family practice issues and general life events

Posts tagged ‘restart’

When too much is never enough

I accepted a while back that I could not do everything.  I was not going to be the mother who volunteered for everything for their child’s school, the doctor who completely immersed themselves in their patients lives with no regard for their own, or the best friend that is always available.  Frankly most of my time is spent between physician and mother, I have few friends that I talk to on a regular basis, and even fewer that I see regularly.  This is ok, life is about choices, and sometimes we sacrifice one area for another.


However, we are currently undergoing some major changes at my clinic.  Were they necessary, could they have been prevented?  I don’t know.  I don’t know if they came about while I was spending extra time focused on my boys and taking care of their needs, and taking a much-needed vacation.  Well, actually I do know that the vacation had little to do with the changes needing to be made, but it could have resulted from time I was focusing on my children and elsewhere.


By the end of this month, all of my staff will be brand new, i.e. working for me for less than 3 months and not yet qualifying for benefits.  One of my front office is brand new, and we are attempting to convert to an outside billing system.  This was previously done in-house, and due to increasing requirements on time and needing to move staff around to cover holes, we have overlooked probably the most important aspect of any company revenue collections.  We are busier than ever and doing the work required to earn income, just seeming to miss the step of actually collecting that money.  I spent my Saturday morning looking at the Accounts Receivable for the past year, and it was terrible and depressing.  How did I miss it?  Well I can give you excuses of well I have been seeing more patients than ever, I have been trying to be a good mother, I have been trying to be a good citizen, and the list goes on.


We have known for a couple of months that we needed help.  In fact, we have been looking for someone qualified and fully trained for about 3 months.  The only takers have been, people neither trained nor having any experience, all wishing to tell me that they are fast learners.  Unfortunately, I have neither the time nor the desire to train someone for this all important job.  Add to that, I would argue that I am not the best one to train another for this job.  There are programs that certify people for this, and I am not certified, but I know probably as well as any physician, and maybe even better than most.  However, I do not know the tricks to fight for my money or all of the other little insights into being a successful biller or coder.  So we have decided to go out.  And let someone else try it for a while.  This is not to say that my employee hasn’t been trying, however, since we terminated another in the front, we had to move her around doing other jobs, leaving the vital job undone.


The other area we have a recent upheaval is our nursing staff.  We witnessed a recent surge in patients which was more than the two nurses we had could handle.  Again we had difficulty filling the position.  Whether it was the potential wanting to much money, not wanting to work as much, or other it took longer than we thought that it would.  Almost immediately after filling the first position, my long time nurse informs me that her husband is being transferred, so I would still have to find another nurse.  So we continue our search, only to be given notice by another nurse, stating that the hours, stress and money had been beat by another group.  So she was also leaving.


I have a problem with faulting myself for this situation, since we were attempting to alleviate some of the load and stress, however, anyone who has ever hired employees knows, the right fit is important.  A combination of work ethic and personality are very important.  However, maybe this is good.  It allows us to re-examine the work flow and find where the critical errors are.  There are issues we have been noticing for a while, but did not know how to fix.  Maybe a fresh slate is what is needed with new ideas to fix this.


The good news to this story is Monday morning, we will have a full slate of employees.  Actually one extra since my nurse who is moving is there until the end of the month, and can help train.  Maybe it will help with the morale of the clinic, all new employees.  There are advantages of starting fresh, however, there will be a slow down due to the need to train the new staff.  I will continue to wonder if there was something I could have done to prevent this drastic overhaul, but will never know for sure.  However, hindsight is always 20-20, but I did not have the ability to see it so clearly before.


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