As the business of your practice continues to change, you probably have acquired numerous managed care contracts and some carve-outs. You may even be considering a merger, affiliation or expansion.

However, while pondering these plans, have you considered your practice manager? Is he prepared to administer a large ophthalmic practice?

So that your practice can win and keep managed care contracts, you need a practice administrator who can: function well as a project manager; analyze complex data and make projections; develop business plans and marketing strategies; and compete for managed care contracts.

Most administrators started their careers as nurses, secretaries, optome-trists or personnel administrators in oth-er industries. But many of these administrators will prove inadequate for more responsibility in your practice.

In a smaller ophthalmic practice, this person must keep the books in order, keep appointments from bunching up and keep patients happy.

In a larger practice, the demands are about the same, but the administrator must control the activities of possibly three employees for each physician, perhaps at a main office and at satellite locations.

In a very large practice, the administrator has numerous responsibilities. Some of these include seeking out managed care contracts, advising the physicians about patient satisfaction, devising marketing plans, preparing for an expansion, and dealing with most of the practice's employees, suppliers and ancillary personnel.

If your administrator can't perform the complex functions of running a multimillion dollar practice, you must consider your options:

• You can train your manager to become a practice administrator.
Your manager already knows your practice's business. But some managers who rose through the ranks will not want to assume new responsibilities, even with a significant salary increase. For example, a manager with a clinical background may be disinterested in accounting.
If the candidate has the ability and is willing to be trained, consider paying for the courses, subsidizing them or loaning the candidate the necessary funds.
• You can hire an administrator from a competitor.
This ensures that the administrator has sufficient experience. But in health care, few people have the skills, training and experience to be high-level administrators. Also, expect to pay a premium.
• You can consider hiring an administrator from another industry.
In other businesses, people with similar skills often earn less than those in health care. It may take your new administrator a few months to adjust to the vagaries of ophthalmology, but he may work for a lower salary.

Regardless of the size of your practice, change is inevitable. Plan now for the future of your business.

Employing an administrator with the right skills for your situation is an important part of that future.