Are you feeling overburdened by increasing documentation requirements, patient messages, prior authorizations, and staffing shortages?
What if you found a way to improve the efficiency of your practice, reduce your workload, and even grow revenue, as well as increase your satisfaction and improve employee retention? It’s all possible by redesigning workflows so allergists spend more time on clinical decisions and less time on administrative tasks.
The key is redesigning your practice team to work at the top of their license. That means you and your staff should work on the most complex, challenging tasks that each of your licenses, training and abilities allow – rather than spending time on administrative tasks that could be done effectively by someone with less training.
Do you find yourself doing tasks that your medical assistant (MA) or registered nurse (RN) could perform instead? If so, you aren’t alone. A 2024 AMA survey indicates physicians spent an average of 15-20 hours a week on administrative tasks and indirect patient care. It’s likely some of those tasks could be efficiently performed by your staff, which could free up your time to see more patients or improve your work-life balance. Importantly, expanding the role medical assistants and nurses play in team-based care can provide them with more fulfilling work and, in turn, decrease turnover. Finally, it could improve your overall work experience.
What are some things MAs and RNs can do to improve efficiency in your office and reduce your administrative workload? Current and former Practice Management Committee members and experts at three allergy practices shared some of the ways MAs and RNs take on larger roles in their practices. Tom Derrico, Charles Furr, Jr., MHA, and Jean Owen, MBA share their tips on what MAs and RNs might be assigned to do:
- Perform a pre-visit chart review 1-2 days before each appointment. Track down referral and ED notes, pulmonary function results, and previous test results in advance so they are available for the allergist during the visit.
- Room patients based on expanded rooming protocols.
- Identify the reason for visit/chief complaint.
- Perform medication reconciliation.
- Perform review of systems.
- Record past medical, family & social history.
- Administer Asthma Control Test based on protocols.
- Perform tests based on standing orders.
- FeNO
- Spirometry
- Peak flows for asthmatics prior to getting allergy shots
- Provide immunizations based on standing orders.
- Flu
- Pneumococcal
- Refill prescriptions based on protocols.
- Triage calls and portal messages based on protocols.
- Educate patients on the following topics:
- Environmental controls
- Immunotherapy
- Use of inhalers/nebulizers
Making these changes involves creating written standing orders and protocols that clearly spell out the rules and policies for conducting patient care in various stipulated clinical situations (rooming a patient, refilling prescriptions, performing tests, etc.). They may also involve providing additional training to staff taking on new responsibilities. The Practice Management Committee suggests creating a taskforce of physicians and staff to work together to create standing orders and protocols as well as identify potential training needs. Try to adopt one or two changes at a time to ensure successful implementation. The College’s Employed Allergist Toolkit has sample standing orders for medication, as well as EHR smart phrases for patient education, HPI and procedures.
One important caveat: make sure the duties assigned to staff are within the scope of licensure for their position. Scope of practice is licensed and regulated at the state level. The American Association of Medical Assistants provides information on MA scope of practice laws by state. The National Council of State Boards of Nursing provides information on nurse practice acts by state.
The AMA has free training modules as part of their Steps Forward program that can help you implement some of these ideas and improve your workflow and processes. Check out their modules on Expanding Rooming and Discharge Protocols, Team Documentation and Medication Management for more information.
