Eyeworld

24 July 2018 EW NEWS & OPINION To the point: Simple practice tune-ups for complex times by John B. Pinto and Corinne Wohl, MHSA, COE reversal. Your practice's commit- ted needs must align with your administrator's understanding of their expected performance and priorities over longer time frames. 3. One of the common ways of getting this board-administrator alignment is through the use of several written documents: a. A written business or strategic plan that has been kept up to date, spelling out your service area, growth goals, and succes- sion planning; b. A written position description for your administrator, which should be in sync with the administrator's employment contract; c. Periodic written performance reviews, typically at 3 months, 6 months, and 12 months in the first year; d. And when necessary, written corrective action plans. 4. Make sure there is a singular, em- powered managing partner of the practice. While the administrator may report directly to the board, their most important interface is commonly with the managing partner, who can help them learn "how the company works," pri- oritize early orientation efforts, and shield them from undue intimidation from fellow board members. 5. A significant frustration for new administrators is getting enough face-to-face time with the manag- ing partner and board. Be careful to not signal your impatience, time pressure, or disengagement by saying things like, "I can give you 5 minutes, what's up?" It is appropriate for the managing partner and administrator to have a meaningful weekly meet- ing; a standing breakfast or lunch meeting is effective and helps to build a deeper relationship. Oth- er owner physicians should make themselves openly available for meetings with the new admin- istrator. Your board should have patience in the early months for somewhat more prolonged monthly meetings, allowing time for issues to be discussed 1. Your board (whether that's you alone in a solo practice or a 20-doctor group) needs to be clear and unified about the prac- tice's mission, values, and future goals. Do you want an adminis- trator who will preside over and preserve a successful, steady state practice or a manager who will drive growth and development? We are often called into practices where the new administrator is hitting bunts and base hits, while the board is looking for home runs. 2. Make sure your board is cleaving to an agreed business plan over time. It is not unusual for a board to abruptly shift from a liberal to a conservative stance after a comparatively minor business markets have tightened consider- ably; competent candidates have multiple positions to consider and are snapped off the market quickly whenever they become available. Accordingly, wages have risen sharply. For the typical three MD, $5 million practice, the wage, bonus, benefits, and tax costs of adding a new administrator can approach $175,000, depending on the mar- ket—nearly twice the figure of a de- cade ago. And that's before recruit- ing and relocation costs, which can top 20% of the first year's salary. So it is critical that you be as diligent in the early months of your new administrator's tenure as you were in recruiting and selecting them. Here are a few key issues and pearls to consider when onboarding your next lay leader. "All stories come to an end to pave way for new ones, but sometimes new stories start from old endings." —Hermann Steinherr N o matter their title, your practice's office manager, administrator, executive director, or CEO is the beating heart of your or- ganization. Changing administrators can feel like the business equivalent of undergoing a heart transplant. In the last decade it has become vastly more perplexing to hire a practice administrator. The average practice is larger and more complex, obliging deeper management talents and more experience. The environ- ment is more challenging, particu- larly in regulatory and revenue cycle management dimensions. Labor Onboarding a new administrator: How to smooth the transition

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