In many ways, office administrators are the yin to a healthcare provider's yang. They manage business operations (overhead, collections, and regulatory compliance), so physicians can focus on patient care, which generates revenue. One needs the other to survive. Yet, because their skill sets are so different, they often fail to communicate effectively, which can impact productivity and patient outcomes. To meet performance metrics today — and maximize reimbursement in a system that increasingly rewards for value — clinicians and office managers must work together in the drive toward better quality.
"Administrators and physicians are really in partnership together and that's how it should be looked at," says Jamie Claypool, a practice management consultant with J. Claypool & Associates in Spicewood, Texas. "The administrator cannot run a practice without the input and support of the physician owners."
Indeed, to ensure both parties are on the same page, physicians must clarify expectations, define the administrator's role, and clearly communicate their priorities. They should similarly set their office manager up to succeed by establishing attainable goals, which may include improved patient safety, more referrals, or increased collections. Administrators should not only be held accountable for meeting those goals, but rewarded when milestones are met, says Claypool.
"I feel that administrators do much better when there's some sort of financial incentive provided, which may be based on profit growth or some other threshold," she says, noting the administrator might receive a bonus based on his ability to boost revenue, remain in compliance, hold down overhead, or ensure revenue cycle integrity. That requires an annual performance review, says Claypool. "I think the administrators should be reviewed annually not just by the physicians, but by the staff," she says. "Good administrators want that kind of feedback."
Laura Palmer, a senior industry analyst for MGMA and former practice administrator, says the better performing practices view both clinical and clerical staff as a single unit in the care delivery team. "In the past, it was really more of a front office versus back office situation, which didn't work effectively," she says. "Now we're seeing a dramatic change in that everybody is part of the patient experience. There's more interaction between physicians and administrators looking at patient care as a whole, so the clinical portion of the visit isn't separated from the business."
Many practices, Palmer says, start the day with a morning huddle in which the entire team reviews the patient schedule. "If one of the patients has a mobility issue, or dementia, or there are caretakers involved, that gets factored in," she says. "It's a chance to discuss what support staff they need to commit to that patient and how it might impact the schedule." Primary-care practices that do a large volume of physical exams and specialist offices with a higher percentage of new patients can particularly benefit from morning huddles, in which the entire team identifies opportunities to streamline work flow. They may, for example, opt to change their admission process by asking patients to report 15 minutes prior to their appointment to complete paperwork.
Physicians and office managers should separately build in time for regular meetings to address any personnel or financial issues that may arise and pinpoint areas of inefficiency, says Palmer. A formal sit down keeps the lines of communication open and helps to cultivate a teamwork mentality. "The practices in which physicians and managers have the best relationships have a set time to meet, rather than catching each other in the hallway or leaving Post-it notes on each other's desks," says Palmer.