I’ve worked with a lot of practice administrators (often in a job called “office manager”). What has always surprised me is the variety of roles they play in their practices. Some are highly focused on a few tasks. Others have tended to play a catch all role, with the physicians and providers constantly throwing new responsibilities at them, often with problematic results. I’ve seen great relationship, well grounded, and others where administrator frustration and burn out was almost guaranteed. It’s too important a job to be part of employee turnover.
Here, for example, is a list of the myriad of jobs expected to be covered by the administrator at one practice I’m familiar with:
Oversee IT—billing and EHR
Wow. All of this covered by one person???
And, of course, the doctors only want to pay $65,000/year for this position. With no benefits.
I won’t even address the salary issue here.
Suffice it to say as practice operational demands become more complex it’s time to reframe the hiring process for this key position. Focus on definition. IF you want to empower an administrator they have to know what’s expected and how the fabric of your practice fits together.
My first suggestion would be to make a list of tasks that you need covered. You could start with the list above—there may be more that are specific to your operation. For example you may have multiple locations, constantly need locum coverage, credential in-house, or retail products as part of your practice. This kind of operational overview and breakdown will be invaluable in many ways.
Treat each as a separate silo. Define what the administrator’s involvement will be in each. If you outsource billing, then just list what kind of reporting relationship the administrator will have with the physicians, as well as the role any physician might have with the billing company. Be sure to tie the administrator to each silo, with as much detail as possible. This is the kind of clarification that’s important to good communication from the outset.
For the tasks that are 100% owned by the administrator, take the time to go over each job requirement with the other physicians, your partner, and even the mid-level clinical staff members who will be interfacing with the administrator. Make sure everyone is on board with the job description and how the administrator will interface with them. It’s important who needs to know what he/she is doing, how much they need to know, and when they need to know. I’ve seen a lot of confusion generated because this wasn’t spelled out.
If you have existing relationships you want to leave as is, make this part of the job description, but clarify the administrator’s role, if any.
And don’t forget the future—how you want the practice to grow, change and evolve over the next 2-3 years. Growth requires planning; planning takes time away from other tasks. And usually the administrator is a critical part of coordinating growth.
Thinking through each silo will help you focus your own vision and awareness of your practice, possibly in greater detail than ever before.
(A note on Compliance: Outsource the set-up, working with a HIPPA consultant among others. This is an area where the complexity and requirements are varied and changing. Don’t expect your administrator to be able to handle this extremely important area without help from an expert.)
Now you’ve put together a comprehensive job description. When you interview address each silo. You may find a candidate who can’t personally handle every task within every silo, but has had experience outsourcing and knows how to work with vendors to accomplish what you need done. You’ll be hard pressed to find someone who can do everything, and you need to make a reality check as to what’s available on the job market, adjusting your want list around the best candidate you can find, and making adjustments to fill gaps. Just be sure to figure out who will be handling these tasks among your partners BEFORE you make the hire.
You want a new hire to understand what’s expected of them, but also feel empowered to be involved in operational issues and decisions. Fuel their self-starter attitude. Empower them through a clear outline of where they fit.
Pay a good, living wage. Good people, who you can trust and build strong relationships with aren’t cheap. If you look to your peers to provide salary comps, make sure you understand the scope of work their admin person is handling, then compare it to what yours is. And incentivize your new hire to do better, setting goals for them to achieve and be rewarded for.
And remember that there are literally dozens of training programs that can help improve and increase any administrator’s job skills. Given the constantly changing face of healthcare, the ROI on these is very high. ---TOM ELLIS
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