Operating a private practice in today's environment has many challenges. Shrinking reimbursements, constantly changing regulations, and rising business costs can all feel like barriers to success. Like it or not, medicine is a business. But physicians spend years in college, medical school, residency, and fellowship to learn how to be a doctor, not how to run a successful or profitable business. Thus, it is critical to have a team member who knows how to do that.
Physicians depend on good office managers to ensure their businesses make money, recoup accurate and appropriate payments, hire excellent staff, and maintain a well-equipped office. A recent discussion in a Medical Group Management Association (MGMA) community forum addressed things that physicians who are beginning their practicing careers should know. One wise administrator, Casey Crotty, CEO of a large multispecialty, multisite association in New Mexico, knows the importance of the doctor-administrator relationship and offered these words of advice: “Doctor, you have earned the right to practice medicine. However, there are several things you should understand that will affect your ability to take care of your patients:
“Be responsible for yourself. My job is to keep you on track, keep the patients flowing and keep the staff moving and happy to the best of my ability. I will run this practice as a business and get every penny due you that I can. However, I can't force you to code accurately, complete your charts, be on time, and keep moving so you're not perennially running behind. I will work with you as much as I work for you; if you're having problems, please bring them to me before they become an avalanche.
“The law is the law. You may not like HIPAA, OSHA, ACA, or other rules but the fact is that they can—and likely will—be used against you. It will have a material impact on our relationship if you choose not to do something for which we're both legally responsible. I can do a lot for you, but in the end you are responsible for knowing the rules and providing the care to the patients.
“Payer contracts are not something we do just because we enjoy wading through all the legalese. If you have a question about a contract and how it affects the way you practice please ask. Don't assume that waiving co-payments or accepting gifts in exchange for payments are insignificant. If you would like something addressed at the next negotiation let's discuss it sooner [rather] than later when we have some wiggle room. And remember, once it's signed, you're bound to it.
“You don't always know what your patients do for a living. They could be a lawyer, another health care worker, or a clerk from the health department. Always assume you're being watched like a hawk and that you are guilty until proven innocent.
“I know all you want is to see your patients and practice the best medicine you can and be paid for the services you provide. I want that too, and in order to do it effectively we must work collaboratively.”
Whether co-led by a CEO, administrator, office manager, or business manager, the success of any size practice depends largely on a well-oiled physician-administrator partnership. To help with that relationship, ACP and MGMA have collaborated to provide physicians and their administrators with online resources for the physician-administrator team. You can access them online.