Are you prepared to manage your practice without your administrator?
The past couple of pandemic years have reminded us that demonstrating outstanding leadership is the key differentiator in a practice’s success ... even survival. The practices that did not falter and responded to unanticipated challenges without delay most often did so with above-average leadership.
If you are among the fortunate physicians with a great administrator, you have been conditioned as the MD-owner to expect things will be handled well. You don’t want to think about what would happen if your administrator were absent for a while or left the position. But departures happen (the average administrator tenure is about 5 years), and you need to be prepared.
By the time your administrator informs you of their plans (eg, knee surgery, maternity leave), the countdown clock has started and rushed arrangements are often haphazard and incomplete. So, it’s best to plan now for a temporary or permanent loss of this critical executive.
YOUR ‘WHAT IF’ PLAN
Ideally you should develop a “what if” plan for your administrator, along with support documentation (eg, an operations manual, checklists, etc.), at the ready. An annual review and update of the plan keeps it fresh.
If this is such a great idea, why don’t more practices prepare in this way?
- Fear of being replaced. Sometimes we see a very human response and pushback when an administrator thinks that “if other people know how to do my job, I am less valuable and more vulnerable.” This is an emotion that can be worked through with a sensitive and supportive conversation.
- Good intentions indicate this plan is “on the to-do list,” but the administrator feels time-poor and no one is asking for it, so it keeps getting dropped to the bottom of the list.
- The administrator is generally more comfortable with having “everything in my head” rather than writing things down. This perspective makes a practice very vulnerable and dependent on one person. Even if the administrator is well-meaning, it is a poor business practice.
Having a “what-if” planning document at the ready will make you more confident that the practice’s needs will be well-covered until your administrator returns or a new administrator is recruited (it can also be used for vacation coverage). And equally important, when this document is shared with all the staff, they will be assured that steps have been taken to keep the practice running smoothly. This reduces staff anxiety and encourages them to step up and fill in the gaps, too.
The Table is a sample four-column accountability document that you can revise for your own practice’s needs.
| This chart is designed to capture my major responsibilities and assign them to others for the duration of my absence. This advanced planning tool clarifies responsibilities for all and is to be shared with managers and all staff. | |||
| ACTIVITY* | ASSIGN TO | PROCESS & TRAINING DETAILS | TRAINING COMPLETED DATE |
| Issues that manager cannot answer and needs support | Computer/network issues (insert contact’s phone # and email address here and for each item in the next two rows) -Phone issues -Property management -Health insurance -Payroll |
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| Equipment malfunctions & technology issues | -Medical equipment -Copier/printer/fax equipment issues -Network issues -Phone issues |
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| How to problem solve patient issues when the patient is upset | -Patient issues need to be directed to the lead of the department (Billing, Tech or Front). If the manager of that department is out of the office, it should go to the next manager on site. If further assistance is needed, please take to Dr. Smith for direction. -For an angry patient in office: If manager is unable to calm patient down, please ask a provider to assist. If needed, call the police. Do not put yourself in harm’s way. We tolerate no physical or verbal violence. |
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| Mail - paper | -Delivery receipts and/or invoices to be given to Melinda. | ||
| Email and voicemail | -I will manage the email from home and forward out emails that need to be addressed. An automatic reply will be set letting people know I am out on leave and will be checking email sporadically. If it is urgent, they will need to call the office. -My voicemail will reflect that I am away and any messages will not be tended to until I get back. If it is urgent, they can dial 0 and talk to a receptionist. |
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| PTO requests | -Mary will approve PTO for all staff. -Approval or denial will depend on doctor’s schedule and staffing per current policy. -Managers are expected to respond to an employee’s time off requests within 5 days of the request. -Communication of these policies will be reviewed to all staff prior to my absence. |
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| HR/employee issues | -Any employee HR issues should be referred to Mary. -Dr. Smith is a resource, too, as needed. |
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| Parking | -For parking questions or issues, reach out to Connect Property, building manager at 000-000-0000 or through the portal. | ||
| Huddles/meetings | -Huddling consistently needs to be a practice priority even while administrator is away. Send minutes/notes from huddles to all so everyone is on the same page. -All department meetings will continue to be held monthly. Reception department will meet weekly. Schedule is posted in the staff lounge. -Doctor and manager meetings will continue weekly. |
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| Payroll | -Mary will approve timecards. | ||
| Saturday schedules | -Saturday schedules are prepared by each department manager at least 4 weeks in advance. | ||
| Access to all online sites | -Master list of logins and passwords is located on the manager shared drive. -If prompted to make a password change, keep this master list updated and in writing. |
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| New staff onboarding | -Onboarding Paperwork-Mary -Training continues to be handled by department manager. |
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| Reminder call software | -Linda will troubleshoots any issues with the reminder call and text software. | ||
| Monthly financial reports | -Will be done from home while I am away. | ||
| Marketing/advertising | -Danielle will be in charge of reporting, including feedback and the clinics/providers visited. -Danielle will have a copy of weekly schedule to visit — subject to change should any need arise. -Referrals numbers to be tracked by Mary while I am away. |
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| When a doctor changes their patient appointment schedule | -Continue to follow new change order policy. -Notify Patricia of reschedules for insurance authorization. -Mary will oversee this and provide all affected with information on changes. |
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| Patient portal communication and internal messages | -Please manage the internal and patient communications for the month of January. If it is an issue with a certain department, please direct to Mary. | ||
| Office supply ordering | -Office supply and Amazon ordering done by Kathy. | ||
| Medical supply ordering | -All supplies will be handled by Justine. -If there are any questions, rep and manufacturer contact information is attached as a resource. Can order directly through them. |
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| Employee interviews | -Mary and Justine will conduct any interviews that may arise. -If both Mary and Justine like and agree on an applicant, include Dr. Smith for final approval. Salary range guides are documented in the HR operations manual. |
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| CAQH management | -Will review prior to leave and make sure all doctors are attested for. I will give Christine a quick rundown, so she is familiar with the site as well. | ||
| *There are dozens of these. Include all that are important to your practice. | |||
CONCLUSION
The pandemic has taught us that strong management and leadership is key to resilience — and resilience, especially in times of disruption, makes the difference between failing, living with mediocrity and pushing forward into success. Being proactive and prepared will keep leading you to success. OM
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