Practice Managers – Seriously How Are You Keeping Up?

By Chad Tunison, Partner, eHealthcare Consulting, Inc.
Twitter: @ehealthcareorg

I think it’s time for the healthcare industry to stand up and give Practice Managers the applause they deserve. It is commonly known that providers (regardless of specialty) have it rough these days due to increasing regulations, however, what never seems to get headlines is just how difficult the people running their businesses have it. I did a quick search on one of the major job boards and found 145 Practice Manager openings in my home state of Indiana; over 100 of these postings paid under $35,000. That is 1.5 positions per county! Constant turnover is well documented, yet we don’t talk about how we can help the underlying issue that is causing it. I happen to believe that regulations, while arduous, were implemented in the best interest of the patient. It remains to be seen whether these changes will continue to have a lasting impact on quality outcomes or if it will be a passing craze like so many healthcare initiatives that came before them.

That all said, it still astounds me that we seem to expect independent group Practice Managers to become experts in technology, governmental compliance, data security, data analytics, billing/coding changes, quality care initiatives, and programs like PCMH almost overnight. Oh, and don’t forget that they still have to hire/fire staff, deal with HR issues, and manage the day in and day out business operations of million dollar + organizations. In working with our clients, I often find Practice Managers who work nights, weekends, and through vacations just to keep up and avoid walking into a “firestorm” every Monday morning.

The shifts in healthcare have been very hard on Practice Managers. Many of their struggles don’t stem from the traditional big 3 “People, Process, and Technology.” It is rather, a direct reflection of Practice Managers across the nation being told, it’s your additional responsibility now to identify what we need to do given these new regulations; however, we don’t have additional dollars to hire assistance for you, and by the way you still have all of the duties of your previous 40 hour + job. It isn’t a realistic expectation and as a small business owner I get the cashflow challenge.

Studies show that turnover costs a practice 20% of the annual salary of the individual lost. So, if you are losing 3 employees a year with $30,000 salaries it just cost you $18,000! I have seen this reality first hand for practices across the nation and it only seems to be getting worse. So how do we stave off this situation? I have a few ideas:

  1. Calculate the average cost of employee turnover for the past 3 years to fund support.
  2. If you can justify it based on your 3-year calculation, hire additional full-time support or raise salaries.
  3. Fully utilize the offerings from your billing partner.
  4. Work with your local medical associations to take full advantage of their offerings.
  5. If you are part of an ACO, make sure you are leveraging everything they offer.
  6. Bring in external experts who understand practice operations AND regulations rather than expecting your team to find the time to research and implement all of the changes required.

Together, I hope we can find a way to make healthcare a better place for Physicians, practice employees, and patients alike.