Urgent Care Startups Cut Labor Expenses with Medical Assistants

Urgent Care Startups Cut Labor Expenses with Medical Assistants

Labor is the single largest expense in urgent care operations. Rather than hire more expensive clinicians, urgent care startups should adopt a lean staffing model that optimizes the training of medical assistants (MAs) so they can perform both clinical and clerical duties. This kind of medical assistant-heavy staffing model can help keep labor costs in check so a new urgent care center doesn’t blow its budget on staffing expenses before its business is financially viable.

The Urgent Care Staffing Model

Many urgent care centers run into financial trouble because they follow hospital system staffing models that employ specialized labor for each task, such as registered nurses for medication distribution, RTs for x-rays and lab technicians/phlebotomists for blood draws. The problem with this staffing model is that many of these specialized tasks are only needed a few times a day in the urgent care setting, so hiring for these positions creates unnecessary spikes in labor costs.

This is why the position of medical assistant aligns so well with the urgent care model. Depending on your state laws, a medical assistant with the proper training and certifications can perform many of the clinical functions typically completed by a registered nurse, providing urgent care startups with significant cost-savings. According to the Urgent Care Association of America’s 2016 Benchmarking Survey, the average hourly pay of an RN was $25.68 compared to $14.86 an hour for an MA. The reality is that RNs are more highly paid clinicians than are actually required in the urgent care setting. And RNs agree; they turn over pretty quickly in pursuit of higher-paying positions in long-term care or nurse management, or they pursue advanced credentials, such as nurse practitioner or nurse doctorate.

Medical Assistant Clinical Scope of Practice

There is no national standard of education or government regulation defining what clinical functions a medical assistant can or cannot perform by law. Each state sets its own laws, so it’s critical that you familiarize yourself with your state’s laws. However, in all states, the licensed physician is legally and professionally responsible for the actions of the medical assistant. Medical assistants essentially act as auxiliaries to physicians. While they are not licensed, they practice under the license of their delegating physician. However, under no circumstances can a medical assistant be presented as a licensed practitioner, and any tasks delegated to the medical assistant must be within the licensed physician’s authority to perform.

Medical assistants typically take patient vital signs, explain and set the expectations for the office visit, and prep the patient for the exam. Properly trained and certified medical assistants can also take on some clinical duties, such as blood draws; operating the x-ray machine; assisting with medical exams; removing sutures; changing dressings; administering medications, vaccines and immunizations; and reporting the provider’s direction on lab results and recommendations to patients. In all states, MA’s are not allowed to provide medical advice without a provider’s direction. They can also work the front desk by helping with clerical, administrative and patient registration tasks.

Ultimately, the scope of clinical tasks that states allow physicians to delegate to medical assistants is quite expansive, making an MA-heavy staffing model a no-brainer.

Physician Resistance to Medical Assistants

One of major barriers to the medical assistant staffing model is physician resistance. Many physicians who get into urgent care have emergency department backgrounds, where they are used to working with nurses. In the ED, nurses tend to manage themselves, while medical assistants require active management from physicians. Coupled with the fact that physicians are liable for the medical assistant’s mistakes, many physicians are resistant to the idea of a medical assistant staffing model.

However, there is no denying the financial benefits to this staffing model, so physicians should keep an open mind about working with medical assistants. Establishing well-defined protocols and directions in advance will give medical assistants structure on how to approach and prioritize clinical and administrative tasks. Clearly communicating the medical assistants’ roles and responsibilities to the care team will take the guesswork out of what the MA should be doing at any given time, and periodically sitting down with the medical assistants to talk about work quality and overall performance will help them start to work more independently.

It may seem like a lot of work up front, but it’s worth the investment. Well-trained medical assistants can perform most clinical tasks in most states, so by forgoing higher paid clinicians such as RNs and moving to a medical assistant staffing model, your urgent care startup can realize tens of thousands of dollars in annual labor cost savings.

Discuss Your Urgent Care Needs

Urgent Care Consultants specializes in starting urgent care centers from the ground up. Let us connect you with one of our experts today.

Employee Engagement has Major Impact on Your Urgent Care Startup’s Bottom Line

Employee Engagement has Major Impact on Your Urgent Care Startup’s Bottom Line

If you think employee engagement is just a soft perk created by entitled Millennials, you’re in for a rude awakening.

Disengaged employees can have a serious financial impact on your urgent care business, making more mistakes than their engaged counterparts and costing businesses billions of dollars annually in lost productivity. That’s why it’s crucial for urgent care operators to build a strong organizational culture that engages and supports employees at all levels of the organization. Failing to do so can bring an urgent care startup to financial ruin.

Table 1 illustrates the returns on salaries a business typically sees based on employee engagement:

Table 1. Financial Consequences of Employee Disengagement
Engagement Level Return on Salary
Fully engaged 120%
Engaged 100%
Somewhat engaged 80%
Disengaged 60%
Data from Employee engagement. Albertson, NY: Employer Assistance and Resource Network; 2014 [cited 2015 March 2].

In the urgent care setting, frontline staff members are the most vulnerable to experiencing disengagement. Why? It’s your frontline staff who has to endure the daily slings and arrows of patient and provider demands.

Take, for example, a registration specialist who tries to share her ideas about operational improvements, but her managers continually ignore her. To make matters worse, her managers also treat her position like it’s expendable because it requires the least amount of formal education and pays the lowest salary of all the positions at the urgent care center.

Demoralized, she starts to make careless errors in capturing accurate patient demographics, resulting in the center later receiving numerous “zero EOB” notifications, which indicate denied insurance claims. The cost in time and labor spent correcting her errors cancel out any profits from those patient encounters. If the registration specialist quits or is let go, the urgent care center must incur the cost of recruiting, onboarding and training a new employee.

The more cost-effective route would have been to keep the registration specialist engaged in the first place.

What Causes Employee Disengagement?

There are a multitude of factors that cause employee disengagement depending on the specific profession, industry or company, but these are the 13 most commonly cited causes of employee disengagement:

  • Ineffective management
  • Emotional labor
  • Repetitive work
  • Unclear expectations
  • Lack of recognition
  • Poor communication
  • Insufficient onboarding
  • Poor work relationships
  • Broken promises from management
  • Employee opinions and suggestions ignored by management
  • Workplace stress
  • Personal life stress
  • System and process issues

Most of the top-cited causes are things that can be controlled by strong leadership and organizational culture. For new urgent care operators, the key is to work on creating this kind of culture right from the start.

Creating an Engaged Culture at Your Urgent Care Startup

There are three key elements to creating an engaged urgent care team:

  1. Implement the Drivers of Employee Engagement
    Human resource specialists, workplace psychologists and engagement experts all agree that there are eight key drivers to employee engagement. Those include:
  • Setting clear expectations
  • Providing employees with regular feedback
  • Providing advancement opportunities
  • Helping employees feel like their jobs have meaning
  • Providing employee recognition
  • Building good working relationships among colleagues and supervisors
  • Allowing employees to have autonomy
  • Soliciting and then implementing employee feedback
  1. Give Managers the Keys to Being Good Leaders
    One of the single most important decisions a company can make is who it names as a manager. Although most physician-owners don’t have the management training needed to build an engaged culture, there are endless resources available that can help them learn. According to a Google study, these are some of the top qualities of a good manager:
  • Is a good coach
  • Empowers the team
  • Treats employees like people
  • Is results-oriented
  • Is a good listener
  • Encourages career development
  • Has a clear vision
  1. Develop Genuine Connections with Staff Members
    A major component of leadership is developing genuine connections with your staff members. This should be easier to achieve when you’re first starting your urgent care center and have a smaller staff, but it should never be forgotten as your practice grows and you have a larger, more departmentalized organization.

Employee engagement isn’t just an extra perk; it’s a crucial component of your business that could seriously impact your urgent care startup’s bottom line. As you develop your urgent care’s business plan, make sure to account for how you will develop your center’s organizational culture so you are prepared to lead your new staff.

Discuss Your Urgent Care Needs

Urgent Care Consultants specializes in starting urgent care centers from the ground up. Let us connect you with one of our experts today.

Do Facebook “Likes” Actually Drive Patient Volume?

Do Facebook “Likes” Actually Drive Patient Volume?

Do Facebook likes really result in higher patient volume for your urgent care center? If you find the value of a Facebook “like” elusive, you’re not alone. That’s why a team at Harvard Business School (HBS) decided to conduct an in-depth study on whether simply “liking” a brand on Facebook actually influences purchasing behavior.

The results may surprise you.

The Value of a Facebook Like

HBS conducted 23 experiments over four years involving 18,000 participants. They used A/B testing to explore an interesting counterfactual: what followers would have done had they not followed a brand on Facebook. What did they find? Social media endorsements alone don’t influence real life behavior in any meaningful way.

It turns out marketers are muddling Facebook likes into a metric that means something that it doesn’t.

HBS found that marketers were confusing cause with causation. In other words, marketers assumed Facebook likes directly lead to purchases. However, what marketers failed to take into account was that the endorsers already had a favorable opinion of the brand, which is the real reason why they were making purchases after liking a brand’s Facebook page.

So are Facebook likes a meaningless metric? Not exactly.

How Your Urgent Care Should Use Facebook Likes

Just because social media endorsements don’t work the way marketers think they do doesn’t mean they can’t be used to drive sales – or in the case of your urgent care center, drive patient volume. In HBS’ final experiment, they studied whether targeting content to “liking” and “non-liking” groups would impact conversion rates. HBS used two groups of Discovery Vitality customers: one that liked the brand’s Facebook page and one that didn’t. They then targeted content to both groups on Facebook and found that the conversion rate was higher in the group that liked the brand on Facebook. Why did targeting to the “liking” group work? It effectively uses the push/pull marketing technique.

Traditional marketing is all push marketing, blasting out ads to consumers. Pull marketing via social media channels asks consumers to come to marketers. With the explosion of social media marketing, marketers had essentially abandoned push marketing in lieu of less pushy marketing techniques. However, the HBS study demonstrates that combining the two techniques by targeting content to receptive consumers is the most effective means of reaching consumers.

Urgent care centers can capitalize on this push/pull marketing strategy by:

  • Boosting specific Facebook posts. Boosting posts allows you to target content to a specific audience on Facebook, making sure your messaging gets in front of your most engaged consumers. The most effective strategy is to let a post get some organic traction first before boosting it.
  • Targeting specific Facebook posts. You don’t have to boost a post to target it to a specific audience. Create audience segments and experiment with different campaigns to see what combinations are the most effective for your urgent care center.
  • Highlight positive reviews and testimonials. The HBS team also noted in its research that savvy marketing firms go beyond garnering social media likes and find ways to highlight well-written positive reviews. Did a patient send you a Facebook message with a glowing review of a provider? Are patients using the reviews section of your Facebook page to post amazing testimonials? Find ways to highlight them in your marketing messages.

The True Value of a Facebook Like

Although there’s no direct connection between a Facebook like and a sale, the HBS team’s research shows social media connects your urgent care with highly engaged consumers. The struggle marketers have in demonstrating the ROI of social media marketing stems from using the tool incorrectly. Rather than casting a wide net and wasting your marketing dollars, use social media to target your messaging to people who actually want what you’re selling.

Discuss Your Urgent Care Needs

Urgent Care Consultants specializes in starting urgent care centers from the ground up. Let us connect you with one of our experts today.

Urgent Care Physicians Play Key Role in Preventing Avoidable ED Visits

Urgent Care Physicians Play Key Role in Preventing Avoidable ED Visits

Urgent care physicians play a more important role than they may think when it comes to preventing avoidable emergency department (ED) visits.

A recent study by the “International Journal for Quality Health Care” reports that only 3.3 percent of emergency department visits are considered avoidable. If that that sounds surprisingly low, the Advisory Board says that’s because the study’s definition of “avoidable” – “discharged ED visits not requiring any diagnostic tests, procedures, or medications” – is too narrow to truly encompass all avoidable ED visits. Rather, the Advisory Board broadens the definition to include:

  • “patients who could have been treated in an ambulatory setting,
  • patients whose visit required ED-level care but could have been prevented by effective and timely primary care, and
  • those who did not need care for at least 12 hours.”

When this broader definition is applied, the number of avoidable ED visits increases significantly, and lack of access to lower acuity care is the first reason to blame. But is that really the case, or can urgent care physicians, who provide lower acuity care than ED physicians, do more to help prevent avoidable ED visits?

Urgent Care Physicians Can Educate Patients

Knowing where to go for medical care can be confusing for patients, especially since there are innumerable barriers to health literacy. Even the word “urgent” can cause confusion. What medical conditions qualify as urgent? Is “urgent” the same as “emergency”? Are urgent care centers the same as emergency departments?

Many patients visit the ED because they don’t think they have any other options or they don’t understand the options available to them. That’s why urgent care physicians shouldn’t just sit back and wait for patients to come to them when they’re sick or injured. Urgent care physicians should play a proactive role in helping patients understand their health care options and how to use health care services appropriately so they only visit the ED when it’s a true emergency.

Urgent Care Physicians Can Build Relationships with Hospitals

Hospitals and primary care physicians often see urgent care centers as competitors who are trying to steal their patients. This only further contributes to lack of access to health care because, instead of directing patients to an urgent care center for immediate medical attention, overbooked primary care physicians often force patients to wait overnight to get in to see them. That means patients aren’t getting the care they need when they need it.

Urgent care physicians need to build relationships with corporate decision-makers at hospital health care systems to help them understand that urgent care centers can be a part of the full spectrum of services hospitals employ rather than a source of competition. If they work together, patient access to care increases, and avoidable ED visits decrease. For example, when a primary care physician is overbooked, she can send episodic, urgent cases to the urgent care center so those patients can get the immediate medical attention that they need. In turn, the primary care physician can focus on caring for chronic conditions, wellness checks and follow-up care.

Urgent Care Physicians Can Fill a Need in a Community

According to the Advisory Board, “providing access to low-cost ED alternatives is critical to decreasing avoidable ED visits.” While they recommend that health care systems connect ED patients to primary care physicians as that low-cost alternative, urgent care centers are also well-suited as a low-cost ED alternative, especially when primary care offices are overbooked or patients need after-hours care.

The most successful urgent care physicians see a need in a community for after-hours, walk-in medical care and they step in to fill it. They certainly do a lot of good in those communities, but they also generate a lot of revenue for their urgent care practices. Identifying where there is a need within a community and building the right relationships with health care systems can not only increase patient access to care and decrease avoidable ED visits, it can also be a lucrative business venture for physician entrepreneurs.

Urgent care physicians may not play a direct role in what happens in the emergency department, but that doesn’t mean they can’t make a difference in the patient care cycle, including preventing avoidable ED visits.

Discuss Your Urgent Care Needs

Urgent Care Consultants specializes in starting urgent care centers from the ground up. Let us connect you with one of our experts today.

Why Successful Urgent Care Startups Need to Think Like Entrepreneurs

Why Successful Urgent Care Startups Need to Think Like Entrepreneurs

When starting an urgent care center, it can be tempting for providers to focus solely on the clinical side of the practice because they’re hanging their hats on the old-school belief that patients will simply find them once their practice opens its doors. Nothing could be farther from the truth. In fact, leaning on that way of thinking sets urgent care providers up for guaranteed failure. Why? To succeed with an urgent care startup, you can’t just think like a doctor; you also have to think like an entrepreneur.

Why Urgent Care Startups Must Think Like Entrepreneurs

The urgent care industry views patients as consumers who choose to use a specific center versus other available options just as they would when they decide where to shop. The industry’s focus on highly visible locations, extended operating hours and excellent customer service has earned it the descriptor of “retail medicine,” which means that great clinical outcomes are not the only factors that make patients choose one urgent care center over another. Patients need to be “courted” with targeted marketing and advertising and superior customer service experiences, so great clinical outcomes are only a small part of the equation.

To be successful in a volume-driven business like urgent care, you must be comfortable wearing two hats: that of a skilled health care provider and a strategic entrepreneur. If you focus solely on the medicine and do nothing to drive patients to your urgent care center the same way retailers drive consumers to their stores, your center won’t be open for long.

How to Think Like an Entrepreneur

You may not have gone to business school, but that doesn’t mean you can’t start thinking like an entrepreneur. Your urgent care center is a business, and your patients are your customers. You need to think about how you can compete for patients while running your business in the most efficient and cost-effective way possible. These are just a few ways you can start thinking like an entrepreneur while running an urgent care practice:

Increase your visibility in the community
As an urgent care entrepreneur, you must always keep your center’s name – or brand – visible to your community by using effective, low-cost marketing tactics. Grassroots marketing and community relations are typically effective ways to keep your center’s name top-of-mind. Put up a tent in your center’s parking lot and do drive-by flu shots during flu season. Participate in community events to get your staff out into the public. Also, contact your local media to see if they want to interview one of your clinicians whenever there are hot medical topics in the news.

Add occupational medicine services
Occupational medicine, which includes work-related injuries, pre-employment screenings, fitness-for-duty exams and compliance physicals, is a natural complement to urgent care services. Adding occupational medicine will increase your patient volume and provide free marketing to the employees of the companies you contract with. After all, when a sick employee can’t get in with his or her primary care doctor, where will HR most likely recommend they go for immediate care? The urgent care center that handles their occupational medicine.

Learn how to lead and manage a staff
There’s no doubt you went through rigorous medical training in medical school, but that didn’t prepare you to run a business and manage a staff full of diverse personalities and skill sets. Accept what you don’t know and set out to learn. Attend association conferences and local management seminars, read books on entrepreneurship and marketing, and connect with professionals who already run thriving urgent care centers to learn from their experiences.

Learn how to identify and fix broken business processes
Getting patients through your door is only half the battle; you need to make sure they’re also recommending you to friends and family or returning when they need additional medical care. If patients experience “service failure” – excessively long waits, inaccurate diagnoses, billing issues, wrong prescriptions, bad service – not only will they not come back, but they’ll tell others not to use your center either.

You need to be vigilant in identifying and fixing any broken business processes that cause service failure. Neglecting to do so can ultimately lead to a broken business.

Create awesome service experiences
Once you start drawing patients into your urgent care center, you must create consumer-friendly experiences that will make your patients “super fans” of your urgent care center. Be extremely conscious of their time, including timely follow-ups if there are delays. Provide a variety of amenities, such as free WiFi, refreshments, TVs in the waiting area and a play area for the kids. And conduct proactive service recovery if anything doesn’t quite go right during a visit.

Starting an urgent care center is a significant financial investment, so make sure your new center doesn’t sit empty after it opens. With the right business strategies, your urgent care business will thrive.

Discuss Your Urgent Care Needs

Urgent Care Consultants specializes in starting urgent care centers from the ground up. Let us connect you with one of our experts today.