December 4, 2023

How Many Staff Do I Need in My Practice?

Navigating the ins and outs of running a successful private medical practice is a bit like juggling — you've got the vital patient care on the one hand and the operational puzzle on the other.

And right at the heart of this balancing act is the age-old question: "How many staff members do I need?"

It's like finding the perfect tempo for a symphony — too few players and the music falls flat; too many, and it turns into a cacophony.

Some practices follow a simple rule: if things get sticky, hire more; if costs rise, cut staff. But that's when things can go out of tune.

If you have a small practice, seeing fewer than 20 patients daily, you might think one person at the front desk cuts it. Well, here's a nugget of wisdom: the most dangerous number in the business world is one. Having just one of anything can send your practice into a nosedive. What happens when that solo act takes a break or leaves?

So, let's delve into the key elements to contemplate while unraveling the factors that determine the optimal number of staff members your practice genuinely requires.

What's the Staffing Ratio?

The staffing ratio refers to the optimal number of full-time administrative and clinical team members required to effectively support a single full-time physician. However, the ratio of full-time equivalent (FTE) support team members to each FTE physician will differ across different medical practices, and there isn't a universally applicable "correct" ratio.

Plus, there are many things to consider when building a team that works well together, is efficient, and provides excellent care.

How do I calculate the staffing ratio for my practice?

A medical practice's optimal staffing ratio is determined by its specific operational requirements and workforce needs.

Gaining insight into your distinct staffing needs involves a nuanced approach. It's essential to recognize that there's no universal solution — staffing demands can significantly differ based on variables such as the practice's size, the range of medical specialties you offer, patient volume, and the scope of services provided.

First, figure out how many doctors are part of your team, but let's put that in terms of FTEs (that's Full-Time Equivalents). So, if you've got a doctor working full-time, that's a straightforward 1. But if someone's not working the whole week, we're talking a fraction of an FTE. Just divide their average weekly hours by your practice's standard full-time hours.

Now, let's dive into staffing. Crunch the numbers by taking the total count of those physician FTEs we calculated earlier. Then, multiply that by the total number of non-physician team members in FTEs that you need to give solid support to just one full-time doc in your practice. That'll give you a good picture of your staffing needs.

However, when figuring out how many support team members your practice needs — the old-school way — we often use full-time equivalent (FTE). First, count up your doctors regarding full-time equivalent (FTE). That's where we use a standard 40-hour workweek. If a doctor clocks in 40 hours, they've got an FTE status of 1. But if it's 30 hours, it's 0.75 (30/40 = 0.75).

But things get tricky because real life doesn't always follow that 40-hour rule. Every hour doctors spend with patients, they do another hour of behind-the-scenes stuff (think patient portal talk, online messages, etc.). So, let's say a doctor has 28 hours of appointments; they're more like working 56 hours a week when you count the extra stuff.

So, keep this extra work in mind when calculating FTEs and setting up your ideal staffing ratio. 

Factors that Influence Your Staffing Needs

Here are some factors that can shed light on your unique staffing needs:

1. Administrative Considerations

  • Billing Management — You might need dedicated billing staff if you handle it in-house. On the other hand, if you outsource to a vendor, you might require fewer internal resources.
  • Prior Authorization Handling — If you manage them in-house, it may demand staff specialized in navigating authorization processes. If you work with a vendor, your internal staffing needs could differ.
  • Outsourced Tasks and Required Roles — Outsourced administrative tasks, such as reception duties, billing, coding, prior authorization, referrals, and credentialing, impact the number and type of staff you need. Each outsourced task might free up time for other roles.
  • Cross-Training Potential — Can your full-time staff be cross-trained to cover various part-time roles? For instance, an administrative team member trained in billing, prior authorizations, and referrals. If yes, it can offer versatility within your team structure.

2. Clinical Workflow

  • In-Office Procedure Frequency — More procedures might require additional clinical support staff.
  • Supporting Team Roles — Assess the range of tasks your supporting team can handle. The roles of both your clinical and non-clinical staff will contribute to the overall staffing picture. 
  • Telehealth Integration — If telehealth visits are part of your practice, they might lead to unique staffing requirements like technical support, scheduling, and communication roles.
  • Examination Room Availability — More examination rooms might necessitate additional staff for room turnover and patient assistance.
  • Practice Layout Impact — Consider the time it takes for physicians, support staff, and patients to navigate the space for their respective needs.

3. Patient Demographics

  • Patient Panel Size — A larger patient base might demand more staff across various roles.
  • Daily Patient Load — The number of patients each physician sees daily impacts the administrative and clinical support required to ensure each patient is attended to effectively.
  • Special Patient Needs — Patients requiring extended assessment times or thorough treatment plan reviews might impact staffing regarding time allocation and specialized roles.
  • Social Determinants of Health (SDOH) — Patients with SDOH or other complex needs might require additional care coordination and support, influencing the staffing mix.

4. Other Considerations

  • Specialty Society Recommendations — Some medical specialties offer staffing recommendations based on best practices. These can serve as valuable benchmarks when determining your staffing needs.

When assessing the ideal staffing levels for your medical practice, it's crucial to adopt a comprehensive perspective considering the diverse elements impacting your staffing requirements. Moreover, you must familiarize yourself with the legal frameworks governing medical practices and develop a thorough understanding of internal personnel protocols for effective staff administration. Additionally, acquiring proficiency in leveraging team documentation techniques can open up innovative opportunities that engage team members, patients, and newcomers, leading to efficient utilization of physician time while fostering enhanced communication and care delivery.

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