Staffing and Training

Are you struggling to build a winning team in the orthobiologics field? Learn the essential roles and skills you need to succeed.
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Join us on the Business of Orthobiologics podcast as we dive into staffing and training strategies that will elevate your practice. Don't miss out!

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Transcript

Intro

Hey, I'm Dr. Ariana De Mers. I'm an orthopedic sports medicine surgeon and I have successfully integrated orthobiologics into my busy practice so that I can provide a continuum of care and treat patients who are in the gap. The gap is this gray area in orthopedics where standard conservative treatments have not been effective, but surgery may not be warranted. And we usually tell our patients, come back when it's worse. What? These are your patients coming to you for help. Orthobiologics is that solution that can fill the gap and help you treat your patients who are in your office looking to you for help. Orthobiologics can also be an excellent treatment for frustrating problems without good surgical outcomes. This podcast will help you create the orthobiologics business that will make you love your job again. We will focus on the value of orthobiologics, patient selection, how to talk to your patients about money, office setup, and other logistics. If this is something you've always wanted but don't know where to start, join me in "The Business of Orthobiologics" podcast.

Dr. Ariana

You need to explain your expectations regarding patient interactions, scheduling appointments, handling inquiries, and maintaining patient records. This, for me, is really important. I really hate to be late. I also hate when I disregard my patient's time. So we don't reschedule. We really try hard unless it's a patient request, and we try to really maintain our pace and our schedule to respect our patient's time. It's important to discuss the accuracy and attention to detail as well as adherence to confidentiality, privacy regulations, including HIPAA. Next, we'll be talking about software and systems training. It's really important to provide training on what you use for your electronic health record, your appointment scheduling software, and any other relevant software tools you use on a daily basis. Please demonstrate how you navigate the software, input the patient information, and schedule appointments, as well as access necessary reports and documentation. Everyone should have a really good handle on where all the things go and how to access them. It is my thought and practice that all of my employees are cross-trained, and they all have a very similar knowledge base on the general day-to-day patient interactions. I then allow a hands-on practice of all of the documentation software to ensure proficiency in using this system so it doesn't take over the interaction with the patient. Our next discussion is patient intake and communication skills. We like to train our new employees on effective communication techniques, including active listening, empathy, and professionalism. I always ask them to demonstrate the process of the patient intake, including gathering demographics, insurance, if you are worried about that. Please note, even if you are a cash practice, if you are referring out for imaging and such, that may be information that's important, and it's important to accurately record it in your system. Additionally, providing guidance on handling patient inquiries, scheduling appointments, managing conflicts for different difficult situations is very important. And I think it goes without saying that I really recommend empowering your employees to act as if they were you in each situation with the good of the company and the good of the patient at heart. Medical terminology and orthopedic knowledge. This is super important from a technical standpoint. We want to be impeccable with our word and we want to be accurate with our discussion, what we're doing, and what we're talking about. So we familiarize our new employees with commonly used medical terminology related to orthopedics as well as orthobiologics. We provide the basic information on common orthopedic conditions, treatments, and all of the orthobiologic procedures that help them understand the patient's needs as well as discussions. I think this is also really important because this helps them to understand what patients may benefit from orthobiologics who have not yet thought of this opportunity. I then share the resources like reference materials, online courses, educational videos, important landmark papers in our orthobiologic research so that they can play an active role in taking care of our patients and guiding our patients to appropriately discussed treatment plans. We do recommend some role-playing and scenarios. Everybody feels a little silly when we do the role-playing exercises where you are the patient and you call in requesting different sorts of scenarios, different appointment types, urgent cases, and patient inquiries. I also do this to include price and insurance objections. This is quite educational, not only for the practice owner but for your employees as well. And it really gives them an opportunity to make sure that they have these really important tidbits of information that they can use at their fingertips. I would highly recommend scripting these various responses for your employees to streamline and standardize these responses so that every patient gets the same answer and we don't pit mommy against dad. Next, we would provide constructive feedback during your role-playing to try to maybe guide or help their skills but also boost their confidence. You know, coming into this, they are not the expert. They are learning. And this is an awesome way to really help them feel confident in doing a good job with our patients. We then address any specific challenges or concerns that they may encounter in their role and provide strategies for them to handle these issues effectively. I'm a big fan of shadowing and mentorship. You know, in a small startup practice, they shadow me. If in a bigger, more mature practice, they can shadow experienced colleagues and observe real-life patient interactions and workflows. Sometimes you can assign a mentor, or experienced staff member who can provide this ongoing guidance, answer questions, and support the new employee during the training period. Now, if you are the only mentor and we only have one employee, well, then that's going to be you. It's doable, regardless of your size of practice as well as in your startup. I would encourage regular check-ins and feedback sessions. And these are super important to schedule weekly. Don't let things go. Don't let them fester and really kind of provide this opportunity for monitoring progress and addressing any additional training needs or, you know, things that they feel that are missing. And then finally, ongoing professional development. We emphasize the importance of continuous learning, continuous professional development, as well as continued personal development. We want them to grow as a whole person. I encourage participation in training programs, webinars, and conferences. My employees come with me to the orthobiologic conferences. They sit in on the lectures to become more knowledgeable and really be able to bring home that next-level expertise for our patients. We also send our employees to patient management and customer service training. And then we also provide opportunities for cross-training. And like I said before, this is key for me, in a small startup of practice, it's really important for the practice not to be dead in the water if somebody calls in sick. I make sure that every single one of my employees is cross-trained to do everything that needs to be done. Each person knows how to schedule an appointment, answer the phones, access the database, and practice processing. They all can help me draw blood, help me assist in my injection-based therapies. And really, it's important for a small practice for everybody to be cross-trained for each other's jobs. So let's talk a little bit about medical staff. You know, you have a doctor, nursing staff, an MA, LVN, or RN, PA, NP, ATC, MSK. And really, you don't have to have all of these. Currently, I have myself, I have an MA, and I have a Nurse Practitioner that works for me one day a week. I have a Laser Specialist, and she is knowledgeable about anatomy, but otherwise, I don't have anybody else. Other staff that we have, we have a research director and a lab director. That is the same person. And she runs my lab, she runs my research, and she runs all of my data collection. And she's part-time, she's per diem. And that seems to work for me right now, and it seems to work for her. Let's talk a little bit about licensure and training. I really strive to train each person to the top of what their licensure will allow. So really, I think you need to make sure you know the difference between an MA and an LVN and an RN, as well as differences in what PAs and NPs can do in their supervision requirements. For me, an MA with a Phlebotomy license is absolutely adequate. And in a small startup company or cash-based company, that price point difference to pay an MA versus LVN versus RN can make or break your company. Additionally, having an NP versus PA for licensure and supervision requirements allows me to be able to have my NP seeing patients when I'm out of town and covering for me if I'm out of town on her own licensure. Whereas a PA may need more close supervision. When we have MSK training, orthobiologic training knowledge, and really, in the state of California, athletic training is not a licensed professional. In the other 49 states, this is a licensed professional and can be used as a physician practice extender, especially in musculoskeletal practice. So definitely do your research. But this can be super valuable. Also, make sure you know from your state's licensure who can do Phlebotomy, who can draw blood because this will be important if you're going to be doing a lot of orthobiologics. And then we have our lab director and research coordinator for our research endeavors to try to further the field and collect our own data so that we can tell our patients what to expect and what our data shows day-to-day, week-to-week, month-to-month, and year-to-year. Next, let's talk a little bit about blood drawings. So blood drawings, really, I think, are ideally done during a time when it impacts the physician requirements, including you know, help with injections or MA setup or something like that. So in my practice, we do blood drawings outside of the times when myself or the physician is in the practice. And then the processing happens away from the doctor-patient interaction as to be able to streamline the doctor-patient interaction. We do this seated in a semi-reclined position. We put a pillow on a mail stand to use gravity, and then we are prepared for Vasovagals. We have recliners, a chair, or a bed that lays all the way back. We have water, juice, and snacks. And then please remember to have a plan for difficult blood draws. My plan is an ultrasound-guided blood draw by myself. Now, this does sabotage my schedule, and it happens not rarely, but it's super effective to be able to move forward, take the blood, and process it for our PRP injection a little bit later that day. Of note, we have had one experience where we could not draw blood on this gentleman. He was young, he was healthy, and oh yeah, he drank about three energy drinks and no water. And so my nurse tried a number of times. I tried, I think, three times, poked him in both arms, hands. We could not draw blood. And honestly, we canceled his procedure and I recommended hydration. And we rescheduled him for a week later, really making sure that he was hydrated. And the next blood draw was super simple and easy. So that does happen. And then you do have to have an idea of how you want to move forward and do that. Let's talk a little bit about the actual processing of the PRP. Like we said before, we train multiple people on how to do this effectively and efficiently so that this is not a bottleneck. If you have a product rep, you can have them process it. Please note, you have to really have a dedicated clean lab area to prepare and process the blood and processing kits. If you do it yourself and not using a [inaudible] cleared kit, I recommend a tabletop hood and a closed system to be FDA-compliant. Otherwise, this is a pretty straightforward skill that most employees can master quite easily. And that allows you to have a flexible schedule that anybody can process. So next thing that I want you to consider is how-- from a logistical standpoint, how you're going to do the processing and transporting. So how do you get the blood from the patient to the centrifuge and then back to the patient? Where's the centrifuge located? Where's the patient getting blood drawn? Is it upstairs? Is it downstairs? Please be aware that it is not within regulatory compliance to transport blood outside the facility, and it should be self-contained in the same building where the centrifuge is located. If that means that you need to move your centrifuge, then that's something that you really need to think about. Please note that all patient identifiers should be present on all blood collections as well as any syringes that contain PRP, PPP, or anything like that. Make sure you have name, date of birth at a minimum. And then from a storage perspective, the FDA compliance recommends not storing this greater than 24 hours. And really, it's frowned upon for storing overnight, depending on the blood draw, you may want to put this in a refrigerator, or if you're using it right away, then you don't need to worry about storage. So next, really, we want to train on injection setup. Obviously, sterility is really important in any kind of invasive procedure, so we will need to train on what to do, how to maintain sterility, and then what you need for each injection. I would create a standard operating procedure and checklist basic for a standard injection. And then for each more in-depth injection, such as PRP, Bone Marrow concentrate, adipose, make sure you have a specific checklist for those injections as well. So an example of mine is that we have skin prep, both by an alcohol or CHG, sterile gauze, local anesthetic, platelet-rich plasma with required specific needles, as well as labeling and a bandaid for the finish. And this is all setup. We have a picture of it on the inside of the cabinet so anybody can pull all the needed things for the injection without having to ask, oh, what kind of needle? What do you do on day one or two? Or how do you want it? So that seems to be quite important for streamlining and, you know, taking out variation in the field. Okay, so we'll talk about business staff and other staff training. So, you know, business staff includes our business manager, operations manager, front office, back office, a new patient specialist, logistics coordinator, and closer. Of note, I do not have seven office business staff. I have a business manager who's also my operations manager, who's also my back office gal, and I have a front office gal who's also my new patient specialist, who's also my logistics coordinator, and my closer. Other staff includes either phones or IT. All this training is the same process as before. And please, please, please don't be afraid to outsource all the things that you don't have training in. You are not all things to all people. You are a physician first and foremost, and you can outsource everything else. So please remember, building a successful team is really important to have your mission and vision and empower your employees through communication and equip them for success and then lead the team. I'll see you next time on Scheduling. Have a great day.

Outro

This has been "The Business of Orthobiologics" podcast. Thank you so much for joining us today. If you want to know more, please join us on the website, "PRP-Now.com", and click on the FREE Masterclass. Also, don't forget to "Subscribe" to this podcast to get more guidance on integrating PRP in your busy practice. Bye for now.