It is not uncommon for a new client to ask us "How do I know if my practice manager is doing a good job?" and "What should I really expect from my manager?" My answer is "that depends." It is important to understand what are realistic goals and expectations for both the manager and physician.
First of all, it is important to determine what you want in a manager and define what his role might be. For example, some physicians expect the manager to run the show — everything from the staffing, billing operations, strategic planning, patient services, and finances. Some just want the manager to provide a little supervision over staff and focus on the billing, or some limit the manager to running the front office. Whatever your position on this is, clarify it, communicate it, and consistently back it up with built-in accountability.
Assess primary functions
Take the time to evaluate the primary functions and processes required to run your practice well. Then break it down into components:
• What requires the manager's expertise and judgment;
• What might the manager delegate, providing insight and accountability;
• What tasks can be accomplished by support staff; and
•What might be out-sourced?
Define the role
Meet with your manager and discuss how you view her role. The two of you can define reasonable expectations for this position in a way that best serves the practice. If you have an existing job description, compare it to your expectations and her time constraints. It's important that your needs are met, but it is also important to be realistic about what can be expected of your manager based on her strengths and capabilities. Once this is discussed honestly, you can come to some conclusions about what the job should look like — in terms of what must be accomplished independently and where management can rely on capable staff as long as there is sufficient oversight.
If the manager is currently doing things that don't require a manager's expertise, those tasks should be off loaded. If employees are maxed out it might be time to consider exploring the cost effectiveness of outsourcing work or expanding the use of technology to open up more manager and staff time.
Put it in writing
Once you and your manager are in agreement the job description needs to be put in writing, and used to build in performance accountability for performance reviews and future hiring purposes.
The manager's job description should clarify desired personality traits, educational level or certifications, specific skill sets, and the amount of experience required to manage your practice.
To further strengthen communication and accountability, establish short and long-term goals for your manager each year. For example, this year you may want him to focus on meeting meaningful use standards, exploring patient-centered initiatives that offer financial incentives, and implementing cost-containment measures to tighten the operating budget. Don't forget to establish time parameters, milestones to be met along the way, and deadlines for accomplishing established goals and objectives.
Set up standard monthly meetings to review the practice's status each month; to include staffing, operations, finance, and strategic planning. Just as importantly, this is a time to review the goals that were established and talk about the progress that is being made. This will keep communication flowing and promptly address obstacles that emerge, so they can be resolved and not exacerbate into major problems that derail management.
The manager should conduct performance reviews for her staff members — these serve to acknowledge performance and maintain an efficient, highly motivated staff. But it is equally important for you, as practice leader, to provide a formal performance review for your manager each year. She deserves this and so does your practice. It's your time to acknowledge a job well done or set the record straight if expectations have not been met.
A practice manager has great influence over your practice's future, so it is important to recognize what is critical to running your practice well — ensuring you are prepared to meet changing expectations brought on by the economy and healthcare reform. It's all about taking those first steps to running your practice like a business; being sure your manager is capable and willing to take your practice to a new level.
Judy Capko is a healthcare consultant and author of the popular books “Secrets of the Best Run Practices,” 2nd edition, and “Take Back Time.” Based in Thousand Oaks, Calif., she is a national speaker on healthcare topics. For more information, e-mail Capko at [email protected].