Eyeworld

by John B. Pinto 10 signs that it may be time to change administrators I n a variation on the old dating joke, there was once a doctor, let's call him Dr. Jones. He looked high and low to find the perfect practice administra- tor. He interviewed job applicants who were wicked smart, but whose ethics were merely wicked. Dr. Jones interviewed candidates who were very hard working, but who simply didn't have the intelligence to run a modern office. He talked to one can- didate who was perfect, except he could only work 25 hours a week. Dr. Jones interviewed ethical, smart applicants who simply didn't have enough experience. Then, after months of fruitless searching, he finally found her. Karen had it all: a Ph.D. in medical economics and a ton of ophthalmic experience. She lectured on ethics at the local university, and she rou- tinely worked 65-hour weeks, taking off only 1 week a year for vacation. Unfortunately, Karen was only willing to work for the perfect doc- tor. And so it goes. Doctor-administrator relation- ships are not unlike dating and mar- riage. On most days, both parties feel the union is sound enough, the exchange fair enough. A long, rosy future is anticipated on both sides. But on other days, one or both par- ties want out. These feelings wax and wane. For many surgeons reading this, a love-hate relationship has existed for years between you and your lay staff leader. You often say to yourself: "S/he's too good to fire, but too (in- sert adjective of your choice here) to keep on the payroll." Let's explore 10 over-the-line signals that it may be time to termi- nate or demote your current office manager, administrator, executive director, or CEO. 1. Trust has been breeched. This first signal is impossible to quantify. It's a feeling. Such feelings can be sparked by one obvious ethi- cal lapse (like letting a personal ex- pense slip onto the company credit card) or an accretion of small items adding up over time. When the "dis- trust score" is over a given mark— and all of us have different tolerance and forgiveness levels in this area— the manager has to go. 2. Your practice has outgrown your manager. Managers and their practices should be a closely matched pair. Ideally, as the practice grows in complexity, your adminis- trator will grow in competency. Sometimes the practice is static while the administrator blooms (in which case the administrator should be the one to leave to find greener pastures). Just as often, the practice grows at a faster pace than the man- ager. Unless your administrator is able to keep up, it may be time for a change. This could mean more CE time at the national meetings, more coursework, a more engaged physi- cian leader, or the engagement of outside expertise. 3. Your practice is stale be- cause your manager is stale. In an ideal world, the administrator and lead physician are a dynamic duo, keeping the company fresh and act- ing as a pacer for each other when one or the other gets stale. Your practice is a living organization. To EW Ophthalmology Business 68 May 2011 It is not necessary to change. Survival is not mandatory. W. Edwards Deming If you don't like something, change it; if you can't change it, change the way you think about it. Mary Engelbreit All changes, even the most longed for, have their melancholy. Anatole France

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