Managing Front Desk Operations... What You Don't Know Could Hurt You!

As a previous multi-clinic private practice owner, an outpatient PT for over 28 years, and a business consultant, it has become increasingly obvious in this continuously changing healthcare environment, that the front desk staff and front desk procedures can impact a practice as much as the treatment provided.  Private practitioners often undervalue the importance of the front desk operations and are really unaware of what truly goes on at their front desk.  This four part article series is going to address the four main front desk procedures that can make or break your practice.


Before focusing on any one procedure, the first questions to ask yourself are: “Do you really understand your front desk operations?”; “Would you be able to sit at the front desk and perform ALL the tasks that you’re asking your front desk staff to do?; and “Do you have the right people operating the front desk”?   Usually, the honest answers to these questions is “No” or “I don’t know”.  There is an old saying “Don’t judge someone until you’ve walked a mile in his shoes”.  So, take a half day to sit at your front desk and shadow your front desk staff to really understand what they do, how they do it and the obstacles which make their jobs difficult.  It will be time well spent.  Not only will it be a truly enlightening experience (which will probably give you a deeper appreciation of your front desk staff), but also it will allow you to better understand and evaluate your front desk people and procedures.


The first procedure that will be addressed in this series is scheduling.  You’re probably thinking to yourself, what is so hard about scheduling?  Believe it or not, a majority of practices lose a staggering number of visits due to poor scheduling procedures for both new patients and existing patients.  Since capitalizing on every single new referral and patient visit is absolutely critical for PT owned private practices, it is imperative that practices adhere to efficient scheduling procedures focusing on customer service and accommodation of patients’ scheduling needs. 


Does your practice currently have written scheduling procedures or are you just “winging it” and hoping your front desk staff is “doing the right thing”? Are the scheduling procedures in your practice conducive to converting potential patients to actual patients and ensuring that current patients are seen as often as recommended, whether that is once, twice or three times a week?  Scheduling includes some decision making, which is often overlooked or not even considered when creating scheduling procedures.  Specifically, how does your front desk staff handle patients whose authorized visits have expired or Medicare patients who have reached their therapy cap?  Often what happens is that unbeknownst to the practice owner, front desk staff dissuade or sometimes even prevent patients from scheduling because they believe it is in the best interest of the practice when, in fact, it is silently crippling a practice.   


A recommended strategy for all private practice owners is to consider designating someone to be a “secret shopper” to call and/or walk into the clinic to observe first hand what greeting the “patient” receives and determine if indeed your front desk staff is providing the utmost in customer service which your practice needs.  It is also helpful to conduct periodic surveys of your existing patient population to see if the front desk staff is accommodating their needs and going above and beyond to make scheduling their appointments easy and stress free.  Bottom line is, every practice needs to have clear, effective written scheduling procedures as well as ways to ensure these procedures are being followed.


Scheduling is multi-faceted.  It includes not only scheduling patients’ appointments but also rescheduling, cancelling and confirming appointments as well as managing patient compliance including frequencies per week and patient dropouts.   Hopefully, your practice utilizes an EMR system which can easily provide you with cancellation and no show statistics, patient frequencies per week and names of patients who drop out but if your current EMR system does not provide this information, you need to either have manual ways to monitor these metrics or consider getting another, better EMR system. 


In summary, scheduling both new and existing patients, is an art and a talent that is often overlooked in a private practice despite its tremendous impact on the patient census.   It is critical that you scrutinize both the people you employ at your front desk and the front desk procedures to ensure that they both are providing what your practice needs to thrive, not just survive!


Debbie Lindabery, has been a physical therapist in the outpatient physical therapy field for over 28 years. Debbie also received her Administrator’s Certification through the APTA’s Private Practice Section in 2012.  Along with her clinical expertise as a physical therapist, she has a unique combination of experience in both outpatient clinical operations as well as outpatient billing.   Debbie was co-owner of a multi-clinic outpatient private practice in charge of operations and has been President/Owner of Medkita, LLC, a physical therapy consulting firm located at 1442 Pottstown Pike, #272, West Chester, Pennsylvania 19380.






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