6 Challenges for Orthopedic Physician Practice Leaders and How to Overcome Them

Laura Dyrda -  
Physician partners are often natural leaders and obvious choices for administrative positions at orthopedic practices. However, physician leaders face many challenges as they step into leadership roles of small and growing orthopedic practices. Rich Battista, MD, president and physician with OAA Orthopaedic Specialists in Allentown, Pa., discusses these challenges and offers recommendations on overcoming them.

Challenge #1: Training in the business world. When physicians go through medical school, residencies and fellowship training, they focus on the clinical aspects of practicing medicine and aren't exposed to the business side of running a practice. This lack of knowledge and experience in business finances can put physicians at a disadvantage when they step into leadership roles. "Finances, human resources and marketing are all facets that are critical to a healthy business and practice," says Dr. Battista. "It's challenging to try to lead people in the direction that the practice needs to go."

Recommendation: Physicians who have the time and resources to expand their business training or earn an advanced degree in business have an advantage, says Dr. Battista. However, if earning further degrees isn't possible, physician leaders should seek out articles in business publications to learn more about finances and best business practices.

Challenge #2: Time management among responsibilities. Physician leaders are responsible for their management duties, clinical responsibilities and familial responsibilities, which can be tough to manage when one aspect demands more time than the others. "It's a very difficult balance between personal, clinical and administrative focuses," says Dr. Battista. "You have to have a stable family life. You can't forget your family even though what you do clinically and administratively takes a lot of time." Worrying about increasing patient volume and taking responsibility for the decisions they have to make is draining on physician leaders. Dr. Battista says his leadership position is unpaid, which makes those responsibilities even harder to take on.

Recommendation: Physician leaders should surround themselves with a support staff that can ease the burden of their responsibilities. The partnering physicians should also consider compensating their leader for his or her role because the extra compensation will allow the physician to focus more on the needs of the whole group. Otherwise, the physicians are focused on bringing in cases for their compensation and are less likely to fully understand and take responsibility in the decisions they have to make.

Challenge #3: Hiring management staff. Physician leaders are responsible for the management aspects of their practices as well as seeing patients, which means they must learn to delegate other responsibilities or hire additional staff for management positions. "Many small practices are run by low level staff because the intensity and case volume is low, but as these practices experience an increase in significant contracts and patient volume, the leaders will have to rethink their business strategies," says Dr. Battista. "Larger practices have CFOs, COOs, CMOs and CIOs because these people have specific training in these business areas. To move your practice to the proverbial next level, you have to have these people." Hiring the right people to help manage the practice can be challenging because the best candidates don't always have knowledge about the clinical aspect of the practice.

Recommendation:
When expanding his practice to the corporate level, Dr. Battista explored options, such as outside consulting venues, promotion from within the practice and posting the positions on public forums. Regardless of where the candidates came from, it was important that the physicians felt they could trust their new administrators. "You should hire the person that has the right fit, commands respect from the physician and employees to manage the business," says Dr. Battista. However, he did say that it was easier to transition from having a medical background and learning business than having a business background and learning about the clinical aspects of the practice.

Challenge #4: Handling disagreements among physicians.
All physicians in orthopedic practices have a wealth of knowledge and opinions about practice management. The elected leaders are the liaisons between practice physicians and administrators and reconcile the needs of the clinical practice with the board of directors. "The physicians at OAA operate very democratically," says Dr. Battista. "We try to think about what is best for the organization while taking into account individual needs." Sometimes, however, physicians and administrators disagree about the best ways to solve problems and make decisions for the practice.

Recommendation:
The best solution is often agreeing to disagree, agreeing to compromise and looking forward, says Dr. Battista. If a particular physician is constantly hindering the decision-making process, it could be necessary to part ways with that individual for the betterment of the group. "At times, making group decisions can be like herding cats. We've not been immune to partners making the professional decision to leave the organization," says Dr. Battista.

Challenge #5: Marketing in the 21st Century. Many community practices rely on word-of-mouth marketing to attract customers, meaning that great outcomes will yield patient referrals to their friends and neighbors. "We enjoy a very high level reputation with our community and word-of-mouth marketing is important in generating a self-sustaining business," says Dr. Battista. However, in today's healthcare market where ASCs compete with hospitals and each other for patient volume, marketing has become increasingly important in attracting patients. When practices are expanding services and facilities, it is also important to expand the practice's visibility within the community and beyond.

Recommendation: Enlist the help of high functioning professional organizations that are experienced in delivering marketing services, such as print and other marketing media. Administrators should also create a practice website to promote services and provide contact information for the physicians. "The Internet is a whole different approach to marketing because you are marketing to people who actually want your services," says Dr. Battista. "Having a good website has really opened up a hugely interesting perspective in how we draw patients into our practice."

Challenge #6: Enhancing patient experience. With so much attention focused on patient satisfaction and improving quality measures at hospitals and surgery centers, orthopedic practices need to make sure the entire patient experience, not just the outcomes, are positive. Patients need to form a connection with everyone at the practice and feel like their needs are being met. If patients have to leave the practice in order to receive services, such as physical therapy, they are less likely to have a positive experience than if the services are located in the practice or close by. "Every stop the patient makes during their recovery should be positive," says Dr. Battista.

Recommendation:
Orthopedic practices should include rehabilitative services in their practice by hiring trained specialists. "Rehab in our practice is a very integral part of the service we deliver," says Dr. Battista. "It gives us the competitive advantage in the market place to provide exceptional care in terms of the comprehensive non-operative as well as operative and postoperative care. All the rehabilitation specialists are our employees, which gives them ownership over success in the organization." Offering ancillary services can also increase practice revenue, says Dr. Battista.

It is also important to make sure the facility is aesthetically pleasing. Dr. Battista says a practice can achieve a positive environment from encouraging staff to smile and making sure the physicians are conveniently accessible to the patients. Someone from the practice should also be calling the patients at home before and after each step of the process, which strengthens the connection between patients and the practice. "We all try to treat our patients as though they were our own family," says Dr. Battista.

Learn more about OAA Orthopaedic Specialists.

Read more coverage on orthopedic practice management:

- 5 Tips for Reducing Orthopedic Practice Overhead


- 10 Articles for Successful Spine Practice Management


- 5 Key Strategies for National Expansion of Orthopedic and Spine Practices




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