Power Your Practice

Writing on the operations of a small independent practice

The front desk


Everything that happens in a practice passes the front desk twice. It is the busiest job in the building and usually the least written down.

03.1Two queues, one person

A front desk serves two queues at once: the person standing at the counter and the person on the phone. They arrive independently, they cannot see each other, and both believe they have priority. No amount of goodwill resolves this; only a rule does.

The common rule is that the person present takes precedence and the phone is answered with a held line or a call-back. It is defensible, but it has to be stated, or each member of staff invents their own version and the experience of the practice changes depending on who is on shift.

The alternative is separation: a period of the day when calls are handled away from the counter, or a division of the two roles when staffing allows. Separation is expensive and it is the only structural fix. Everything else is a coping strategy.

03.2Interruption is the workload

Desk work is not one job. It is a queue of two-minute tasks, each of which is interrupted before it finishes. Filing, chasing, refilling and preparing all require a run of uninterrupted minutes, and the desk never gets one during opening hours.

The practices that handle this best make the run explicit: a protected half-hour before opening, or after the last appointment, when the desk does the work that cannot be done in fragments. Protecting it means not booking into it, which returns the argument to the calendar.

03.3Arrival flow

Arrival is a short sequence — recognise, confirm, direct, record — and it goes wrong in predictable places. Someone arrives early and stands waiting for acknowledgement. Someone arrives for the wrong day. Someone arrives with a question that belongs to a different conversation entirely and delivers it at the counter with three people behind them.

The fix is rarely technology. It is deciding in advance what the desk says in each of those cases, so the response is immediate and the queue keeps moving.

03.4Write the procedures down

A small practice can run for years on the knowledge in one person's head. It works until that person is on leave, and then the same questions are answered four different ways in a week.

A desk manual does not need to be long. A page per recurring situation — arrival, cancellation, a call about an account, a request for records, a complaint at the counter — written in the words the desk actually uses, is enough to make cover possible and to make training a morning rather than a month.

03.5The desk as an early-warning system

The desk hears the problem before anyone else does: the same question asked repeatedly, a form nobody understands, a confirmation message that generates a phone call every time it goes out. That information is only useful if there is somewhere for it to go.

A standing five minutes at the end of the week, with someone writing down what came up more than twice, converts the desk's irritation into a list of fixable things. Without it, the same friction is absorbed silently until it becomes turnover.

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About this site

Power Your Practice is a writing project about the administrative half of small professional practice: how the day is arranged, how the desk copes and how the paperwork keeps moving.

It recommends no products and reviews no organisations. Everything published here is written for the site.

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