Three sample components of practice management that are crucial during a pandemic.

We wanted to provide readers with a break from “all things COVID-19,” and write about something else this month. But after a bit of brainstorming, we realized there is really no great separation between disaster management and the regular kind. The best day-to-day practice management and leadership methods ultimately prepare your practice to effectively withstand even the deepest and most abrupt adversity.

Airline pilots think the same way. If they are flying their jet within proper parameters at all times, they are always prepared for surprises.

Imagine you’re a passenger on an airplane flying at 35,000 feet and there is an emergency — the right engine has just flamed out. Your pilot has 35,000 feet to work through the problem and get you on the ground safely. Now imagine it’s the same problem, but it occurs shortly after take-off when you are only 15,000 feet above the ground. There’s a lot less time to sort things out.

Without too much of a stretch, as an administrator or practice owner, you could put yourself in the pilot’s position. Replace 35,000 feet with 35% profit margins and 15,000 feet with 15% profit margins. And replace a conked-out engine with a disabled surgeon, the loss of an important contract or COVID-19 (sorry ... we couldn’t help ourselves).

Three central components of great practice management — change management, teamwork and improving staff skills by reducing turnover — will not only influence how successful your practice is during easy times, but also how quickly or slowly you can get out of trouble.

CHANGE MANAGEMENT

More than ever, successful problem-solving in your practice centers on your staff adapting briskly to change and working together toward rapidly changing goals. In the past few months, this has been especially true for practices located in communities that have been most deeply impacted by the pandemic.

Change management — which constitutes an entire field of study and application for some professionals — is a systematic approach to transforming an organization’s processes or goals. It’s not likely that you’re a change management specialist. You probably have never taken a class in change management or cracked a book on the subject. But in times like these, you can really advance your managerial performance by embracing the basics of change management.

At its core, change management can be boiled down to a company culture, overcoming the natural fear-based human resistance to change and combining these with practical steps to both make and adapt to company-wide adjustments. There are numerous academic and industrial examples of change management models, but they boil down to the following:

• Identify the issue that is driving the need for change (Dare we say COVID-19, again?).
• Collect the data necessary for data-driven decision making.
• Undertake planning that involves all stakeholders.
• Harbor the resources needed to achieve change.
• Communicate the outcomes desired and the steps required to achieve them.
• Manage the expected resistance, which is a normal component of change. Typical resistance to change is derived from fear of the unknown, fear of not performing well under the new circumstances and fear of losing status as roles change.
• Acknowledge and celebrate each success along the way.
• Assess successes and failures that happen during the change process and make mid-course corrections.

You can apply this generalized change management model to your practice, eventually codifying it into written procedures and setting new, higher expectations for managers and boards alike.

Below are a couple of additional reminders that all fall into the same category of “things to do right whether times are good or bad” and are also success factors for making positive change. These two reminders could be easily expanded, because everything that you did right in 2019 will help you transit 2020 with the least possible damage.

TEAMWORK

Excellent teamwork is not a new concept. Such teamwork is the key difference we have seen in practices that are now (mid-summer) back at 90% of capacity and those that are struggling to hit 50%. If you are one of the practices in the former category, that raced (with finesse and safety) to recapture previous patient volumes, strong teamwork was probably central to your success.

THE IMPACT OF HIGH TURNOVER

Staff turnover, the percent of lay staff who leave each year (for any reason), is now running much higher than usual. Employees recently supported by higher than average unemployment benefits or those forced to leave their jobs because they need to care for children at home have created staffing gaps and, in some cases, a flurry of new hires. It takes even the brightest new receptionists months to grasp all of the elements involved in their job ... and it can be a year or two before billing and technicians master their craft.

High turnover can devastate productivity, reduce morale and kill profitability. Suppressing staff turnover — down to 20% or less — is key in good times and bad.

NEXT STEPS

When we look back on our “COVID year” (Please don’t make it years), the lessons learned will be numerous. Each one will make you a better manager or owner when healthier times return. Meanwhile, take stock now and meet with your team. Review the steps taken to solve each major issue in the last few months. How could things have been done differently or better?

Here are some questions to ask yourselves:

1. In retrospect, how was our crisis management response? How would we describe rebound from disruption, and what would we have done differently given another opportunity?
2. Do we have a history of moving through change smoothly, or was the pandemic just a continuation of our history of dysfunction?
3. Do we have “change champions” in our practice? Do we want to groom one or more senior members of our team to be ready to help in the next crisis?
4. Do we use written documentation in planning change, or have we been too informal and verbal and left room for misunderstandings?
5. Do we utilize tools such as Gantt charts or project management flow sheets to help communicate and accelerate policy changes? OM

Corinne Z. Wohl, MHSA, COE, is president of C. Wohl & Associates, Inc., a practice management consulting firm. Corinne earned her Masters of Health Services Administration degree at The George Washington University and has over 30 years of hospital, physician practice management and management consulting experience. Her latest book, co-authored with John Pinto, is “UP: Taking Ophthalmic Administrators and Their Management Teams to the Next Level of Skill, Performance and Career Satisfaction.” For information on how to purchase this book or other inquiries, she can be reached at czwohl@gmail.com or 609-410-2932.

John Pinto is the founder of J. Pinto & Associates, Inc., an ophthalmic practice consulting firm established in 1979. He is the most published author in the world on the subject of ophthalmic management and economics. The firm serves organizations worldwide, ranging from solo practices to high-volume market leaders, teaching centers and medical product companies, providing strategic planning, financial benchmarking and analysis, operations enhancement and marketing counsel. He can be contacted at pintoinc@aol.com or 619-223-2233.