Finding and keeping great front office staff

Your office staff aren’t just the face of your practice, they’re a critical component of your team.  Consultant Rosemarie Nelson shares tips on staffing your office, successfully and happily.

Your front office staff are the face of your practice — an expression of your practice’s philosophy, attitude and values. So it should be a top priority to hire and retain top-quality people to fill such roles as receptionists, phone operators, medical secretaries, and transcriptionists.

But it can be a challenge to keep these people and keep their morale high because these positions often include high levels of stress for low pay. So try something different, right from the start: Pay more for the right candidate.

If you pay someone more than they think they’re worth, they’ll work up to that level. If you pay people less, they’ll work down to that level.

It may not be as easy to keep the stress level low. One of the main stressors for front office staff is interacting with unhappy patients — people who are unhappy simply because they’re not feeling well. To lessen the likelihood of burning out the person at the front desk, rotate this throughout the practice. You’ll enjoy the benefits of cross-trained staff members as well as increased loyalty. And you’ll increase the odds that the person at the front desk will greet your patients with a smile, make them feel welcome, and convey a happy attitude.

Here are some more tips for getting and keeping top-notch front office staff.

Promote professionalism. Treat your front office staff with kindness and respect. Beyond a friendly hello in the morning, be sure your staff have the right equipment to do their jobs. Keep equipment working and up-to-date. Make sure staff know how to use the equipment and make it convenient for them whenever possible. For example, if the receptionist needs to scan/copy patients’ insurance cards, place the scanner/copier near her desk.

Uncover weaknesses. Even with the best intentions, front office operations are prone to kinks. At times, phones may go unanswered, patients may reach the exam room already dissatisfied, and these bumps can lead to sinking front office morale and even resentment among staff. A staff fallout can then affect patient flow, feeding an ongoing negative cycle.

Hold all staff to the same standards — the mini-max performance rule: “The minimum you get from one employee is the maximum you can expect from another in that position in terms of performance.”

Fix the phones. Periodically use a chart to track incoming calls. Create a matrix with hours of the day along the right and the reasons for the calls across the top, e.g., to schedule an appointment, talk to a nurse, refill a prescription, or get a referral. For one week every quarter, have the staff track how many and what kinds of calls come at certain times of day. If you find you get numerous appointment calls in the morning, you can then staff accordingly. By tracking what’s coming in, you can proactively plan rather than react.

Your phone company can provide you with additional information, such as the number of incoming calls, hang-ups, and busy signals. So if you discover after a month that 10% of callers get a busy signal or that 5% hang up, you know you need to improve your phone service by adding more lines, more people, or both.

You might also consider adding or tweaking your existing automated phone system. Program your system to have the greeting first, then the identity of the practice. The first option — after directing callers with a true emergency to go to the emergency room — should ask callers whether they want to make an appointment, then transfer them to the operator. You can also include an option to hear directions to the practice or refill a prescription.

Although people are used to such phone trees, make sure your message and directions are clear, available, and friendly, especially for new patients. And, remember to direct patients to your website for access to online services.

There should be no backlog of phone calls at the end of the day. Voice mail should be checked every hour. If there are too many voice mails to keep up with, you need to get someone, such as a float nurse, to provide extra help.

Constantly seek solutions. You can eliminate a lot of phone calls by using a patient portal on your website. A portal is an interactive tool that can answer patients’ questions, allow them to schedule appointments, deliver test results, process prescription refill requests, provide directions to the practice, and generally save staff a tremendous amount of time, while improving service to your patients.

One of the best ways to keep your front office streamlined is to ask the staff for suggestions. We think that as managers we know the answers, but we’re not doing the jobs every day.

You’re also likely to get higher buy-in from the staff if they’re carrying out their own ideas.


Rosemarie Nelson, MS, is a principal with MGMA Health Care Consulting Group and blogs at Practice Pointers.  Her experience as a medical office manager and in information technology, combined with 20 years of consulting to physicians and practice professionals, gives her a unique insight into the needs and challenges facing today’s physicians. She has presented and written extensively in the field.


2Ascribe Inc. is a medical transcription services agency located in Toronto, Ontario Canada, providing medical transcription services to physicians, clinics and other healthcare providers across Canada and the US.  Having recently introduced WEBscribe, a client interface portal for document management, 2Ascribe continues to implement and develop technology to assist and improve the transcription process for physicians and other healthcare providers.  As a service to our clients and the healthcare industry, 2Ascribe offers articles of interest to physicians and other healthcare professionals, medical transcriptionists and office staff, as well as of general interest.  Additional articles may be found at

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