By Joe Hymes

When confronting harsh economic realities, occupational health professionals have to put their finger on the pulse of the top accounts that drive volume.
In other words, they need to “feel the pain” of their clients by meeting with them regularly to understand the market metrics that drive their business. The program director and the sales team must become experts in their business and adjust accordingly.
One of the most critical factors in the ability of a program or practice to sustain itself is staffing in response to demand and anticipated seasonal variation.
Here are some suggestions along those lines:
- Ask clients to let you know if they plan to hire or create new positions (or if they anticipate a hiring freeze or layoffs) so you can add (or reduce) clinic staff, as needed. We can’t be expected to be ready for anything, all the time.
- Staff your clinics based on current and expected patient volume, not what you hope it to be. Be brutally realistic. NAOHP staffing and productivity models are a good resource for this.
- Establish a “floor” staffing level based on the lowest-volume times, then incorporate some flexibility based on daily market trends: Round one is the right size based on current and expected volume; round two is flexing the staff to less than full-time. This could be as many as two full-time swing positions if the size of the clinic warrants it.
- Review sites with extended hours and calculate the savings that would be achieved if those hours were reduced and patients were diverted to the hospital emergency department. Build a system to capture next-day referrals emanating out of the emergency department.
- Match provider staffing to volume. This requires a determination of hours worked, whether a second provider is needed, or if there is an overlap between the day and evening shifts. If your program has multiple sites with a manager at each location, can the positions be consolidated? It is difficult to cut back staff hours, but sometimes staff have to be part of expense reduction. Remember, a leader risks losing credibility if no action is taken. Across the board pay cuts in the 5-10 percent range are another approach worth considering.
- Be a hands-on manager. What happens when you cut a number of people and customer service suffers? To address complaints from staff about “doing more with less,” establish clear policies and procedures and manage staff within that context. Visit all sites regularly. Relieve someone at the front desk for lunch or send them on a break if they had an unexpectedly busy morning.
- Catch staff doing things right and reward them. One of my employees walked a patient to his car in the rain. The patient had crutches and was trying to carry his paperwork, medications, and one shoe. (Yes, we did let him drive since his left foot was injured.) Rewards may be a $10 gas card or a Starbucks gift certificate. Celebrate the good things that are being accomplished, post them, and update them regularly. It never hurts to bring along some food.
Joe Hymes is recent past president of the NAOHP Board and an NAOHP
Professional Achievement Award recipient based in Ann Arbor, Mich.