Managing Physician and Administrator Relations

I recently attended a Medical Group Management Association sponsored conference on the "Business of Care Delivery." Discussions focused on how physicians and administrators can work together to meet the complex challenges facing medical practices; now and in the future. These discussions focused on leadership and management, collaboration, and improving the quality of care provided to the populations that we serve.

Unilateral decision maker vs. practice facilitator

Basically, when you consider the physician mind-set it is one of decision making, autonomy, and dealing with things now. These concepts are not always congruent with the mind-set of the practice administrator. The administrator is trained to focus on the complexity of coordinating multiple practice issues inside the office, as well as outside the office. This coordination requires a set of skills that are not taught in medical schools.

So instead of discussing "managing the physician," it seems more appropriate to address how the physician and administrator can work together. Typically the entrepreneur physician provides leadership to the entire group. In other cases it is the administrator that provides that leadership. Both must focus on the mission of the practice which relates to providing quality patient care, as well as maintaining the health of the business. Without this balance there will be no group of physicians to provide care to the patients.

We should strive to work together in any way possible. Physician and administrator decision making follow the same path; however, the time frame for action may be significantly different. The autonomous physician who is evaluating a patient will attempt to define the problem, seek information, consider alternatives, and decide the best course of action. Administrators will follow that same pathway; however, others will either be involved with the decision-making process or with the implementation. This then has a direct impact on the timing and expectations around the final outcome.

Clinical vs. administrative role: each is equally important

Recognizing the need for the tandem roles of physician leader and practice administrator will be necessary for the practice to survive, let alone thrive, in the future. This requires effective communication, acceptance of both the individual and the role, and a clear focus on what is ahead. It is not necessary to look at whether to join with the local hospital or lead the formation of a larger group of physicians. It is more important today to recognize the need to accept each role.

Clear communication channels

Assuming that all practice leaders are on the same page is not always wise; you need to have an established channel for communication. It is essential to maximize everyone's time and effectively utilize all mechanisms available for information sharing. Active listening ensures that all decision makers are on the same page. And remember, management terminology may be foreign to the physicians - so use terms and concepts that are easily understood. Beyond what you do verbally, it is always necessary to make sure that policies are documented in your practice manual, to avoid confusion.

Ensuring that physicians and administrators work effectively together requires providing each with the necessary information to do their job well, understanding and respecting both roles, making sure adequate resources are available, and giving mutual respect. Administrators can facilitate these tasks by setting appropriate goals, providing adequate training, and developing benchmarks for all members of the practice.

Owen Dahl, FACHE, LSSMBB, is a nationally recognized medical practice management consultant and author of "Think Business! Medical Practice Quality, Efficiency, Profits." He can be reached at odahl@owendahlconsulting.com or 281 367 3364.