1. Hire 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 Rich Battista, MD, president and physician with OAA Orthopaedic Specialists in Allentown, Pa. “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.
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.
2. Delegate responsibilities. Though physicians are capable of tackling practice management and billing responsibilities, it is inefficient use of the physician’s time to deal with these types of issues. Physicians should entrust a capable individual(s) with practice management responsibilities or outsource these tasks in order to focus on providing the best treatment for their patients. “The trick is to make sure you’re delegating to the right people. The policy of forcing everything to run through a central authority makes the company stagnate because it just isn’t efficient,” says Jay Nussbaum, CEO of Healthcare Watchdog, a medical billing and advocacy group with offices in New Jersey and California. “The doctor needs to learn to delegate both internally and externally. The doctor should be focused on medicine.”
3. Train 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.”
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.
4. Keep lines of communication steady between practices. When there are several practice locations around the area, it’s difficult for the physicians and leaders to see each other and manage the practice hands-on. “We have a lot of meetings and video conferencing and we do a lot to maintain the culture, which is really important,” says Todd Albert, MD, spine surgeon and president of Rothman Institute. “But you’ve also got to have a really great managerial staff.” Rothman Institute has created several divisions within the company and appointed a chairman for each division. Dr. Albert has close communication with division chairmen and trusts them as leaders among other practice physicians.
5. Exercise transparency among physicians. Every physician in the practice should have access to every other physician’s practice data. This information includes production, compliance, and business office performance data such as payer mix, sessions worked, charges generated, denials, on-time dictation completion and total patient volume. “In the absence of information, everyone assumes the worst,” says Daniel Murrey, MD, MPP, a spine surgeon and CEO of OrthoCarolina. “It really is important that transparency exists to keep people comfortable as part of a large organization. We’ve developed a data warehouse here that has become an integral part of management and governance. It takes the suspicion off the table because everyone knows everybody’s score.”
6. Admit to mistakes. An important aspect of maintaining respect from physicians is earning their trust, which means admitting to failures, says Patrick Hinton, executive director of the Jacksonville (Fla.) Orthopaedic Institute. If, after extensive consideration, the administrator’s decision produces negative results, the administrator must identify these failures and collaborate with the physicians to work through them. “If the administrator makes a mistake, he or she should go to the physicians and tell them and then figure out what needs to be done,” says Mr. Hinton. This will earn the physician’s trust, he says.
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