Help your young partner become a better practice owner.

Associate physicians have critical roles in successful practices, but there is a whole other level of seriousness obliged of partners. Since they have skin in the game, partners must know how the business game of ophthalmology is played.

We are often asked by clients to coach their new partners on how to be better owners. Giving young doctors a jump-start in this area accelerates the pace at which they will help you build a financially robust practice.

Business education for young partners is doubly important in multi-generational practices where young and old doctors do not mesh. In such practices, each generation has its own perspective on what makes a business succeed, and each doctor simultaneously tries to build his own practice. Even in practices where these conflicts do not exist overtly, differences in business experience along with risk tolerance between young and old can make boardroom meetings less productive and delay decision-making.

One way to help new partners become more productive board members is to teach them general practice management concepts. This knowledge guides their understanding of the inner workings of your practice and how decisions impact others.

Here are 10 coaching points that will help newer partners jump-start their understanding of how your practice functions business-wise and how they can help to lead the practice forward.

1. FINANCIAL AND VOLUMETRIC BENCHMARKING

As a competent owner, you must have the same command of the financial benchmarks of practice as you do for your patients. Understanding financial reporting in business is similar to knowing how to interpret a patient’s exam data; substitute ROI or “return on investment” for “IOP,” and you get the idea. By knowing the normal limits of either value, you are a better owner or a better doctor.

Fortunately, you need to grasp only a few dozen norms, including tech payroll hours per visit, profit margin and the cost of optical goods sold. With benchmarks like these, you can make data-driven decisions.

2. ACTING LIKE A SHAREHOLDER

As a business owner, your fiduciary responsibility is to make decisions that are best for the overall practice, not for yourself alone.

Ideally, you started thinking and acting this way from the beginning as an associate. You need to earn respect to be valued as a leader. As you graduate from associate to shareholder, your actions are viewed under a microscope by staff and peers.

3. TEAMWORK

The most fortunate doctors learned teamwork playing team sports in school. But, if you did not play sports (or played solo sports like tennis or golf), the most difficult part of becoming a partner may be learning good leadership — as well as good “followership.” This is leveraged if you work in an especially large practice where teamwork has complexities and subtleties not present in smaller organizations.

4. PROBLEM-SOLVING

Doctors do not need an MBA to become excellent business problem-solvers. Think like a doctor, as you have already been trained, and use these skills to solve business problems. Review the subjective and objective data of the presenting problem, diagnose, apply treatment, re-evaluate to see if the problem has cleared up and, if not, apply another treatment. Repeat until solved.

5. COMMUNICATION

You communicate differently as a doctor than as a member of a business team. With a patient, while you may be collaborative to a degree, you are mostly directive. In a business setting, the emphasis is on collaboration (even if you think you have the one, right answer at the outset.) One new role for young owners is to be part of (and sometimes lead) efficient, productive meetings.

All of the textbook knowledge in the world about how business works will not be useful if you can’t effectively communicate.

6. HUMAN RESOURCE (HR) MANAGEMENT

HR management includes how to: hire, fire, enforce policies consistently, follow employment law and compose written performance standards. Even if this area is mostly handled by your management team, you need a sensitivity to consistently apply fair policies to all employees.

7. HARNESSING THE POWER OF OWNER-ADMINISTRATOR COLLABORATION

The strongest practices are led by the dyadic pairing of a managing partner and administrator. Even if a young doctor will not graduate to the managing partner position for many years, it helps to learn early on how this common management structure works (and how variations on MD-administrator collaboration often lead to practice failure.)

8. UNDERSTANDING THE ROLE OF MID-LEVEL MANAGEMENT

Mid-level managers have titles such as “optical manager,” “director of technical services” and “billing coordinator.” These positions boost the core strength of your practice. Mid-level managers also have a challenging role working side-by-side with their team as supervisors. One minute they are leaders, the next they are followers to upper level management or doctors. Knowing their specific responsibilities and common challenges will help you understand the depth of their role and how you can help them develop as leaders.

9. DEVELOPMENTAL STAGES

All vigilant parents watch for their children to pass through various developmental stages as they grow older. Practices also have developmental stages, based on their scale. For example, solo practitioners and staff can function smoothly with less formal written communication compared to larger practices.

To eliminate inefficiencies and staff confusion, larger practices need to develop care pathway policies and procedures that apply to all technicians and doctors. Young doctors need to become as sensitive as young parents to these natural stages of practice development and recognize developmental lags.

10. MARKETING AND PRACTICE DEVELOPMENT

The average practice grows at about 5% in visits and revenue dollars per year. Below this figure, you are likely losing market share and creating an environment where the doctors start to compete with each other for tapering patients. Large practices have formal marketing managers; but, in the average practice with just two or three providers, everyone owns the marketing function.

Doctors must learn effective outreach discipline and customer service. Clerks must stay on top of recall. The administrator is often on the front line placing ads. Young owners must find their own way to contribute to practice growth.

CONCLUSION

To become an effective partner and board member, it takes a foundation of basic concepts combined with an interest in business affairs, close observation, patience, ambition and ongoing mentoring.

The business of medicine has nearly as much intellectual content as medicine itself and is a fascinating next course of study for young surgeons. OM

Corinne Z. Wohl, MHSA, COE, is president of C. Wohl & Associates, Inc., a practice management consulting firm. Corinne earned her Master of Health Services Administration degree at The George Washington University and has over 30 years of hospital and physician practice management experience. She can be reached at czwohl@gmail.com or 609-410-2932.

John B. Pinto is president of J. Pinto & Associates, Inc., an ophthalmic practice management consulting firm established in 1979. He is the leading author in America on the business of ophthalmology. His latest book, “Simple: The Inner Game of Ophthalmic Practice Success,” is now available at www.asoa.org . He can be reached at pintoinc@aol.com or 619-223-2233.