Setting the tone: Office culture and training administrative staff
In Practice
By Victoria Houghton, assistant managing editor, March 1, 2016
In this month’s Answers in Practice column, Dermatology World talks with Barry Leshin, MD founder of The Skin Surgery Center in Winston-Salem, North Carolina as well as his clinical manager, Missy Wiggins, and his practice administrator Tamara Hunt who also serves as regional vice president for the practice’s umbrella company, QualDerm Partners about how to train administrative staff to fit a practice’s culture.
Dermatology World: Tell me about your practice.
Dr. Leshin: Our practice has three dermatologists, three Mohs surgeons, a dermatopathologist, a pediatrician-dermatologist, four mid-level providers, and four practice sites. We have a large clinical support staff including RNs, medical assistants, and histotechnicians. And, of course, we have a large administrative staff that supports us.
Our practice has recently gone through a major transition. We feel that the consolidation in health care is very relevant to our specialty, and that scale will provide leverage in managing overhead, enhancing payer contracts, and protecting us from narrowing networks. Towards that goal, we have affiliated with a management company/capital partner. A year into this partnership, we are gratified by our steady growth. Within the next six months we anticipate adding five practice sites and nine more providers. Moreover, the burden of practice management has shifted from physician-owners to our management team. It has been liberating.
Dermatology World: How would you describe your office’s culture?
Dr. Leshin: Our fundamental goal has always been to provide exceptional care with attention to the highest level of patient service and optimal efficiency. These principles have been the blueprint of our culture, and we try to model and promote this for all of our staff.
Ultimately, our intent is to have our patients become our ambassadors. From the first phone call through the patient-provider encounter, we are hoping that our patients will leave our office saying “wow, I’ve never experienced that in a health care system before.”
Dermatology World: What does that culture entail in terms of practice operations?
Dr. Leshin: Let me give you just one example. So many times a patient calls a physician’s office and gets a phone tree of options. It’s an alienating introduction. So, we always have a person answer the phone. Half of our patients are elderly, and the impersonal nature of an electronic message can frustrate and confuse them, and hinder their access to us. We try to eliminate such barriers.
Hunt: We assist patients with placing phone calls to their insurance carriers in order to verify their coverage for procedures that will be performed at our facility. Many of the patients are elderly and need assistance. Insurance companies will communicate to patients that understanding their insurance coverage is their responsibility. The process is difficult and patients need assistance in navigating the process. We help educate the patients without giving advice on which insurance companies or products they should participate with.
Dermatology World: In keeping with this culture, when hiring for a front desk position, what do you look for — both positive and negative — in the candidate’s attitude and personality?
Hunt: The number one quality when recruiting a new employee has to be recruiting someone with a service-oriented spirit. You have to recognize, when you interview potential staff, that they’re willing to go the extra mile for patient needs. Not just simply that it’s just a job. I truly believe that you can teach a technical skill, but you can’t teach the interpersonal skills needed to provide an outstanding customer service experience. That’s what I look for — the personality and presentation of the candidate first, the skill set second.
Dermatology World: Once you have hired someone, what steps do you take in training them and indoctrinating them into your office culture?
Wiggins: Our new hires train with preceptors. Our nurse preceptors have experience in educating and training new staff to promote our culture and mimic the behavior of the preceptor.
Hunt: We have phone scripts for staff that can be altered based upon what the patients’ needs are. For instance, for patients with a general dermatology question, we have a script that helps us communicate with a patient appropriately and not upset the patient in regard to the condition they are requesting to be seen for in the practice. There are scripting opportunities around every phone call. We try not to place patients into voicemail and we make sure that their needs are met before they get off the phone.
Dermatology World: How do you ensure that the practice staff is operating by the tenets of your office culture?
Dr. Leshin: We have a mission statement for the practice and we’ve posted it in a number of places in our office. The mission statement was developed in the early days of the practice when I gathered all of my staff and we sat in a circle and wrote down a list of everything they wanted the practice to be. Then I took the entire list and I melded it into a mission statement. It has proven to be a timeless touchstone.
Also, patients are regularly surveyed following a visit, and we have suggestion boxes in the office. If a patient has a complaint, or there’s a scheduling problem, then we generate a quality assurance (QA) report detailing the circumstances. In our quarterly quality assurance meetings, which include all of the team leaders, patient surveys and suggestions, and the QA reports in that quarter are compiled and reviewed. If there is a systemic problem, we’re able to identify and address it. This provides a mechanism for holding all staff members accountable. We just feel very strongly that job performance is optimized by this marriage of responsibility and accountability.
Dermatology World: What role does the front desk staff play in overall patient satisfaction?
Dr. Leshin: The grim-faced receptionist, often on the phone, with a cluttered desk and a clipboard full of paperwork ready to give the patient is the industry standard. Why not startle your patient with a warm, engaging personality, and differentiate your practice as they cross the threshold? It could be the seminal event of creating the patient ambassador!
