NEWS & OPINION EWAP SEPTEMBER 2023 51 time with my administrator? Do we have a weekly scheduled meeting together, or do I meet with them intermittently when it is convenient for me? Do I show respect for their time and role? Do I fully consider their recommendations and approve their good ideas? Then ask your administrator if there are ways that your working relationship and communication could be improved or if they are happy with the way things are. The answer we hear most often from unhappy administrators is that meetings throughout the practice are not prioritized. This communication deficit is a key reason for poor staff performance, staff frustration, low patient satisfaction, and increased management challenges. 4. As a physician, I depend on my administrator. How do I know when an unreasonable dependency has been created? There is nothing wrong with a healthy interdependency with the administrator. The administrator role is designed to decrease the administrative time of physician leaders so they can focus on patient care time. However, it is important to fully understand the specifics of their role and be prepared and able to step in to either perform some tasks yourself or know how to direct others to fill in the gaps. When an administrator is dismissed or leaves unexpectedly, their absence can create operational chaos if a backup plan is not in place. In small and mid-size practices, a physician commonly acts as the interim administrator. When you lose a manager, scores of wheels can fall off the bus— timely billing and cash flow, human resource management, passcode management, accounts payable, and financial/ bank account management. For larger practices, a strong core of mid-level managers can ease the disruption, but there are still many details that administrators do not generally share with department managers. You also want to be able to hold your administrator accountable (and vice versa) to the practice goals and role of the position. This is only possible if you fully understand their role and responsibilities beyond reading the position description. Another important aspect is to have strong financial controls in place to deter embezzlement opportunities. No one wants to think that the administrator they have worked with for years would ever divert funds, but it happens more than you can imagine. With close oversight and controls in place, opportunities for theft are decreased. 5. What is the appropriate way to interact with mid - level managers without undermining the administrator? Some administrators can get protective or defensive when you communicate directly with the mid-level department heads that they oversee. This needs to be handled sensitively for trust to be maintained between the physician and administrator. The best approach is to include the administrator in the process. We see that managing partners have the most success when they participate in formal “management committee” meetings, held about every 2 weeks with their administrator and mid-levels all in attendance. 6. What kind of meetings should be held regularly for good communication? Beyond these “management committee” sessions, physicians should make sure that the following group meetings are being held: • Managing partner/ administrator meetings – weekly • Department meetings (chaired by the department manager) – monthly • Board meetings (administrator and physician owners) – monthly • Provider meetings – monthly, bimonthly, or quarterly, depending on practice size and the issues the practice is working through • All-staff meetings – monthly, quarterly, or semi-annually, depending on the size and geographic footprint of the practice 7. How do I eliminate or reduce the avoidance of conflict in a practice? Avoidance and withholding of information work against open, free-flowing, trusting communication. If top leadership behaves this way, the practice culture follows. Ways to keep communication flowing and always improving include: • Set the expectation that great communication is a priority. • Accept that feeling uncomfortable and approaching issues openly (especially when sensitive topics arise) is necessary to provide high-quality patient care and service. • Set the example for being open to hearing constructive criticism and improvement suggestions. Issues don’t go away when they are not talked about openly. They linger and fester beneath the surface, becoming larger and more difficult to solve over time. • Encourage all practice employees and providers to speak up. Let them know that they will be heard. EWAP Editors’ note: John Pinto is President, J. Pinto & Associates, San Diego, California. Corinne Wohl, MHSA, COE, is President, C. Wohl & Associates, San Diego, California.
RkJQdWJsaXNoZXIy Njk2NTg0