Hiring Your Replacement

For Michael Maynard, it was a fly-fishing trip to Patagonia that put his life in perspective. After 22 years as practice administrator of the Springfield Clinic in Springfield, Ill., he was ready to call it quits. “It was the first time I’d been away from the clinic without being contacted by phone, and it was very relaxing,” he recalls. “I had just turned 63 and was putting in long hours and I thought, ‘Now I have the opportunity to relax a little and spend more time with my grandchildren.’”

Maynard notified the chairman of the board of his intent to retire upon his return, agreeing to weigh the decision for several more months. “That’s how I started the two-year process,” says Maynard, who retired in January.

Indeed, as administrator of the massive 200-physician clinic, it was neither prudent nor practical to submit his two-week notice. “We knew we wanted to hire [my replacement] from within so it would take time to train that employee to take over the reins, but also to recruit someone to fill that person’s shoes,” he says. “The complexity of saying, ‘Guess what guys, I’m not going to be back on Monday morning’ was not realistic.”

Whether leaving to pursue other opportunities, or to join the ranks of the retired like Maynard, the process of handing over the reins of your practice’s business operations is complicated at best. If you’re leaving on amicable terms, generally it’ll be your job to find your successor, bring her up to speed, and make the transition as seamless as possible.

That was Maynard’s goal from the start. “Some people really like the ego boost of hearing how much your employees really miss you. But to me, my last test as a manager was that the partners and physicians within the clinic would say, ‘You know, we really don’t see the difference here,’” says Maynard. “That takes a lot of strategic planning.”

It takes time

If you’re planning to bid your practice adieu, you should let your physician shareholders know as soon as possible - but only after your plans are final, says Bob Bohlman, a consultant with MGMA Health Care Consulting Group. “You have to alert your present employer and say, ‘These are my plans and this is my target date for termination, but I am somewhat flexible in that respect.’ Ask if they want you to proceed with recruitment, and if so, do they want you to do it yourself or hire a search firm.”

Keep in mind that it often takes six months to a year to recruit a new administrator, the most senior position on the business side of the practice. That includes time to narrow the field of qualified job candidates and another three months or more to allow that person time to transition out of his old job. As such, it’s critical that you give your current employer as much advance notice of your pending departure as possible. Remember, too, that if you hire (or groom from within) someone who is under-qualified for the job, it’ll take even longer to get him trained.

Judith Maly, administrator for Richmond Nephrology Associates, is already grooming her office manager to take over the reins when she retires in three years. “When I started working here, she was the file clerk and the lowest paid employee, but it was obvious to me she was the brightest employee we had,” says Maly. “She had great management potential and was very hard working.”

When they implemented an EHR four years ago, Maly put her office manager in charge. She also sent her to the local college for night classes in accounting and business administration because she didn’t have a college degree. “I have gradually turned over more and more responsibility to her,” says Maly. “She now interviews and hires for the office staff and I give final approval.”

Such transitions, in which the incumbent administrator slowly relinquishes responsibility to her replacement, require an extra dose of humility, notes Maly. “You have to leave your ego at the office door and not be intimidated because someone just might be able to do a better job than you,” she says. “This approach would not work for everyone, but in our case this will be a seamless transition for my staff and the doctors.”

As painless as possible

Obviously, if you’re leaving your practice for another job, you won’t be able to stick around for months on end. But you can still do your part to make your departure as painless as possible. Here’s how:

• Leave a detailed list of all important contact numbers, along with a schedule for inventory, financial reports, and a staffing calendar, complete with requests for time off.

• Clear out the clutter in your paper files and computer, and leave your desk as organized as possible.

• Designate someone (if you’re long gone before your replacement starts) to update your successor on the status of any future plans in the works - renovations, technology upgrades, pending lawsuits, raises, and new hires.

• Leave instructions on your accounting software, in case your successor hasn’t used the program.

• Above all else, though, leave your phone number handy in case there are any questions or need for advice. “I certainly suggest leaving the door open since that creates a real comfort level and a favorable relationship with the person assuming that position,” says Bohlman.

Lastly, whether you get the chance to train your successor or not, it’s critical that you as the outgoing administrator show your confidence and support in your future replacement. Doing so makes the transition easier for everyone. “I never contradict [my office manager] in front of staff or vice versa,” says Maly. “Disagreements should be dealt with behind closed doors.”

Shelly K. Schwartz, a freelance writer in Maplewood, N.J., has covered personal finance, technology, and healthcare for more than 12 years. Her work has appeared on CNNMoney.com, Bankrate.com, and Healthy Family magazine. She can be reached via physicianspractice@cmpmedica.com.

This article originally appeared in the November 2009 issue of Physicians Practice.