April 2018


To the point: Simple practice tune-ups for complex times
Help your administrator keep and earn life points

by Corinne Wohl, MHSA, COE, and John B. Pinto

I know of no single formula for success. But over the years I have observed that some attributes of leadership are universal and are often about finding ways of encouraging people to combine their efforts, their talents, their insights, their enthusiasm and their inspiration to work together.

—Queen Elizabeth II

You can help save your administrator’s life, at least figuratively in computer gaming terms.
Freshly hired administrators are like heroes at the beginning of a video game. They start with 100 life points. Then over the ensuing months and years, depending on the practice shareholder’s generosity and patience, the administrator’s score rises and falls.
After a string of clustered errors, your administrator’s points may run out, and you’ll find yourself wondering if it is time to part ways. But as a practice owner, consider the role you may be playing in adding or shaving life points from your hard-striving administrator. By unduly shaving points, you are harming yourself and your company.
Ophthalmic practices are complex, dynamic operations—the most elaborate “video games” imaginable. With myriad business issues and employee personalities to orchestrate, your administrator has a profoundly challenging job, which you can make easier or harder to perform.
There are many days when being an administrator is a dream job. Surrounded by great doctors, it is an intellectually stimulating environment. One day is never like the next. Employees attracted to the healthcare arena have caring, hardworking, loyal personalities and can be fun to work with. There are plenty of fascinating financial and operational challenges to be uncovered and solved. It’s a gratifying position to hold on the best days.
But real life practice stressors rear up like video game villains and disrupt an otherwise great job. You know it well because it happens to you at the same time:
• The laser breaks mid-clinic session.
• Flu hits and three techs call out on the same day.
• A key payer glitch holds up payments, A/R rises and you have to put off vendors.
• The candidate physician you desperately needed was recruited by your least friendly competitor.
• Your IT contractor just delivered bad news.
Welcome to a typical month in your administrator’s life, filled with pressing challenges that can either advance or sink their career, depending on their judgment, skill, and luck.
You have a lot of motivations for your administrator to be long-lasting. Losing a senior manager can cost more than half of their annual salary in disruption, dropped balls, and recruiting costs. Like medicine, effective business management is impossible to learn in the classroom; long-tenured administrators get smarter and more valuable to you every year.
Let’s consider eight things you alone or in combination with your executive can do to preserve their life points and help them stay in the game as long as possible.
1. Prioritize excellent communication by allotting appropriate time commitments for meetings. Board meetings, management committee meetings, department and all-staff meetings are essential for smoother practice operations. If the entire management team connects often (with the lead doctor in attendance), your administrator can avoid having to be a messenger between many parties, and everyone gains the same understanding of where projects and priorities stand.
2. If you and your partners don’t know where you are going, your administrator won’t know where to lead the organization. Tight alignment among the partners behind a written strategic plan helps set objectives for the administrator and the entire management team. Without clear goals—or even worse, with conflicting goals from partners—your administrator will make only some (or none) of the partners happy, accelerating their dismissal.
3. Appropriate resources must be available to bring forward the practice’s goals. Administrators are resource managers and resource allocators. If you want to provide five-star medicine, they need five-star resources:
• Annual budgeting should feel like a collaboration, not a wrestling match.
• Make sure that capital equipment is acquired in line with community standards as well as the reasonable desire of the board to stay on the cutting edge.
• Stay at or ahead of the demand curve for physical facilities as you grow.
• Work closely with management to agree on staffing levels that are proportionate to your budget and patient volumes.
4. Administrators are not the only workers who lose life points; associate providers are in the same boat. You and your administrator can work together to ensure that partner-track providers not only become partners but cover their expenses along the way. Your administrator can provide extra value by coaching younger doctors with little experience. And you can help by joining with your administrator as the two of you co-coach new doctors. Success doing this will not only help your providers thrive, but will be a new kind of coalition between you and your administrator, increasing their tenure in your company.
5. Consider the length of service of your administrator to the practice and the amount of successes and failures over that time period. If there has been a recent lack of confidence, is it deserved? Or are your expectations too high? In surgery, you hold yourself to the standard of perfection. Anything else can feel like failure. But in the business world, the standard is lower than perfection; no one dies or goes blind in business. You should expect errors to be recognized and corrected quickly, but nailing perfection each time the first time is not realistic. Don’t chase your administrative leader off with unreasonable standards.
6. To stay informed and energized —and to feel valued by their boards—administrators should be provided with ample continuing educational opportunities, supported by a reasonable annual allowance. The cost of attending the annual ASOA meeting is paid back many times when your executive implements just one idea to improve revenue or taper costs.
7. Administrators need to be backed up strongly in public. If you are working effectively, you and your administrator will get into disagreements, and even mild (hopefully transient) conflicts. Save appropriate professional confrontations for closed office doors. When you emerge, the two of you must be viewed as a leadership team that is aligned and a force to be respected. If not, you are undermining your management team at every level.
8. Finally, realize that these same principles help to also increase mid-level manager tenure. Your head tech, lead receptionist, optical director, and billing manager all need public support, liberal continuing education, clear goals and excellent two-way communication.
Following these eight approaches will ensure a management team that thrives, strives, and stays around long enough for your extra efforts as an owner and physician leader to be rewarded.

About the authors

Ms. Wohl is president of C. Wohl & Associates Inc., a practice management consulting firm. She earned her Masters of Health Services Administration degree at George Washington University and has 30 years of hospital and physician practice management expertise. She can be contacted at czwohl@gmail.com or 609-410-2932.

Mr. Pinto
is president of J. Pinto & Associates Inc., an ophthalmic practice management consulting firm in San Diego. His latest ASCRS•ASOA book, Simple: The Inner Game of Ophthalmic Practice Success, is available at www.asoa.org. The 5th edition of Mr. Pinto’s Little Green Book of Ophthalmology is now at press. He can be contacted at pintoinc@aol.com or 619-223-2233.

Help your administrator keep and earn life points Help your administrator keep and earn life points
Ophthalmology News - EyeWorld Magazine
283 110
283 110
True, 4