NEW! The Administrator’s Desk: A Manager’s Eight Commandments

“Wanted: Highly trained administrator capable of integrating multiple business systems, managing staff, coordinating billing, and reacting to changing healthcare environment. Full responsibility for financial success of practice. No direct authority.”

Put that way, it’s easy to understand why practice administrators often feel frustrated on the job. On one hand, you’re charged with managing all the business affairs of a medical practice. On the other hand, your power to make decisions and direct change is often undermined by physician partners.

That’s why political savvy and leadership skills are such important traits for managers to possess and cultivate. Since you often can’t make demands of physicians or even staff, you have to foster a workplace atmosphere of respect in which problems are solved as a team and the open exchange of ideas - and even productive debate - is encouraged.

Easier said than done? Quite.

That’s why we’re starting this new column just for practice administrators. In it, we’ll explore proven techniques that can help managers polish their job performance, become more assertive, communicate more effectively, and work successfully with physicians to improve the patient experience and the bottom line.

Managers, you’ve been asking for a column like this. Welcome to it.

We thought we’d start with a list of best practices, culled from seasoned veterans in the field who have made mistakes along the way and found solutions that work. We got the idea from Chris Kelleher, practice administrator for SC OB/GYN in Columbia, S.C., whose has created “Kelleher’s Rules for Administrators” as a list of lessons learned that he shares with colleagues. Some of our rules are his rules.

Clip these and keep them handy while at work:

1. Don’t be a yes man (or woman). To earn physicians’ respect, administrators must bring their own perspective and expertise to the table - even when their opinions run contrary to the direction the practice’s physicians wish to take, says Kelleher. Just be sure to keep it professional.

“You’ve got to delicately tell the physician that you’re in this together,” Kelleher advises. “They pay you to be their thought process and to help implement policy, but if you can’t talk honestly about how you feel, you’re not going to accomplish anything.”

2. Keep your boss out of trouble. Sometimes a practice administrator’s most important task is to help physicians help themselves. If the top brass are all wet on a proposal, Kelleher recommends slowing down its implementation. Mind you, that doesn’t mean it’s OK to sabotage projects you don’t agree with. Just make sure the process is deliberative, allowing time for discovery and careful management.

3. Leave your door open. Stay abreast of both morale and sentiment among your staff. “You can’t lock yourself in your office,” says Ed Carne, a longtime practice administrator and the current chief executive of DuPage Medical Group, a 240-physician multispecialty group near Chicago. “Good administrators are always checking the pulse of the office.”

4. Don’t interfere. It’s one thing to be a team player, but stepping in to do another staff member’s job too often sends a message (inadvertent though it may be) that you don’t trust your staff to get it right. Pinch-hitting also confuses customers, patients, and employees, inviting repeat requests for similar “quick favors” down the road. “Do it once, and it’s a favor,” says Kelleher. “Do it twice, and the job is yours.”

5. Be responsive. When doctors call you with questions or concerns, respond to them quickly. “This is one of the most important lessons I’ve learned,” says Carne. “Even if you don’t know the answer, it’s important to call the physician back and tell them you’re working on it. It’s always appreciated - and often, it relieves any pressure they may have felt.”

6. Invite input. At larger practices, be sure to involve both physicians and nonphysician managers in the strategic planning process. Doctors often consider implementing new equipment or procedural changes that could affect other departments.

“I need to be able to prepare for those changes,” says Carne. “If we’re going to grow as a company, everyone needs to be part of that growth.” In fact, in any size practice, everyone’s opinion matters; each staff member has unique insights into how your practice might work better.

7. Don’t rush hiring decisions. Carne says that when hiring for any position, it’s important to pay attention to any gut-level warning signs you may perceive, despite the pressure you may feel to quickly fill the vacancy. “If you get a feeling that this person is not right, spend the time to do more … reference checks, because a lot of times you’re right,” he says. “Wait for the right person. Don’t settle for mediocrity.”

8. Always question strategy. Before undertaking any new project, Kelleher tells practice administrators to always ask themselves, “Is the juice worth the squeeze?”

Note: "The Administrator's Desk" column will always be available under our Web site's "Operations" category.

Shelly K. Schwartz is a freelance writer in Maplewood, N.J., who has covered healthcare and business issues for 12 years. Her work has appeared on CNN/Money.com and Bankrate.com and in Healthy Family magazine. She can be reached via editor@physicianspractice.com.
This article originally appeared in the January 2007 issue of Physicians Practice.