The staffing mistake your health center can no longer afford to make

6.4 million people have been enrolled in coverage through the federal insurance marketplace for 2015. Consequently, the nation’s uninsured rate has dropped to historic lows, especially in expansion states, and these states are spending less on health care for their uninsured. Many Federally Qualified Health Centers (FQHCs), for the first time, are experiencing competition for their patients who were previously uninsured. They're looking to gain efficiencies and cut costs, and there is no greater cost than labor.

Many health centers, faced with slim margins, consider labor cost something to be managed under tight control and err on the side of understaffing versus overstaffing. Most employees have experienced the stress of short staffing firsthand. It creates inefficient work patterns, avoidable operational problems and generally results in lower productivity. 

In 2014, I read the Good Jobs Strategy by Professor Zeynep Ton.  She is singing my song, except she actually draws on a decade of research rather than mere intuition and anecdotes. She showcases successful companies and creates a compelling case for why it really is more profitable to treat your employees well.

Model retailers cut waste everywhere they can find it, except when it comes to labor. In fact, they build in a little slack to avoid being short staffed. With an appropriate workload, employees are engaged and involved in continuous improvement in the form of innovation, waste reduction, process and safety improvement. When patients are overbooked and employees are overworked, the patient experience is negatively impacted, never mind time for innovation and safety improvement. 

Patients with bad experiences and insurance are very likely to look elsewhere for care. This competition is a new challenge for many health centers. I was pleased to see Professor Ton referenced in a recent New York Times op-ed, and I hope she continues to proselytize. Her whole premise is that you make a decision to treat your employees as a profit center or a cost center. The choice is yours.


Lesa Peterson is a Director of Health Access - FQHC Systems at FQHC Germane and a Consultant with Merces Consulting. Previously, as the Director of Operations for a community health center, she was responsible for the administrative operations of the organization, including a Ronald McDonald Care Mobile® program.

Read more about Lesa here.

To contact Lesa, email her at LPeterson@FQHC.org.