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Poorly Defined Responsibilities: A Big Problem at Medical Practices


Five major problems arise when important responsibilities are not clearly assigned at medical practices.

Anything important in a medical office must be the responsibility of somebody in authority.  If not, things slip through the cracks, no one is sure who has the final say, staff can’t be held accountable, and both time and money are wasted.

Consider these problems that arise when major responsibilities are not clearly defined:If it is everyone's job, it is no one's.
What happens when no single physician or administrator is responsible for licensure, renewing contracts, banking, and accounts receivable trends?  Typically, everybody is too busy to attend to these time consuming matters, deadlines get missed, and important monitoring is neglected.

It is appealing to say that everyone is responsible for good order and discipline, but it is only individuals who can be held accountable.

It is unclear who to go to when questions or problems arise.
Without a designated individual in charge of a task, there is no obvious person to ask when problems arise. A common result is that several people are drawn into a discussion where everyone has an opinion but no one has expertise or special knowledge.  This is a huge waste of time without the promise of a clear, appropriate resolution.

It is unclear who should intervene and impose discipline.
Suppose a staff member has a hard time getting to work on time, or a physician has anger management issues?  Just who in the practice has the standing to initiate a discussion?  Either nobody addresses the issue, which guarantees the problem will continue, or someone jumps in and is subject to a fair criticism that he is overstepping his authority.  In both cases, no one has the ability to impose discipline.

No one really understands the issues involved.
Without a designated responsible party, there may be no one in the office who has a good understanding of the broader implications of a particular responsibility. Personnel and compensation issues are particularly subject to this problem.
The almost inevitable outcome is to consult someone in the practice who has no more knowledge of the subject than anyone else in the practice.  The result is the blind leading the blind. 

There are conflicting expectations.
If one physician wants staff to always answer the phone within three rings, and another physician insists staff should give full attention to a patient standing at the desk, no one can be satisfied.  Each physician will, at different times, be frustrated that her wishes are ignored, and staff will be stressed because they can’t keep both physicians happy.  No one wins.  Conflicting expectations and demands are a significant contributor to the high turnover of medical office staff.

It is neither necessary nor desirable for a single person to be responsible for all areas of a practice.  What is essential, however, is that each function in the practice has a named person who is responsible for, and has the authority to guarantee, its satisfactory execution.

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