When I think of this country’s independent medical practices, I see the manifestation of small businesses — each operating on the backs of hard work, financial investment, and the dream to "go at it" within a unique vision. While the landscape is considerably different now than the historical precedence, the result remains the same, although the referral channels have not.
If we continue with the concept that a medical practice is no different than a small business, then the practice manager serves as the chief operating officer, or in baseball terms, a five-tool weapon — someone who can do everything from managing the finances of the practice to scheduling appointments for patients as well as vendors. The practice manager would also serve as the key liaison and business partner to the physician, acting in the role of founder, CEO, and small business owner. Based on this relationship, this partnership highlights the most important role within the business landscape.
Much like in any small business, the elements of management can be the difference between sputtering and thriving, and that is no different for any medical practice. The concept of practice management was created to better solidify the roles of the one individual in a practice that is responsible for making the majority of the business decisions. If we also think holistically of what "practice management" means in its current form, it in no way reflects its origins of the term where human resources decisions ruled the day.
So, if we wrap this idea in a bow, the result is a medical practice where a physician and a practice manager have created a unique symbiosis creating an operation that is as sound medically as it is operationally. If we were to dive deeper, wouldn’t a "practice manager" actually describe their role as more than simply managing the day-to-day operations of a practice?
I strongly believe that practice management, in both the traditional and contemporary sense, has failed on its initial promise to create a more efficient practice. Not only does the title of the role unfairly describe the objectives of the person in a business management role, it also completely ignores the fact that a practice carries similar operational needs to any sort of retail establishment.
Let’s breakdown the concept of traditional practice management, and adjust it to meet the needs of today’s changing practice environment:
• Patient Relationship Management: The concept of scheduling is much more than call center automation. In the same vain and operation as a hospitality manager, a practice manager must juggle their role between patient relationship manager and a performance manager, filling the schedule with "desirable" patients. Before this gets taken out of context, let’s consider what an ideal/desirable patient means to a practice — they are invested in their health via effort and physical investment (i.e. insurance and lifestyle). While technology has made the idea of scheduling easier for those managing the practice, the environment is quickly changing where elements of marketing may need to be incorporated in order to keep a schedule that is both filled and efficient.
• IT Decisions: Speaking of technology, a practice manager must now think as both an IT specialist as well as a futurist, understanding app and mobile trends to the patient. Created through a pressure to automate and become as efficient as possible, the practice manager must think like a clothing store owner and stock shelves (i.e. make tech investments) that anticipate trends and scale to meet the technological needs of everyone from the physician to the rest of the staff.
• Operations Manager: The importance of this role is more back office than front office. An operations manager is part-HR specialist, where they coordinate on creating internal harmony and cultural practices, to a vendor manager, where they juggle which operations can happen in-house and those that need to be outsourced. This role also would suggest that having a line of vendors means always weighing the pros and cons of sustaining or changing the partners they work with.
• Physician-first Environment: While the focus is heavily on the business operations and management, the core of the practice experience is the patient. The reason the practice manager’s position has become so sought after by vendors, is that there is no clearer route to the physician. In an environment that is focused on the physician, the practice manager often manages processes that need to go unnoticed by a practicing physician. Success is sometimes determined by lack of troubles and the perception of a well-oiled machine.
So, let’s recap. Does someone who markets a practice to fill appointment openings, chooses legacy software with patient and tech trends in mind, promotes open positions via social media, and chases down every collection under the sun, sound like an old school practice manager? No? I agree. It sounds like the idea of practice management looks a lot different.
Michael Sappington is CEO of gloStream, a performance management services firm providing physicians and medical practices with EHR software, practice management technology and revenue cycle services. E-mail him here.