Enhancing Practice Performance

Evaluate your contingency staffing needs

There are advantages to hiring part-time staff; here is what to consider before doing so.

By not building flexibility into your staffing strategy, you could adversely impact your practice’s profit margin and viability. Employing a balanced mix of full-time and part-time staff can provide your practice with scheduling flexibility, cross-trained workers and tighter financial control, which are critical in the challenging times ahead in eye care.

Think of your practice as needing “core” and “contingency” staff. Core staffing is defined as those staff whose duties are always required, with little relationship to patient volume. Contingency staff are those whose contributions and hours are dependent on agreed-upon patient volumes.

When patient volumes fluctuate, basing your staffing levels on an agreed staff-to-patient ratio is effective. For example, in the typical practice setting, the benchmark for reception and phone staffing is 0.5 staff hours per patient visit. Such a benchmark doesn’t vary if the staff all work full-time or if some work part-time. A practice seeing an average of 700 patient visits per month needs about 2.0 reception/phone FTEs, which could be handled by two full-time workers, or four staffers, each working half time.

In America, depending on the economic times, 15% to 20% of personnel work part time. According to recent Ophthalmic Professional subscriber surveys, that figure is closer to about 7% or so in eye care, where our historically robust finances allow us to be a bit loose in the area of rationalizing down labor costs.

Here are the pros and cons of hiring part-time staff.


The most obvious benefit is that you can schedule the part-timers to work longer or shorter hours as patient volumes dictate. For example, when surgeons are in the OR, you have fewer demands for technicians, scribes and testing.

During a client site visit, while the surgeons were in the OR, it was apparent to us that the practice was overstaffed in several departments. Numerous staffers did not have enough work to keep them productive.

The question arose: are they not following management’s direction to backfill their downtime with important secondary assignments? For example, a telephone operator can prep upcoming patient paperwork when not on a phone call. Management can anticipate and prepare collateral assignments for these slower times. Ultimately, this client decided to be more organized about keeping staff productive. And, when they experience staff attrition, they will hire more part-time employees for a more flexible staffing schedule.


Your practice is responsible for paying part-time staff the hourly rate for the time they work, with little to no related employee benefit expenses. With fewer financial commitments to staffing expenses (or at least more flexibility), you can significantly reduce labor costs. It has been our experience that as much as a 20% savings can be achieved for a given payroll hour.

Keep in mind that paid time off (PTO) is often included as an employee benefit for part-time employees, but on a limited or pro-rata basis, if the employee is regularly scheduled to work 30+ hours per week. State labor laws differ, so be sure to check with legal counsel for your own state rules.


Another positive aspect of offering a part-time schedule for some staff is that it can help you attract employees. Many part-time workers want shifts that are harder to schedule, such as evenings and weekends, whether it’s their second job or they need to avoid a conflict with childcare schedules.


Reducing your full-time staff’s evening and weekend responsibilities can be a morale booster, too. Be cautious not to over-promise to your full-time staff, however, when changing the schedule like this — it doesn’t mean that a full-timer will never have to work the less popular shifts. Advise these workers they are still responsible for all types of office-hour coverage, on an as-needed basis, if more coverage eventually is needed or the evening and weekend employee coverage changes.


The biggest downside of employing part-time staff workers is when they take scheduling flexibility for granted. Ideally, you schedule their work hours for the benefit and convenience of your practice, not the other way around. At times, you may allow part-time staffers to dictate when they can work, on a short-term basis, and it will still benefit the practice (for example, allowing the employee the flexibility to attend a college class for a semester). This may help to retain a seasoned, well-trained employee in whom you have already invested time and training.

But, this can be a slippery slope. We see too many practices in which the part-time staff alter, by subtle or not-so-subtle demand, their schedules more for self-benefit, rather than for the practice’s benefit. Consider all benefits and downsides of these requests, and when staff ask for them, stay focused on the underlying purpose of hiring of part-time workers: to benefit your practice and not for them to work at their convenience.


Applying the concept of core vs. contingency staffing (typically full-timers vs. part-timers) can make some administrators and owners uncomfortable, both for practical and sentimental reasons.

You may worry that you will lose critical staffers if you do not guarantee a 40-hour workweek to all employees. On top of this, principled practice leaders feel understandably responsible for their hardworking, loyal employees’ financial well-being.

Both these perspectives are important to consider when you’re trying to balance practice operations, economics and morale. OM