Physiatry Practice Management Resources

The more jobs your employees can do, the better it is for them, for you, and for your patients.

Among life's inevitabilities, along with cell phones that cut out and computers that go down, are employee absences. And you have to plan for them. If your staffers are cross-trained, you or your office manager can quickly plug critical gaps without calling in temporary workers, running up overtime costs, or stinting on patient services.

"Cross-training employees is a form of enlightened self-interest," says Kenneth T. Hertz, a consultant with the Medical Group Management Association and former administrator of an 11-physician surgical group. "It's also smart practice management and good customer relations."

Certain functions—front desk, billing, and collections—lend themselves to cross-training. "It's important that the billers know how the collectors work and vice versa, and the front-desk people should be knowledgeable about those functions, too," says Hertz.

Cross-training starts with hiring the right people—folks who can multitask, want to learn new skills, and can shift gears quickly and effectively. It also requires planning: Who will do the cross-training? How will your practice find the time for it? How do cross-trained employees maintain newly learned skills? And should staffers receive additional pay for taking on new duties? Office managers and practice administrators weighed in on these and other topics.

A win/win proposition for you and your staff It's hard to think of a downside to cross-training. You might have to close the office for a half-day or a full day every few months to get the training done. Or you might need to write a check to an off-site venue where you send employees for additional training. But the benefits are numerous.

"We save $30,000 to $50,000 a year because we don't use temp agencies, and haven't in eight years," says Chris Kelleher, administrator of a 10-physician ob/gyn practice in Columbia, SC, which cross-trains all clerical and some clinical employees. "If you need to hastily move someone into a different slot, you don't have to fumble and they don't have to learn at the physicians' or patients' expense."

Additional benefits of cross-training:

It allows for consistency of operation. When employees learn the particulars of other jobs in the office, they know the requisite policies and procedures, what paperwork is required, where needed materials are, and so forth. In other words, people don't have to wing it—with all the error-prone dangers that implies—if they're called upon to temporarily fill a vacant slot.

It increases options. Ken Hertz sees cross-training as almost a necessity in a small group, because the practice can remain functional when key people move on, get sick, or take a vacation. "In larger practices, if people are cross-trained you're well-positioned if you have to trim your workforce," says Hertz, who's based in Alexandria, LA. "That's something we don't like to think about, but we're certainly seeing it a lot."

Cross-training is even useful in filling small gaps, like when a worker takes lunch. The medical records person at the multispecialty Sunrise Medical Center in Phoenix learned how to field phone calls, schedule appointments, greet patients, and collect copays, so that she can step in when the front-desk clerk steps out, says Kelly Chrisbacher, the practice's office manager.

It's a quality improvement tool. "When one employee sits in for another, there's a fresh mind in that job," says Kelleher. "We get many ideas and suggestions from cross-trained people, such as how to do a job more efficiently."

It increases empathy and promotes teamwork. Cross-trained staffers get a better appreciation of the difficulties and limitations of their colleagues' jobs. "The people in our billing office sometimes complain if they don't get a copy of a referral or an insurance card from the front desk," says Chrisbacher. "I periodically rotate billers through the front desk so they'll know how hard it is to simultaneously field phone calls, greet patients, and handle multiple charts without something slipping through the cracks."

It uncovers hidden talents. Someone who's hired as a receptionist might find she has a knack for coding, or a biller might turn out to be a crackerjack medical assistant. Helena Dahan, office manager for a four-physician internal medicine practice in Philadelphia, says that an MA became the practice's managed care coordinator after demonstrating a facility for the subject during cross-training sessions. "The more a staffer learns, the more she's worth as an employee," says Dahan.

It's a morale booster. Cross-training makes for a more diverse and interesting workday, allows and encourages employees to grow in the job, and gives them opportunities to learn new skills. "Our staff really likes the change of scenery and the variety," Kelleher notes.

It's a patient pleaser. Patients are less likely to experience insurance snafus, difficulty in reaching your office via telephone, or long in-office waits if cross-trained employees are on hand. "With cross-training, you're always going to be as fully staffed as possible," Dahan says.

Keeping an eye out for cross-train-ability Forward-looking physicians and office managers make their hiring decisions with cross-training in mind. Karla J. Trout, office manager of a six-physician cardiology group in Frederick, MD, asks job applicants open-ended questions that might help her ascertain cross-training potential. "One of the questions is, 'What would you do if your boss made a decision with which you strongly disagreed?' I'm looking for someone who's willing to speak her mind, but in a respectful manner," Trout says. "Someone who can think for herself is a lot easier to cross-train."