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Grand Rounds in Urology Contributing Editor Neil H. Baum, MD, Professor of Urology at Tulane Medical School, gives advice on how urologists can improve staff morale in their practices with effective staff meetings. He explains that a highly motivated staff is one of the pillars of a successful practice and argues that the purpose of staff meetings is to get staff feedback, identify problems, introduce new ideas, and enhance morale. Dr. Baum notes that key elements of running effective staff meetings include circulating an agenda, taking notes, preparing a to-do list, and sending out notes within a day or two of the meeting. He particularly focuses on the importance of bringing “sparkle” to staff meetings by, for example, having staff share the best things that have happened to them in the practice since the previous meeting, or by acting out relevant scenarios. Dr. Baum emphasizes providing an environment that is fun, rather than an environment where everyone is moving from one crisis to the next. He also gives suggestions on how to improve performance reviews, recommending that urologists try to do one with each staff person every three to four months and have them complete a worksheet with questions about their goals before each review. Dr. Baum also suggests periodically surprising staff with fun activities to show appreciation. His bottom line is that by taking good care of staff, a urologist ensures that staff will take outstanding care of patients.

Grand Rounds in Urology Contributing Editor Neil H. Baum, MD, Professor of Urology at Tulane Medical School, gives advice on how urologists can identify the causes behind and reduce the number of no-shows in their practices. He defines no-shows as patients who miss their appointments without calling ahead of time, leaving expensive holes in a practice’s schedule. Dr. Baum recommends that urologists identify the cause of no-shows in their practice by reviewing the electronic medical record, calling patients to ask why they did not keep their appointment, calculating the number of no-shows on a quarterly basis, and monitoring the trend. He explains that no-shows tend to be self-pay and Medicaid patients, patients with urgencies or emergencies, new patients, and patients given appointments for dates more than 4 or 5 weeks after they call. Dr. Baum then gives several suggestions on how to prevent no-shows, such as creating daily “sacred” time slots in the schedule for new patients, urgencies, and emergencies so that these patients can be seen soon after they call without disrupting the schedule. He also recommends sending automated appointment reminders that give patients the option of confirming, canceling, rescheduling, or leaving a message. Dr. Baum argues that charging no-shows is not a great option, since these fees can be difficult to collect and can create ill-will. Instead, he suggests urologists should consider no longer giving appointments to repeat no-shows. He concludes that preventing no-shows is a proactive process and that urologists should identify and remove the obstacles preventing patients from keeping their appointments.