Let me throw my 2 cents in. I have been in practice for 20 years, solo for 10. Keep your payroll as small as you can for as long as you can because it is your biggest overhead. On the other hand, you need to have a practice that flows well and does not appear stressed. Patients pick up on that and are not always so understanding when it takes days and days for you to get back with them on tests or results or questions. Personally, I believe a small practice has to have people who are cross-trained. All of my employees can do most of everyone else's job except the finer intricacies of the billing. If I were hiring a new person (as I just did) I would hire a primary biller, maybe even just start them out part-time. Once they have mastered your billing system, expand their duties so they can answer the phone, make appointments, get referrals, call patients back. Also teach them to deal with the vendors, perhaps handle payroll, and take over some of the duties which are now bogging you down. Then teach them how to bring patients back, do vital signs, enter info into AC. And, although hiring people with experience is sometimes nice, don't refuse to consider people with absolutely no experience. Sometimes it is better to train them yourself, do it right the first time, the way you like. I hired my sister (absolutely no medical experience) 7 months ago and she can almost do anything I need in this office (although she prefers giving shots to horses more than to people!) The benefits of cross-training are obvious. When one employee is on vacation or is ill, the others can cover adequately for them. My two full-time employees alternate weekly front or back office in order to keep their skills sharp. It also provides each with variety in duties (good thing) and a fair sharing of the "grunge" tasks. I have just hired a new part-time person who is learning the billing (with the object of replacing eventually my long-time biller who will be retiring soon). But, she will also learn the front and back office at least well-enough that she can cover if needed. The other benefit to cross-training is allowing for checks and balances. I often surprise employees by asking them to switch tasks unexpectedly. For instance, I may ask Lindsay to open the mail and make the deposit (not her usual daily job), and then have Ann post. This "shake-up" keeps people on their toes and, I believe, also reduces the threat of improprieties. Having only one person opening mail, posting and making the deposit can be a set-up for embezzelment.
Anyway, good luck whichever direction you go. Long Live the Solo Practitioner!
Leslie
