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Three Practice Management Responsibilities for Doctors


As a physician, take some time to learn a few medical practice management principles to more fully support your practice manager.

I really wanted to write a poem to express my admiration for my office manager, but poetry is not my forte. And neither is my ability to be the administrator of a medical practice. But guess what? I am studying management practices and hope to sit for the ACMPE exam in the next year.

MGMA 2014

At the MGMA 2014 conference Oct.26-29, Rebecca Fox, MD, will be copresenting a session about the need for doctors and administrators to work as a team. The session is scheduled for Mon., Oct. 27.

Why am I putting myself through yet another exam if it’s not what I want to primarily do? Especially when I already have a strong office manager? Because I want to be a better practice owner and be able to support my office manager.

Here are just a few examples of how I can support my office manager by understanding a bit of what she does:

1. Financial Analysis. I like to play with the financial numbers. I especially like to figure out for myself if each of the providers in our office is seeing enough patients to cover his costs and earn a profit for the practice. Excellent medical care is very expensive and in order to provide the highest quality equipment and personnel to deliver that care, a medical practice MUST be profitable.

To determine the break even number of patients, one must determine what the cost per day is for a provider divided by the average collections per patient visit. Once a provider gets beyond the break even number of patients per day, the rest is profit.

The “magic number” in our pediatric practice is 22 patients per day which equates to three patients or four patients per hour, clearly an attainable number while still having enough time for each visit. This number has remained the same for the past five years.

I have found that it is easier for providers to hear this information from me, the practice owner, than from the administrator. Also providers really like to know that they are “earning their keep” and helping keep our practice financially solvent.

2. Human Resources. As physicians, we competently communicate and deal with our patients and their families. But most of us are uncomfortable in the HR realm when dealing with employees. One of the most important duties of the office manager is to keep employees working smoothly. However when there is a particularly difficult situation (such as terminating someone), it is really supportive to your administrator to sit in on these challenging employee interactions.

Your office manager will do all the talking as he has much more experience with this. As the practice owner, your job is to simply be present to bear witness. But your very presence will signal to the employee that you completely support your admin’s decision in the matter.

3. Vacation Scheduling. With 15 providers in our office, it is quite a challenge to have everyone take their vacations without leaving gigantic voids by having too many providers gone at one time. A few years ago I took over approving vacation schedules when the providers were really giving the office manager a hard time about their time off. We are fortunate to have so many providers but having more than three out of the office at any one time creates problems with being able to see our usual volume of patients.

When creating the vacation calendar, everyone picks two weeks. The owners pick first. Then we go through the list of providers by seniority with the practice (our most senior employed provider just happens to be a nurse practitioner).

Once we are through the list, we go through again to pick the remainder of contractual vacation/CME. So far, I have been able to work with the providers about their preferences if there is a conflict with dates.

Everyone seems to think that this is an equitable arrangement and my management of the vacation requests really takes the pressure off the office manager.

By more fully understanding the specific of office administration, my office manager and I make a very strong team which keeps our practice running smoothly. As a physician, take some time to learn a few medical practice management principles to more fully support and understand the job your administrator does every day. And above all, says thanks to your manager. As a doctor, you probably don’t want to do that job too!

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