American Association for Physician Leadership

Team Building and Teamwork

How Practice Managers and Physicians Can Work Together to Meet Demands

Nicola Hawkinson, DNP, RN

February 8, 2017


Abstract:

The demand for healthcare and the need for healthcare workers are expected to keep growing. Practice managers are taking on more autonomous roles to best fill employment demands. As physicians take on more entrepreneurial roles in their practice, practice managers are acting as intrapreneurs to further healthcare innovation while adding more value to the practice.




Healthcare is a high-growth industry, and to better navigate the ever-changing landscape of the industry, healthcare providers are looking at themselves in a more entrepreneurial way. Their practice is a business that needs to succeed, and managers have enlisted the help of what are known as “intrapreneurs” to ensure greater success. How a medical practice operates in 2016 is vastly different from how practices operated as little as 5 to 10 years ago. Maintaining quality and controlling cost to the patient are top priorities to keep up with demands.

Managers believe that the best employees will be more than their job description and will seek additional responsibilities outside of their day-to-day activities. Intrapreneurs have the ability to make managers look really good because their actions show that managers are innovating, thinking outside of the box, and delivering more value to the overall organization.

The Role of Entrepreneurs versus Intrapreneurs

Entrepreneurs have the luxury of building a company’s culture from scratch, whereas intrapreneurs often fight against a long history of many deeply held and widely shared beliefs, assumptions, and practices—some of which run counter to intrapreneurship itself. The main disparity between an entrepreneur and an intrapreneur is that an entrepreneur has the freedom to act on his or her whim, whereas an intrapreneur may need to ask for management’s approval to make changes in the company’s processes, product design, or just about any innovation. An entrepreneur is someone who, through his or her skills and passion, creates a business and is willing to take full accountability for its success or failure. An intrapreneur, on the other hand, is someone who utilizes his or her skill, passion, and innovation to manage or create something useful for someone else’s business.

Entrepreneurs provide the spark, and intrapreneurs keep the flame going.

A physician or group of physicians decide to open a practice where they know they have a patient demographic that has unmet needs. A practice manager or a nurse practitioner or physician assistant can be an intrapreneur who operates somewhat autonomously and adds value to the practice. Entrepreneurs provide the spark, and intrapreneurs keep the flame going.

Growth and Opportunities in Healthcare

Healthcare occupations and industries are expected to have the fastest employment growth and to add the most jobs between 2014 and 2024, according to predictions by the U.S. Bureau of Labor Statistics.(1) With the anticipated increase in the proportion of the population in older age groups, more people in the labor force will be entering prime retirement age.

This growth is projected to generate 9.8 million new jobs—a 6.5% increase between 2014 and 2024.(1) Doctors and nurses are in the perfect place to recognize problems needing solutions to improve patient care and outcomes. Tapping into this wealth of expertise will be critical to make the biggest impact possible. Often collaboration and partnership are needed to bring brilliant ideas to life. Patient-centric innovation offers amazing possibilities for improving patient care and patient outcomes. But not every doctor and nurse has the time or expertise to bring their great idea through all the hurdles and barriers to a point where it can actually help patients.

Employee Management

In most cases, practices suffer when an employee decides to leave, because recruiting and finding a replacement is difficult and time consuming. Instead of having to struggle to find a replacement, take the extra steps to keep current employees happy: ensure the salary is competitive, the work environment is stable, and there is opportunity for growth. High turnover can be damaging to your practice; the more steps you take in the beginning to minimize the likelihood of an employee leaving, the better off your practice will be financially.

Some employees are harder to replace than others.

Not all employee turnover is bad for a business, although some employee departures can seriously damage a practice. Although you can say that everyone is expendable, some employees are harder to replace than others. If you are unwilling to compensate or reward employees for a job well done, you could lose them. You might also lose employees because they are not the right fit for your office culture. One way to reduce turnover is to limit the possibility of it occurring in the first place. But also have a plan in place for when turnover occurs. If you are diligent about your hiring process, you can reduce the incidence of turnover.

Staying on top of the legislation and current topics in healthcare and education will only benefit healthcare employees and the practice as a whole. In addition, encouraging medical providers to attend continuing education seminars will also help the staff feel empowered during this time of transition.

High-quality healthcare depends on the presence of well-trained, dedicated healthcare professionals. Hiring high-quality providers will enhance the service the physicians are providing as well as keep patients happy with their care.

Making Expectations Clear

Poor communication between managers and subordinates can seriously damage a business’s productivity and result in employee frustration, low morale, and employee departures. Your human resources (HR) office should create written job descriptions for each employee, to ensure each staff member knows what is expected of him or her and so that critical jobs get handled. These job descriptions also serve as the basis for evaluations, ensuring that employees are not surprised and angered by year-end reviews that address work they did not believe was assigned to them.

Perceived or imagined barriers may keep employees from even attempting any effort aimed at increasing productivity or innovation. HR needs to work with managers in order to develop processes for identifying and eliminating any real or imagined barriers to productivity. When these barriers are eliminated, healthcare providers on the front line have the opportunity to drive healthcare innovation and ideas.

Choosing the Best New Employees

Practice managers find and recruit potential employees for the practice. When done correctly, this can help alleviate stress and an overwhelming workload for physicians. It is true that the cost of finding, interviewing, and training a new employee is considerable. But hiring mistakes are even more costly. Aside from the big issues—salary, benefits, and taxes—consider the space, equipment, and training a new employee may require. Every new employee should be considered an important investment that will yield returns in time. Employers tend to hire too quickly when there is an urgent need to fill a position (e.g., an employee left without giving much notice). You may not want to burden staff members with additional work in the short term, but rushing to get someone new hired can result in overlooking red flags, causing more work in the long run. Not taking the time necessary to evaluate carefully what you are looking for and determine the actual needs of the practice can lead to trouble. It is important to nail down the details of a job description and then hire the person who most closely fills those needs. Staff vacancies can be opportunities to develop the old, available job into something different that may be better suited to the current needs of the practice. This is a good time to get input from others and change the job description if necessary. Using a multistep approach to hiring will create a more organized and productive search.

The interview process is a crucial step and should be taken seriously. Identify what you need and lay out a detailed job description that is very specific about job responsibilities:

  • What type of candidate do you need?

  • Are you looking for someone with a lot of experience, a mid-career sort of person, or a recent college grad who will learn on the job?

  • What personality type will fit best with your office culture—an outgoing, funny person or someone less sociable?

  • Consider the necessary skills and education needed to fill the responsibilities.

Carefully consider the applicants. Review the resumes, and invite a select group into the office for a first round of interviews. Inviting qualified applicants to more than one interview may sound like a waste of resources, but it is not. Look at the first interview as the first round; you are weeding out candidates who are not a good fit. The best employees are often hired through a collaborative process, so it is a good idea to invite top candidates to meet with other physicians and managers at the practice. This is yet another way physicians and practice managers can work together. Colleagues may think of scenarios that you did not consider or ask important questions that had not occurred to you during the first round. A second round of interviews also helps garner more opinions. In addition, it provides an opportunity to observe how the candidate handles him- or herself with different types of personalities. Involving others in the hiring process provides more input, which has the benefit of finding a person with a better chance of working out right from the start.

Talent Management

Employers believe competitive success is tied to effective talent management. Allowing practice managers to focus on talent management and the overall needs of the practice will be beneficial to your practice in the future. Physicians need managers who understand how their practice operates and can evaluate where the practice will be 5, 10, or 20 years from now. Understanding the ebb and flow of a practice is crucial for continued success. High-performing and innovative employees are the foundation of productivity. By far the most crucial factor in workforce and team productivity is hiring and retaining employees with exceptional capabilities and self-motivation. Effective managers and leaders set direction and execute.

Physicians and practice managers need to work together to find a balance to meet healthcare demands.

A great manager/leader is the most important productivity factor. Leaders and managers play a critical role in defining the direction, purpose, priorities, goals, and roles of the workforce. Practice managers should focus on team and individual goals, performance metrics for continuous improvement, and effective rewards to drive performance.

Physicians and practice managers need to work together to find a balance to meet healthcare demands. Allowing practice managers to take on a more intrapreneurial role will give managers the ability to anticipate what the practice needs while physicians focus on patient care.

Reference

  1. Employment Projections: 2014-24 Summary. Bureau of Labor Statistics; www.bls.gov/news.release/ecopro.nr0.htm . Accessed June 2, 2016.

Topics

Collaborative Function

Develop Relationships

Working with and Through Others


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