Eyeworld

EW Ophthalmology Business March 2011 137 ing doctor. In cases in which the senior ophthalmologist has excellent leadership abilities and people skills, is a competent administrator and delegator, has entrepreneurial talent and experience, and really wants to do the job, this is an excellent solu- tion. However, if the senior ophthal- mologist is clinging to the post de- spite the lack of these qualities, he or she might be doing the practice more harm than good. In universal terms, either you have what it takes or you don't. Generally, leaders evolve. Typically, the best leader is the ophthalmolo- gist who takes on that little bit of extra work that makes a world of positive difference to the practice. Consider a practice meeting in which someone proposes an idea that everyone immediately recog- nizes as brilliant. If it is imple- mented, it may mean millions of dollars of revenue for the practice. Everyone gives the idea lip service, but only one of the ophthalmolo- gists takes it a step further and turns the idea into an action plan. That same ophthalmologist will also probably be the one who imple- ments it, tracks it, adjusts it, and re- ports progress to the other ophthalmologists. Likely, that oph- thalmologist is always the one who takes charge. That ophthalmologist is a good managing doctor. The role of the managing doctor Although a non-doctor practice ad- ministrator should be able to man- age the practice's day-to-day operations, there are certain things that only an owner-ophthalmologist should handle. Director of strategic planning: The group should establish the basic goals and direction. The practice ad- ministrator will handle the fact find- ing, financial modeling, and other details. But you still need an over- seer to pull it all together, someone with the authority to commit the group. The managing doctor will scout out new practice business opportu- nities (even ones that are not yet part of your strategic plan), what the competition is doing, where the market is headed, who the major players are, where the practice cur- rently fits within that framework, what the practice's optimal pro- jected position should be, and how to get there. Coordinator and contact point: It is then the managing doc- tor's job to coordinate the efforts of all the practice's ophthalmologists, including efforts promoting the practice to the outside world so that no one is acting in a vacuum and the practice's resources are effi- ciently utilized. The managing doctor also serves as a clearinghouse for information gleaned from outside sources by all of the group's ophthalmologists about payers' plans, what other groups are doing, new managed care products, and the like. Operations specialist: The managing doctor's most important role is to make decisions about oper- ational issues that must be resolved immediately. When there are truly major de- cisions to be made, it is vital for the practice to have an ophthalmologist with "sign off" ability to make those calls for the group. In certain situa- tions, you need a quick decision made by someone with the author- ity to spend the money, incur the loss, or otherwise impact practice fi- nances. Financial watchdog: Every ophthalmology practice should have at least one of its owner-ophthal- mologists keep tabs on the practice's financial indicators. Have your practice administra- tor generate the appropriate reports and monitor receivables, billing, managed care contracts, payables, overhead, and financial trends. These should all be reported to the managing doctor to oversee and to determine when and what action is needed. Managed care negotiator: Comparing patient care contracts is another important concern. The practice administrator should do the data gathering and preliminary analysis and the managing doctor should make the final decisions about what should be done to best promote the practice's welfare. Certain matters must be dis- cussed doctor-to-doctor, so, at some point, such matters must be turned over to the managing doctor who is in a position comparable to the man- aged care entity's medical director. ABOUT THE AUTHOR Mark E. Kropiewnicki, J.D., L.L.M., is a principal attorney with Health Care Law Associates P.C., Plymouth Meeting, Pa., and a principal consultant with The Health Care Group Inc., Plymouth Meeting. He can be reached at 610-828-3888 or mkrop@healthcaregroup.com. needs a managing doctor Inter-doctor intervener: As ophthalmology practices grow larger, the need for basic inter-doc- tor ground rules increases. Not all of the ophthalmologists will follow those rules. The practice administra- tor is not in a position to enforce the rules among the ophthalmologists. Only another ophthalmologist can do that. The managing doctor should be given the authority to in- tervene to make sure problems are remedied. Additional issues to consider Once you have decided that a man- aging doctor makes good sense for your practice, there are still other is- sues to consider and resolve. How much authority over the other owner-ophthalmologists will the managing doctor have? How much administrative time away from clinical responsibilities will the managing doctor be given to perform his/her duties? Will the managing doctor be paid? If so, how much? Summary Treat your practice like the business it is. Give the managing doctor a man- date to tend to your business at the ophthalmologist level, work with your practice administrator, cooper- ate and communicate with your other ophthalmologists, and accom- plish well thought-out business goals according to a formal business plan. Be glad you have a managing doctor doing what must be done to keep your practice flourishing. Give the managing doctor the time and the needed authority to act on your behalf and support him or her along the way. Remember, businesses (includ- ing your ophthalmology business) do not survive and certainly do not thrive by luck. The most successful businesses and ophthalmology prac- tices have learned, by watching the world of business, that effective leadership is key. EW

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