Physicians Practice - July/August 2008 - (Page 61)

THE ADMINISTRATOR’S DESK WHO’S IN CHARGE? AS A PRACTICE EXPANDS, SO DO ITS MANAGEMENT NEEDS. HERE’S HOW TO DELEGATE AUTHORITY WHILE RETAINING OVERALL CONTROL. B Y S H E L LY K . S C H WA R T Z You’ve worked there. We all have. The ofﬁce with too many cooks in the kitchen. Clerical staff who report to team leaders who report to managers who report to supervisors. They have meetings to discuss their meetings, but nothing ever seems to get done. Or perhaps you’ve spent some time treading water in the other end of the management pitfall pool a 42-physician, independent practice with 14 locations throughout Pittsburgh. Her office, for example, recently created a management position to oversee implementation of its new EMR system. “Even though our EMR vendor provided us a project manager, I pushed for an internal manager because of the magnitude of this project.” WHO’S THE BOSS? “The person running the practice should have the authority, responsibility, and the accountability for the practice.” It worked for Pediatric Alliance. But how can you avoid over- or under-appointing people in charge? TIME TO RAMP UP? EMR manager, Pediatric Alliance also recently brought on a human resources manager to handle personnel matters. “Initially, we all divided those responsibilities, but the jobs were too scattered among our employees and no one had enough time to devote to it to really do it right,” says Wertz-Evans. “There are so many federal laws for the Family and Medical Leave Act alone, and there are exact procedures you need to follow when you discipline or ﬁre an employee, so we felt we needed someone with experience.” THE BASICS Sarah Holt, practice administrator — the one struggling to get by with too few workers. Either way, such ofﬁces are characterized by the crazed looks in employees’ eyes, chronic morale problems, and a steady stream of resignation letters. As practice administrator, of course, you know ﬁrst-hand how challenging it is to strike the perfect personnel balance — one that maximizes your resources yet ﬁts comfortably within your budget. Partly, that’s because your need for midlevel managers is constantly in ﬂux. Your practice expansion very often means having to create additional layers of hierarchy within your staff. “It’s not always how fast your ofﬁce is growing, but how complex a speciﬁc job is,” says Liz WertzEvans, CEO of Pediatric Alliance, WWW.PHYSICIANSPRACTICE.COM Determining when to create additional layers of hierarchy, of course, depends on multiple factors, including your specialty, your workload, and your projections for growth. If your front desk clerks or billing staff are coming to you daily with complaints or questions, it may be time to empower someone with strong leadership skills to head up individual departments. Promoting people to departmenthead status can both lighten your load and ensure your ofﬁce remains current with regulations and insurance. For example, in addition to its To operate efﬁciently, a medical practice should have at least the following basic structure: an ofﬁce manager or administrator running the business end of the practice, a front desk clerk, a nurse or medical assistant, and the physician. Many also require a designated billing clerk to enter charges and ensure insurance claims are ﬁled correctly. Everyone under that management structure, except the physicians, should report to the administrator, ensuring one person maintains responsibility and accountability. As your practice grows, and you create additional layers of hierarchy, it’s the department heads who then report to the administrator. “The person running the practice should have the authority, responsibility, and the accountability for the practice,” says Sarah Holt, administrator of Doctor’s Park, a 35acre medical campus with all specialties represented, as well as practice administrator of Cape Surgical Clinic within the park. “It all has to go back to somebody.” JULY/AUGUST 2008 | PHYSICIANS PRACTICE | 61 http://WWW.PHYSICIANSPRACTICE.COM

Table of Contents Feed for the Digital Edition of Physicians Practice - July/August 2008

Physicians Practice - July/August 2008 Contents The Bigger Picture: Battle Royale in the EMR Market Letters Physicians Practice Pearls: Hire Right Noteworthy Cover Story: Healthcare Reform: Voting for Change Patient Relations: Dealing with Problem Patients The tech Doctor: Is Self-Service Medicine Inevitable? Technology: Do EMRs Make You a Better Doctor? The Guide Idealab: Cash-Only Care Still Works The Administrators Desk: Who’s in Charge? Ask The Experts What Went Wrong: ‘Why Our Great Idea Didn’t Work’ Coding Start It Up: How to Launch a Practice: Operations Partnership: Don't Let Partner Conflict Destroy Your Practice Appraisals: What’s Your Practice Worth? Getting Advice: How to Hire a Consultant Classifieds Advertiser Index

Physicians Practice - July/August 2008

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