Assemble a dream team

How can you tell whether a prospective accounting firm is of this ilk? Lamberth advises outlining the current financial state of your practice during the initial interview and then listening closely for any innovative planning ideas your candidate may suggest. Or just ask outright, says Hertz: “What are some specific ways you plan to be proactive in helping our firm plan for the future?” If you get a blank look in response, you’ll know this is not the candidate for you.

Hertz says that new practices trying to start out properly — or old practices attempting to reboot — can benefit from three advisers: an accountant, an attorney, and a practice management consultant. These three professionals should work in concert with one another to ensure your practice’s financial systems are both saving and earning money. Problems can occur if any of these three advisers stops being a good team player.

“You want to make sure none of them has too big an ego,” says Lamberth. “Some accountants may try to protect their turf,” especially if their firm offers add-on services that the practice’s attorney or consultant may already be handling. If that’s the case, the accountant may have an eye toward finding an opportunity to shoot the other advisers out of their saddles rather than cooperate with them in your practice’s best interests. (Of course, this undermining can stem from any member of the team, not just the accountant, so beware.)

How can you assess the likelihood of such corporate competition occurring with your practice in the balance? Lamberth suggests querying your CPA candidates on their teamwork experience, especially within medical practices. Get the details on past collaborations. What was the division of labor, and who decided what that division would be? What were some of the key group tasks that benefited the practice? If the prospective accountant stumbles over her answers during the interview, you may want to move on.

The best-case scenario? Without your prodding, the prospective CPA will volunteer to collaborate with other financial professionals. “He should be saying, ‘I want to make sure I’m part of a team of advisers for you,’” says Lamberth. “He should be bringing up the idea himself.”

Ask around

Don’t be shy about seeking a second opinion on any of your accountant’s recommendations, says Mandell. Often a second accountant will spot issues the first one missed.

Mandell describes one such situation in which an accountant he knows was called in by a client as a second CPA. His fresh set of eyes immediately spotted an area in which the client could reduce his taxes by $2.5 million — well beyond what the first accountant had identified. “The only way to know whether or not you’ve gotten good advice is to see a second person,” says Mandell. “Your CPA is never going to say, ‘Go get a second opinion on what I told you.’ You are the only one, and it’s important to do it.”

Also guard against over-paying for such services, advises Hertz. According to the MGMA, outside fees for professionals who assist physicians in business matters — which include attorneys, consultants, and accountants — should total 1 percent or less of a practice’s annual revenue. “If an accountant says, ‘It will cost you $75,000 for me,’ I’d make sure and run the other way unless he’s going to be your surgical assistant as well,” says Hertz.

Both Lamberth and Mandell agree that doctors often make the mistake of delegating to their office managers or another employee the task of retaining an accountant. “The doctor shouldn’t expect that by hiring an accountant or a bookkeeper that it relieves him of all the responsibility of watching the finances,” says Mandell. “He still needs to be exercising basic controls, looking at bank statements, signing checks. He still needs to maintain oversight of the money.”

As a physician business owner, you must walk that fine line between appropriately involving yourself in your office’s important business transactions and micromanaging them. In this case, trust your employees to do their jobs, but take a hand in interviewing prospective accountants, and always retain ultimate control over important financial decisions. It is, after all, your practice.

Suz Redfearn is an award-winning healthcare writer living in Falls Church, Va., who has written for a variety of publications, including The Washington Post and Men’s Health. She can be reached via editor@physicianspractice.com.

This article originally appeared in the June 2007 issue of Physicians Practice.