I don’t have an office manager. And I seem to be an anomaly. Everyone, from insurance salesmen, supply vendors, telemarketers and patients, asks for the office manager when it comes to anything that pertains to money. They are completely taken by surprise when my staff says, “We don’t have one. The doctor takes care of that.”

Now, I understand, my time is probably better spent dealing with clinical matters. I would probably have more time to deal with the wonders of prior authorizations if I had an office manager to call the phone company to eke out a better deal for our phone service. I would probably be able to squeeze in another visit or two a day if I didn’t have to tend to the minutiae of running a business.

On the other hand, I can’t afford another non-income-generating employee - a full-time, salaried employee with benefits at that.

I often wonder how other small practices do it. I understand that, in a large practice with several providers, multiple offices and a myriad of staff members, an office manager is essential; but an office manager would also be affordable.

I know a couple of other small offices without managers. And I know several where the spouse is manager; which to me (no offense to any of you out there) is generally a tough environment for the other employees.

Of course, my other problem is that my practice is my baby. And I want to be very hands-on. I’m not sure I could relinquish the responsibility of the day-to-day details to somebody else. At least … not yet.

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I don’t have an office manager. And I seem to be an anomaly.