Like most administrators, your education and experience have given you all the tools you need to help your practice succeed — the confidence to tackle new challenges, the vision to spearhead profit-generating initiatives, and the leadership skills to transform your office into a model of healthcare efficiency. Not that you'll get the chance to prove it.
Between payroll, scheduling and the endless parade of financial reports — not to mention the broken fax machine in between — there's little time left over to put your managerial talent to the test.
“As an administrator, our days are divided into tasks and projects,” says Mary Pat Whaley, administrator for Halifax Regional Medical Center's six physician clinics and author of the blog managemypractice.com. When you find that your tasks are overwhelming your projects, that’s when it’s time to hire an assistant.”
Indeed, administrative assistants play a valuable role in helping to manage the day-to-day busy work that bogs you down, leaving you to focus on the bigger picture. That’s increasingly important in healthcare today as regulators and insurance companies pile the paperwork ever higher, says Whaley. Yet, another salary can be a tough sell in today’s economy where physician owners are focused on doing more with less. “If you can show the doctors how this position is going to pay for itself you have a much better chance of getting that person on board,” says Jamie Claypool, president of J. Claypool Associates, a practice management consulting firm in Austin, Texas. “Tell them that if this person takes over your payroll duty it will free you up to work on developing that new facility, or that it makes you more available to work on accounts receivable with the billing staff so you’re more productive in billing, which would pay for that position. You have to cost justify because all the doctors see is another salary, plus benefits.”
Do you need a full-time assistant?
Before preparing your case, however, consider long and hard whether you really want, or need, a full-time assistant. You may be able to lighten your workload by assigning some of your current responsibilities to underutilized members of your staff. “Make sure you’re not busy all the time because you’re overly controlling,” says Whaley. “Is there anything you can delegate to your staff?” You can’t delegate confidential tasks to your team, like payroll, she says, and you should always oversee accounts payable yourself, since that’s the riskiest area for embezzlement, but opportunities to pass along duties like data entry, training new recruits, and conducting vendor cost comparisons abound.
And while it may sound nice to have an extra set of hands on deck, keep in mind that having an assistant can be tough. “I’ve had some assistants that I wished I didn’t have,” says Whaley. “When they’re good it’s great. But when they’re not so good, it’s hard to turn them loose because you’ve spent so much time training them.” Plus, she adds, it can change the office dynamic. “It can be very hard with an assistant because they’re in this no-man’s land,” says Whalen. “They’re not truly one of the staff, because they know a lot of confidential information, and a lot of people have trouble drawing that line. Younger people, in particular, have a hard time trying to fit in on that flow chart.”
Outsourcing
The most cost-effective way to get the help you need is to start by outsourcing jobs like payroll, data entry, and data analysis. Payroll, in particular, lends itself well to outsourcing due to its time consuming and confidential nature, says Whaley. “These days, having an assistant doesn’t have to mean hiring a full-time body in the office,” she says. “You want to look very carefully at your options.”
She cautions, however, that administrators should find out what those vendors will do for you and more importantly, what they won’t. “If you have a payroll service that does all your taxes and cuts your checks, there’s no way around the fact that someone still has to oversee all the punches in the swipe system or on the computer,” says Whaley. “You still have to run that down.”
Virtual assistants, who work remotely and provide professional administrative assistance as needed, can also be a “very good use of your money” for special projects, says Whaley. “Say you need to update your policy manual and you’ve made notes in all the margins and marked it up, but you realize you’ll never get this done,” she says. “You can go get a virtual assistant online to type this 45-page document, send it to you for final approval, and then have them make 20 copies that are bound and mailed to you. That’s a great use of outsourcing.”
Part-time help
And then, of course, there’s part-time help in the office, which is far less expensive because it eliminates the need to pay for benefits. Diane Cook, administrator and chief executive for the 9-physician Abilene Cardiology Associates practice in Abilene, Texas, says administrators should look first to valued former employees, including those who retired or quit to raise a family.
Her practice, for example, uses a former insurance supervisor in their office who was looking to reduce her hours. “When I came on board I felt she was terribly underutilized and I recognized the need for assistance with a lot of projects so I changed her reporting order and now she reports to me,” says Cook. “She’s my go-to person to help solve day-to-day system issues.”
Cook says she and her assistant trade payroll responsibilities every other month, double-checking each other’s work. She also cross-trained her to pinch hit in all departments when other staff members call in sick or take vacation. And she trained her to negotiate payer contracts. “I was the only one who was able to do it,” says Cook. “Whenever we have contracts that come up for renewal we go over them together and come up with a fee schedule and we work hand in hand to generate monthly reporting and year-end department analyses. It frees me up to handle other management issues.”
As far as Cook is concerned, her assistant is her peer. “We back each other up,” she says.” I tell her all the time that I don’t know what I would do without her. We’ve been doing this for eight years and it’s just worked out great.”
Stick it out
If you’re new to the job and your workload justifies the expense of retaining full-time help, Whaley offers one final word of advice: “Try to tough it out for the first year without an assistant if possible,” she says. “You really need to get to know your practice and the details of each process so you know how to do everything. That way you can monitor it appropriately after you hire an assistant and you'll know when things are going wrong — or right.
Shelly K. Schwartz is a freelance writer in Maplewood, N.J., who has covered personal finance, technology, and healthcare issues for 12 years. Her work has appeared on CNNMoney.com, Bankrate.com, and in Healthy Family magazine. If you’d like to comment on this or any topic raised in The Administrator's Desk, please direct your remarks to physicianspractice@cmpmedica.com.
