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DODGING BULLETS: Five consultants dish about the biggest mistakes they see practices making day after day — and how to avoid them.<
by: Pamela Moore, PhD
We asked some of the country’s busiest practice management consultants about their biggest pet peeves. What mistakes do they see repeatedly in practices? What’s the stuff that just makes them nuts? Well, they had plenty of crazy stories (they might sound eerily familiar) and ample frustrations. “I’m 52, and I'm losing my hair, but I’m going to lose all of it if I keep seeing these same problems,” worries Michael Brown, president of Health Care Economics in Indianapolis. While the specifics differed for each consultant, it quickly became apparent that all their complaints fell into two big buckets: staff and strategy. Luckily, they offered plain solutions that can help. Here’s your chance to learn from the best and brightest, before you have to pay them to come in and fix things in your office. THE RIGHT STAFF You might expect practice management consultants to get worked up over poor A/R or bad collection policies, but the one thing that made everyone on our consultant panel groan is staffing. Too many offices have the wrong staff or the wrong number of staff. People are at the heart of their problems. One major mistake? Retaining incompetents. Practices “intuitively know something is wrong but don't act on it,” says Elizabeth Woodcock, a professional speaker and consultant based in Atlanta. “Change is hard for physicians, especially when it comes to personnel. ... I’ll ask someone, ‘What is this person really doing for you?’ And they’ll say, ‘Well, Elizabeth, she's been loyal, very loyal. ... Other times I get, ‘Oh, she's so sweet.’ OK … [but] is she working?” Woodcock just consulted with a two-physician practice. One staff member had a full-time job credentialing. “It’s physically impossible to fill your time credentialing for two doctors, but the employee was being paid $56,000 a year. Why? Well, she’d been loyal,” says Woodcock. This staffer had been at the practice for more than 30 years, and the job was essentially the only position left for her at the practice — she wouldn’t learn how to use a computer. “The impact on the rest of the staff is just phenomenal. One bad apple can ruin the batch,” Woodcock observes. Staff members who come in late, do nothing, or simply aren’t doing a good job ruin the morale of everyone else, Woodcock says. Those who do arrive on time, for example, need to cover for the employee who is always late. Worse than the extra work, everyone on the staff begins to feel like management doesn't care. If the physician owners don’t seem emotionally invested in the practice, you can be sure no one else will. The only solution is to tackle underperformance head on. “Often times these people [poor performers] have had glowing performance evaluations for 15 years. For whatever reason, it's kind of swept under the table,” Woodcock notes; everyone prefers to avoid conflict. But then, when it comes time to take action, Woodcock has seen some practices forced to resort to a big severance payout. It’s difficult to terminate someone for cause if there is no record of poor performance. It’s much better to accurately document performance along the way, based on well-established and consistently applied policies and job descriptions, and confront problems openly. Short-term pain, long-term gain. Just do it. THE RIGHT NUMBER OF STAFF Brown sees the same problems with prizing loyalty over competency. Sure, some staffers have been around 40 years, but “some of those people were incompetent 40 years ago, too.” The result, he thinks, is overstaffed practices. When tasks don’t get done because staff aren't capable, the knee-jerk reaction is simply to add more staff. Nine out of 10 times, practices he vis< |
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