all of your patients in their homes, parents of children with special needs may especially appreciate your being on the road.
Take over the space you already have
If your practice has taken over a room or two for storing supplies, or as a sample closet, it’s time to clean them out. Store supplies and samples elsewhere, and convert the room back to seeing patients. Reclaim your records room by scanning the contents of old charts and disposing of the paper; storing old charts off-site; or going totally paperless. Or, get bigger rewards by taking back part of your waiting room. With more exam room space, you may be able to reduce patients’ waiting times—and the need for the space in which they wait. This will not only boost revenue, but improve patient satisfaction.
Outsource functions
To regain square footage, evaluate your options to relocate administrative functions that don’t need to be on-site. The business office staff and telephone operators may both be options. Recognize that there is a downside for relocating your staff, however. You won’t be able to have their immediate assistance during staff shortages, and you’ll lose the team environment that comes with everyone under the same roof.
Evaluate non-productive space
If you have private offices, consider sharing. “Bullpen” offices are efficient and promote collegiality as well. A convincing exercise is to spend a week capturing the time you actually spend in your office. Most physicians spend less than an hour a day in their offices, if even that. If you’re crunched for space, you’re paying a premium for that hour.
Although these solutions may offer some extra space at no or low cost, when you run out of options, it’s time to move. A new space can improve your productivity, but don’t limp along with too little for years.
Practice Management Q&A
QUESTION
Our billing system vendor recommended that we stop sending out statements that have small balances. Should we do this? And how should we define “small”?
ANSWER
Your vendor is right. You don’t want to send out a statement for $0.99 because it will cost you more than that to print, process, and mail it. My recommendation is to send statements for $5 and above, while suspending those for lower account balances. Setting a higher minimum balance, such as $10 or $20, could cause you to miss out on collecting patient co-payments. One way to avoid this small balance problem is to make sure your staff asks for payments—small and large—on all balances from patients at the time of service.
QUESTION
I notice many retail stores asking me to sign on an electronic signature pad. Is there any reason that we cannot capture parents’ and guardians’ signatures in the same way to reduce some of the volume of paper in our pediatric practice?
ANSWER
You certainly can! Electronic signature pads are relatively inexpensive. Many come with software that can integrate signatures into your existing management information systems, or store them on your computer hard drive in a separate file. Either way, it’s a great record of the patient being present and their parent or guardian signing for privacy notice or other documents. Of course, check with an attorney to evaluate where original signatures may be recommended or required by state law (e.g., informed consent). Find a sampling of these machines from different vendors at www.windowsmarketplace.com by searching on the phrase “signature pad.” Or go to the Web site of vendors of practice management or electronic medical record systems to find if they have an integrated option that will work for you.
