Turn your paperwork over to a professional

Where to find relief from medical practice's
biggest bugbear

By Abe Konigsberg

"I went to med school so I could help people get well. I didn't anticipate that I'd be wasting half my time on boring paperwork," says an Edmonton FP in a two physician practice. This doctor and his partner decided to do something about the situation. They wanted to concentrate on what they do best — practising medicine — so they left the management side of their practice to a man they affectionately call their "pencil-pusher."

Tim Smith, Vice President of Ottawa-based Practice Solutions Inc, says that he gets many calls for help from doctors overwhelmed by the business side of medicine. The simplest solution to practice management woes is to simply join a large group practice as an employee. But Mr Smith acknowledges joining a large group isn't for everyone and that by hiring the right person you can maintain the independence that comes from working solo or in a small group without drowning in paperwork.

GETTING HARD TO HANDLE
If managing your practice is starting to wear you down, you could benefit from outside help. "It's hard to generalize, but if physicians are spending more of their time on administration than on patient care — they should first call us," says Mr Smith. "They need some help. If they're not happy with their staff and the administrators in their practice providing those services, we can help them with that."

FINDING GOOD HELP
"We've spent quite a bit of time helping doctors recruit and train clinic managers for various sizes," says Mr Smith. "Typically, they don't have a manager — someone left or got terminated or the practice simply grew to the point where it's no longer manageable — and they don't know how to go about finding someone qualified to run the clinic for them."

"We'll sit down with the doctor and develop some specific roles and responsibilities for the person we're looking to hire and then we'll go and recruit someone." He notes the ideal candidate for running a practice usually has a background in accounting, an MBA, or some good administrative experience at a hospital. But it's a tight job market and he warns that doctors shouldn't obsess over finding someone who's an expert on healthcare — it's their organization skills and business acumen that you're really looking for.

SHARING MANAGERS
Smaller practices often use part-timers. "There have been cases of smaller practices — say three to five physicians — that cannot really afford a full-time clinic manager but could find someone who works in a bunch of different clinics and supervises them all," he says. "That's a good alternative, and it's even within the reach of a solo doctor." He notes that it's easier to attract a great part-time manager when you work in a medical building with other clinics which this manager could potentially work for.

As an alternative to hiring a boss to take over your managerial burden you could work with a company that specializes in running your practice for you. "There's Appletree, AIM Healthcare Group, Med-Emerg and other [medical management service organizations] who either own the clinic and have the physicians work in there or they have some sort of partnership or association with the physician where they are basically taking over the management of the practice," explains Mr Smith (See sidebar for details). "A few — not a lot — offer management services but typically these companies provide everything — it's a turnkey solution."

BUFFER ZONE
There's another reason to consider offloading practice management duties to a third party — it helps protect you from disputes with patients and partners over money and the practice's policies. "A good example today is uninsured services and charging patients directly for these services," says Mr Smith. "There may be different philosophies among physicians over what policy should be. If there was a management service type organization those types of issues would be fairly distant." But bringing someone else in to run things does have its problems. "Physicians still have to adhere to policies or that could lead to issues with the administrator running the clinic," he warns.