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Interested in Growing Your Practice?
Your office administrator may play a key role.
LESLIE GOLDBERG, ASSISTANT EDITOR

"You do not need to understand anything about ophthalmology to be an ophthalmic administrator," says Ray Mays, a retired major in the Marine Corps who now oversees the administration of four practices and one ASC for Eye Centers of Tennessee, LLC, one of the largest practices in Tennessee. "It's nice to know, but the real question is how do you get 70 people to work together every day? What are the employment laws? What are the tax implications? You are doing the same administrative job independent of being in an ophthalmology practice."

Values First, Subject Matter Next

A key concept to remember is to hire for values, attitude and aptitude first, and skills second. "It is far more important that a person have leadership, managerial skills, a good business sense, know how money flows, and have an understanding of spreadsheets and financial reports than understand the practice of ophthalmology," says Larry Patterson, M.D., medical director of Eye Centers of Tennessee, LLC.

The article Practice Success, from Advisory Publications, suggests that you look for the following traits when trying to find an effective office manager:

►Raw talent. Running a practice requires intelligence. Look for someone who learns fast, adapts to change easily and processes information quickly to draw sound conclusions.

►Self-motivation. Takes pride in work and gains personal validation by looking for ways to improve.

►Entrepreneurial attitude. Constantly on the lookout for new opportunities or new and better ways to operate.

►Organizational skills. Must be able to prioritize, stay focused and know when to delegate.

►Technical skills. If they can demonstrate a clear grasp of how each job is done, they can earn staffers' respect and they can identify less productive workers.

►People skills. Must be able to hire, fire, supervise, discipline, train, encourage and retain staffers. The individual needs outstanding communication abilities. He needs to know how to get the point across clearly, when to joke, cajole and encourage — and when to play the "heavy."

Do You Know What it Takes to Grow Your Business?

Many physicians may not be fully aware of the intricacies required for daily management of their office. As a physician, they must not lose sight that their focus needs to be on surgery and patient care. The person or people hired to run your practice must have a complete knowledge of running a business, so that you are free to practice medicine.

Mays states, "You need someone who is comfortable in the business world. I think the best thing is to find someone that doesn't even know what a code is. Anybody can work hard; it's hard to get other people to work hard. If you can get that, you will always make more money."

"Most doctors are not great businesspeople," concurs Dr. Patterson "Ray said to me when he first started at the practice 'One thing is clear. You should be doing very little besides seeing patients, because that is when we generate the most revenue.' The goal became to keep me in the exam room and the operating room." Dr. Patterson notes that doctors have to realize that if they do not let go of practice control, it will lead to decreased revenue and increased hours.

"Conducting the exam is what the doctor is trained for," says Mays, "but if you want a successful business, how do you grow it? How do you compete? How do you set up a retail establishment? This is what keeps the lifeblood of your business pumping. These are the core things that all businesses have in common. Being a smart ophthalmologist doesn't mean you are divorced from business practices —accounts receivable and collecting accounts receivable and accounts payable and paying accounts payable and cash flow monitoring."

Shared Goals and a Shared Future

In order to help ensure an office administrator's success, make sure that he knows what your short- and long-term goals for the practice are. Work with him to design realistic timelines in which these goals are to be met. Choose a specific time during the week when you will meet to review the office's progress.

As your practice grows larger, a system becomes more important because your ability to oversee and communicate directly and frequently with each employee becomes more difficult. Written operating systems become absolutely essential when you expand to more than one office location.1

"If you want to grow your practice, you need to create a system where the doctor can do the 'doctor thing'. Everything else needs to run on its own, so when the doctor goes to sell the practice, he has something to offer beside himself. "We started branding eye centers in Tennessee, so that it isn't about the single doctor." Says Mays. "Ophthalmology is getting tougher and you are going to need to have sharp business skills. And you are going to have to know how to market and convince clients that they should come to you."

The Big Picture

Mays will tell you that he had no intention of being an administrator for an ophthalmology practice, but Dr. Patterson had a larger view of potential business growth that appealed to him.

Initially, they spent a lot of time together and made up the processes as they went along. "For the first 4 years, I saw Dr. Patterson more than I saw my wife. We were building buildings, building a business, putting together a surgery center. We worked all the time." The relationship has since changed.

The two have fallen into a routine. They no longer need to speak on a daily basis. They both understand that the business is day-to-day. That it is showing up every day and if you aren't 10 minutes early, you're late. Mays explains that growth is slow and steady and that slow growth is better than fast growth. They are still working the same plan as 8 years ago, but says Mays, "If I quit or if he quits, it doesn't mean that the plan stops. It just means someone else is taking it over."

"If the person who is running your business is not savvy or does not know how you want your business run, you are at a huge disadvantage," concludes Mays. "Medicine is not immune from capitalism. If you aren't better, faster, cheaper, you aren't going to make it."

Learning to focus on patient care and leaving your administrator to focus on the rest will increase your quality of life. "If you let go, you will enjoy life and your practice more," concludes Dr. Patterson.

Reference

1. Charles E. McCabe, edited and updated by Ryan P. Allis. Motivating and Retaining Employees.