Never before has it been so important for clinicians to assess their staffing mix. The COVID-19 pandemic has led to an acute shortage of workers and a growing number of medical assistants who only want to work part time.

Michael Galper, MPH, an adjunct professor at the UCLA Fielding School of Public Health’s Department of Health Policy and Management in Los Angeles, California, offered some strategies for coping with difficult in hiring staff. These include implementing travel restrictions for meetings, conferences and seminars; moving most large employee meetings to virtual formats; and updating work-from-home policies to be more flexible; and cross-training employees to be able to cover for absences, he said.

Practices also should consider technological solutions that could decrease the need for staff. Organizations must first identify the problems they are trying to solve and then weight the cost of the technology against the costs the technology will minimize or eliminate, he said.

Ron Holder, chief operating officer for the Medical Group Management Association in Denver, Colorado, said practices need to consider offering employees flexible schedules. Some staff may prefer to work three 12-hour days or have a schedule of 11 to 7 instead of 9 to 5. “There may even be some people who would like to have evening clinics for any number of personal reasons,” Holder said. If a medical practice can spread the workload throughout the day instead of adding more volume in the same 9-5 slot, it may be able to reduce office space requirements and offer more convenient hours for patients.


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Artificial intelligence (AI) offers the hope of improving efficiency so practices can get by with less staff, according to Holder. For instance, AI can provide medication alerts to call attention to allergies or harmful drug interactions and suggest smaller sets of codes to use for billing based on clinical information entered into medical records.

“We aren’t really in a place where these types of AI will replace the judgment of physicians, but AI can be helpful in highlighting elements of a patient’s history and/or encounter that a physician really should be sure to look at out of the massive universe of information that exists, not just clinically, but in the realms of billing and compliance,” Holder said.

Practices also might want to consider hiring lower-licensure staff, such as medical assistants, who may be more available. With more medical assistants, practices can often reduce impediments to patient flow such as by handling patient intake forms and coordinating allocation of patients to examination rooms. “This allows for patients to have a higher percentage of their time in the office actually interacting with the care team and not sitting in their car, the waiting room, or the exam room, for the next person to come see them,” Holder said. 

As part of their efforts to improve efficiency, Jeremy Cauwels, MD, chief physician at Sanford Health in Sioux Falls, South Dakota, said all physicians need to take the time to optimize how they take notes so every click and keystroke are well-organized and logical. “Using a tool like digital dictation can also help save time when you know you’re going to be talking for any extended period,” Dr Cauwels said.

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