Bringing a Practice Manager On Board
Physicians have a lot of factors to consider, including personality, data knowledge, and comfort with handling confrontation.
Practice managers can help make or break your office. They set the stage for the culture of the office and can either keep things running smoothly or create unnecessary speed bumps. This person should be well-versed in financials, collections, and regulatory issues, as well as detail-oriented and able to handle the daily tasks of running a medical practice. But other characteristics might not come to mind, namely, personality, data knowledge, and physicians' role in supporting them, according to GeoJan Wright, faculty instructor and consultant with the Practice Management Institute, a nationally recognized provider of medical practice education for managers and staff based in San Antonio, Texas.
According to Wright, physicians she has worked with over the years tend to avoid conflict when possible. Consequently, they often hire practice managers who are somewhat passive and do not like to “make waves.” The status quo can be fine, but if the practice manager does not challenge staff or set higher expectations, their practice will not grow, she said.
A practice manager has to be comfortable with confrontation “because there is going to be some,” she said. “They have to be able to engage because they are going to have patients, as well as employees, who are going to test their management skills.”
Wright is a fan of using personality tests to gauge if someone will make a good practice manager. There are a handful of resources that offer this kind of testing, such as Personality Plus. This tool separates people into personality types – sanguine, choleric, melancholy, and phlegmatic. People who make the best managers are a good mixture of choleric (go-getters) and melancholy (detail-oriented), Wright said.
“Depending upon their personality, they may not be suited for the level of detail required to manage a practice,” she said.
According to Criteria Corp., based on West Hollywood, California, that offers pre-employment testing, the top skills and abilities that make a good office manager are good verbal comprehension and expression; the capacity to communicate with supervisors, peers, and staff; active listening skills; and the ability to obtain and comprehend various types of information.
Medicare and perhaps other insurance carriers will increasingly base their reimbursements in part on the quality of care that physicians provide. Because of this, the role of office manager has to be data driven. Office managers will have to know how to access, navigate, comprehend, and extract data from practice management systems. For patients with chronic diseases, managers will need to ensure they are measuring quality statistics so they are able to maximize reimbursements and tweak data to improve scores, Wright said.
“They will need to know how to advise the physician on ways to rank high in these quality aspects and they can't do that when they don't really know what is going on in the practice,” she said. “This is something most managers haven't really had to do.”
When physicians hire a practice manager or promote someone within the practice to the position, they usually expect the individual to jump in and take over. But physicians should transition the individual into the position and assess what the person knows or does not know about the job. Someone who has moved through the ranks and spent time on the accounting side may have strong knowledge of accounts receivable and collections, but no leadership or IT skills. Physicians have to ensure that the person they hire as practice manager is going to be receptive to receiving education they need to conduct the practice's business. “Otherwise you could potentially set that person up for failure if there isn't some sort of agreement on both sides,” Wright said.
The amount of money that can be spent training a practice manager is limited, as is the time away from the office that can be spared. Physicians need to identify areas in which practice managers are proficient and deficient, and then plan on training courses accordingly. Various groups offer webinars and online training. Some, such as the Medical Group Management Association, host conferences and offer in-person training and online classes.
Physicians willing to make a large investment in training a practice manager might want to consider paying for a distance learning program, such as the one offered by the University of Cincinnati Clermont College, which offers a year-long distant learning program to train people in all aspects of practice management.
After physicians have mapped out a training plan, they should have the practice manager sign a contract committing them to the educational program for 1 or 2 years, depending on how much money is allocated for training. Wright suggests adding a pro rata reimbursement rate into the contract obligating the employee to reimburse the practice if they leave before the agreed-upon time.