How Much is Your Untrained Employee Costing You?

Your medical practice is only as strong as its weakest link—employees who lack training and make your practice look unprofessional can negate all of the effort and hard work from the rest of your team. Lack of training causes low productivity, an unsafe work environment, and increased expenses. Frequent mistakes not only cause patient frustration, but also coworker frustration: the coworkers have to clean up the messes that untrained employees create. Untrained employees can lead to serious financial and legal consequences. For example, a survey showed that 44% of the participants admitted to having shared sensitive company information because they “wanted to bounce ideas off of people”; 30% did so because they “needed to vent”, and 29% stated that they “did not see anything wrong with it.” These statistics show just how risky it is to have an untrained employee who can easily commit HIPAA violations for which you will be held responsible. When patient PHI has been compromised, the practice can face overwhelming financial penalties—and can even face criminal charges, depending on the nature and severity of the violation. A recent study shows that security breaches cost the healthcare industry $5.6 billion annually. The OCR has capped the fine for a severe HIPAA violation with no intent to correct at an annual maximum of 1.5 million dollars; however, even a fraction of this amount can seriously impact the financial stability of any practice.

Aside from HIPAA violations, untrained employees can cost you in many other ways:

Accidents or injuries while on the job: not only can an untrained employee injure himself while working, and seek financial compensation from your practice, but they can also create risky situations for other employees or even patients. Furthermore, accidents can lead to broken equipment, wasted supplies, and many other negative consequences. All such adverse incidents must be remedied and documented by the practice manager.

Bad customer service: every employee represents your practice. If an untrained employee provides bad customer service, displays a negative attitude, or is unable to answer common patient questions, it makes your whole practice look unprofessional and can cost you patients. When patients leave your practice due to subpar customer service or unknowledgeable staff, more often than not they will let their frustration be known to their friends and family, on social media and on Google reviews—leading to you losing even more patients and credibility.

Not collecting enough money from patients: If your untrained employee is a receptionist who is scared to ask patients for their co-pays or unable to explain patient balances, you will lose a significant chunk of money that should have been collected at check-in. Patient responsibility amounts have been climbing, and are now at around 23% of all A/R—and these balances are the hardest to collect if not collected at the time of service. If your untrained employee is a biller who improperly verifies a patient’s insurance—or does not verify it at all—and the patient gets seen, the practice loses money on that patient, whether by not collecting any money at all or by spending time and resources collecting it.

Not billing properly: no matter how amazing your providers are, how friendly your front desk receptionist is, or how caring your nurses are, your practice will not be able to operate if your billing department is not bringing in the revenue that you have worked so hard for. For example, an MGMA survey shows that better performing practices in primary care have an average Days in A/R of 23.54 days, as opposed to other practices who average 39.56 days. If your untrained billing staff is not following up on claims efficiently, many of your claims run the chance of being denied for untimely filing—causing you to lose large amounts of money.

Additionally, more so than in any other field, employee mistakes in healthcare can be deadly. Medical errors have been found to be the third leading cause of death in the US, with over 250,000 deaths per year caused by such errors. Some of the most common mistakes made by untrained healthcare employees include medication errors, infection issues, and charting or documentation mistakes. As we all know in healthcare, if it was not documented, it didn’t happen. This mistake may seem minor and easy to correct—if caught. However, if an untrained nurse forgot to document an allergy that a patient had, and the patient had a severe allergic reaction to the course of treatment provided, your medical practice as well as the individual provider treating the patient is now at risk of a malpractice suit—which comes with attorney fees, incurred financial losses, a damaged reputation, and higher malpractice insurance premiums. And this is only one way in which a documentation error by an untrained employee can lead to dire consequences.

Each of your employees directly represents your practice. The costs of not training your employees are too high for this to not be a priority for you. If you do not already have one in place, implement an onboarding and training process for all new employees—a general one for all new employees which introduces them to your practice mission, vision, core values, and goals, as well as a role-specific training process for each new employee to learn the intricacies of the position for which he or she was hired. Ensure that your training does not stop at new employees: existing employees need continuous training as well. Find a way to make it fun as well as informative—no one wants to sit through the same boring training routine over and over again. Although a new onboarding and training process may take some time and manpower to develop, the benefits of having such a program in place will be worth the effort exponentially when every employee at your practice is knowledgeable, professional, and on board with your practice’s vision and goals.

For assistance in setting up your practice’s onboarding and training program, contact Leading Management Solutions to set up a free consultation.

About the Author:

Sonda Eunus is the Founder and CEO of Leading Management Solutions, a healthcare management consulting company ( Along with a team of experienced and knowledgeable consultants, she works with healthcare practice managers to improve practice operations, train employees, increase practice revenue, and much more. She holds a Masters in Healthcare Management and a BA in Psychology.

When is a Medical Error Considered a Crime?

Originally published on November 22, 2016 at By Anita Haridat, Ph. D

Although there have been many advances in health care, there are still many issues that surround adverse events. The rates of medical errors are increasing even though multiple strides have been made in order to facilitate quality care. With all of the implications that have surrounded the field, when is a medical error actually considered a crime?

From all of my professional experiences within hospitals in New York, it seems that an organization’s “reason for being” is to provide the best possible health care when needed. Unfortunately, I’ve also learned that problems arise when the hospital’s mission is “to generate a profit”, to “advance science”, or any other mission that might be at odds with providing the best possible care in the short term. The same applies to individual clinicians and clinical teams within the hospital.

Then, I thought about a common patient safety movement commandment “errors represent system problems.” In a sense, it also represents the fact that “thou shall not blame.”  Like most complicated issues in life, the truth lies somewhere between these polar views. Overall, the “no blame” view is right – most errors are committed by good, hardworking doctors and nurses, and finger-pointing simply distracts us from the systems fixes that can prevent the next fallible human being from killing someone.

Yet, taken to extremes, the “no blame argument” has always struck me slightly naïve. Let’s look at a case from just this year in April. A 24 year old received a routine wisdom teeth removal and woke up coughing during the procedure. He was given the powerful anesthetic propofol, but his condition quickly deteriorated and he was transferred to a hospital, where he died three days later. According to the patient care report, the paramedics said that the patient woke up during the procedure, started coughing and was given propofol. When the patient stopped breathing, CPR was started and the paramedics were called.

After they arrived, the paramedics found two pieces of surgical gauze in the patient’s airway as they tried to intubate him. How can such a careless mistake lead to the death of an innocent man?

What’s most shocking is the healthy 24-year-old goes in for an operation as routine as having his wisdom teeth removed and dies in the process. So the question remains- when is a medical error a crime?

According to dozens of enterprises for risk management, there are three kinds of behaviors that can lead to errors:

Human error – inadvertently facilitating a process other than what should have been done; a slip, lapse, or mistake.

At-risk behavior – a behavior or process that may increase risk or recognition that the behavior is mistakenly justified.

Reckless behavior – a choice that is made to disregard unjustifiable risk in a conscious manner.

Were the surgeons involved with the case criminally prosecuted? I doubt it. There was legitimate remorse and regret towards the family. However, I will go so far as to say that there should have been counseling, suspension or arguably firing done. The case is still open- just like so many other medical error cases and unfortunately, my main question still stands. What are your thoughts?


Leading Management Solutions helps medical practice leaders identify ways to improve operations to increase revenue, employee engagement, and patient satisfaction. Learn more about us at


About the Author:

Anita Haridat has her Ph.D in healthcare/business administration and her master’s degree in clinical nutrition. She has several publications in sources such as EGO Magazine, Natural Awakenings Magazine, Syosset Patch, Our USA Magazine and many more. Her passion for health and wellness has created multiple stepping stones for paving the way of creating a positive well being. Her first book can be found here:

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