Recently, my secretary was out on maternity leave for 6 weeks.
I run a small practice, and my medical assistant works from home on the far side of town. So I was on my own at the office. My MA and I split things up, and since I was the only one physically in the building, I took over all the front office stuff and she took the back office.
I ran the front desk for the whole time – checking people in and out, taking copays, copying insurance cards, giving referrals to therapy places, sending logs to the billing company, and doing other everyday stuff.
Plenty of people asked why I didn’t hire a temp, obviously not knowing how close to the edge a modern solo practice runs. If I hire a temp, that’s another salary to pay, meaning one of the other three of us here would have to skip a few paychecks. I’m not going to put my secretary on unpaid leave for that time. She’s awesome, has been with me since 2004, and has stuck with me through good and bad years. If I don’t pay her that time, she can’t pay her rent, and I don’t have the heart to do that to her. Maybe a big corporate person wouldn’t lose any sleep about it, but I would. Great people are hard to find, and I want to keep the ones I have.
Besides, if I hired a temp, I’d have to train them from the beginning. I don’t use off-the-shelf medical software, just a system I designed myself. It would take time out of my day to teach them how to use it, where I send patients for tests and referrals, and how to sort documents accurately into the correct e-charts. So, for 6 weeks it just seemed easier to do it myself. I know how I like it done.
It wasn’t easy for my MA as well. She had to take over scheduling appointments, handling billing questions, making reminder calls, and doing other miscellaneous stuff. Even after work was over, I’d be at home catching up on all the dictations I hadn’t had time to do, and we’d be going back and forth by phone and email to settle different issues until 8:00 at night or so. By the end of the 6 weeks, we were both pretty burned out and exhausted.
I’m sure the patients weren’t thrilled, either. During that time, they could only reach a voice mail box telling them to leave a message and we’d get back to them as quickly as possible.
I assumed my practice was the only one dinky (or poor, by medical standards) enough to have to resort to this – until I had a chance conversation with a local family practice doctor, when he mentioned he’d had to do something similar when his secretary retired and he didn’t find a replacement for several weeks. A cardiologist mentioned doing the same thing while we were chatting at the hospital. Like me, they were both in solo practice.
This is, apparently, the nature of a modern small practice. The revenue and expense streams are too tight to allow for an extra salary, so even the doctor pitches in to cover. I’m sure my colleagues in large groups will laugh at the thought, but I don’t care. I have to do what’s right for my practice and to survive in the modern medical climate. And if working the front desk for a few weeks is what’s needed to stay independent, so be it.
Dr. Block has a solo neurology practice in Scottsdale, Ariz.
