Transcript Chapter Twenty- Four Medical Practice Management and Human

Medical Practice Management
and Human Resources
Chapter 25
Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Introduction
The management of a professional medical office
can greatly influence the success of the operation.
Good management allows the physician to see
and treat patients in a functional environment
while the business side of the practice operates
as it should.
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This chapter will examine:
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Importance of management in the physician’s office
Desirable qualities of the medical office manager
Three types of leaders
Types of power
Motivating employees
Burnout prevention
Intrinsic and extrinsic motivation
Reviewing résumés and applications
Follow up after interviews
Staff meetings
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Who’s in Charge?
Facilities with three or more employees should
designate one person as the office manager.
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Chain of Command
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Allows the office staff to consult with the
physician regarding administrative or clinical
problems, complaints, or grievances
Prompts employees to allow those individuals
whom the physician has placed in charge to
have the first opportunity to solve problems
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Qualities of Good Managers
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Fair
Flexible
Dedicated
Sincere
Able to handle conflict
Able to see the whole picture
Supportive of staff
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Duties of Office Managers
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Prepare and update
policy and procedure
manuals
Develop job descriptions
Recruit new employees
Perform orientation and
training
Conduct performance
reviews
Dismiss employees
Plan staff meetings
Perform customer
service
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Maintain staff harmony
Establish work-flow
guidelines
Ensure compliance with
federal and state
regulations
Improve office efficiency
Supervise purchasing
Educate patients
Eliminate time-wasting
tasks for the physician
Market the practice
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The Power of Influence
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Successful managers must be interested in
people and enjoy working with them on a daily
basis.
Managers have a great deal of influence on the
people they supervise.
By helping others get what they want, an
individual usually gets what he or she wants.
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Successful managers…
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Know that employees need encouragement
Are confident enough in their own skills to let
employees receive credit for their ideas and
performance
Let their employees help them “look good”
Help employees reach their goals
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The Manager as a Leader
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Leaders nurture other people.
Leaders have a strong belief in people.
Leaders see others as successes rather than
failures.
Leaders listen to people.
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Positioning
Sit next to employees when talking instead of
across from them at a desk when possible.
Sitting behind the desk separates the manager
from the employee and places distance between
them.
Sitting at a desk might be appropriate when
disciplining or terminating employees.
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Types of Leaders
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Charismatic: inspire allegiance and devotion
from their followers.
Transactional: structured and organized.
Transformational: innovative and able to bring
about change in an organization.
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Styles of Management
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Autocratic: makes demands and insists that
tasks be done his or her way.
Democratic: fair-minded and asks the opinions
of the staff when making decisions.
Laissez-faire: easygoing and does not make a
lot of demands on employees.
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Leading During Transition and Change
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Change is a part of the life of every person and
business.
Many people try to avoid it completely.
Businesses cannot grow without change.
Managers who are able to lead employees
through change and transition are valuable to
their employers.
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Who Moved My Cheese?
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Change happens
Anticipate change
Monitor change
Adapt to change quickly
Enjoy change
Be ready to change again and enjoy it again
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Power
Power is the ability to influence employees so
that they carry out their directives. The types of
power are:
 coercive
 expert
 legitimate
 referent
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Abuse of Power and Authority
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Managers who put up walls and barriers will
have a difficult time forming a cohesive team.
Checks and balances within an organization
help to stop abuse of power.
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The Power of Motivation
What motivates a person to reach a goal?
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Challenge
Money
Praise
Satisfaction
Freedom
Fear
Family
Insecurity
Fulfillment
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Integrity
Honor
Reputation
Responsibility
Prestige
Needs
Love
Competition
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Motivation
Intrinsic
 Internal or originates inside someone
Extrinsic
 External and more material in nature
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The New Office Manager
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May face negative reactions from employees
Do “nothing” first
Meet with employees individually
Create a plan of action
Staff meeting
Meet employee needs
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Create a Team Atmosphere
The wise manager constantly takes steps to
improve employee morale, including scheduling
frequent meetings and keeping employees
abreast of changes.
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Low Morale
Low morale may exist because of:
 Recent changes in management
 Recent changes in policies and procedures
 Terminations of other employees
 Lack of business
 One employee who displays a poor attitude
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Use of Incentives and Employee
Recognition
Incentives give the employees reason to perform
above and beyond the call of duty.
Recognition is a strong method for improving
employee morale and encouraging outstanding
performance.
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Problem Employees
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Never hesitate to counsel the employee who is
not performing at the expected level.
If the manager does not make a habit of writing
formal reprimands, there may be insufficient
documentation to terminate the employee.
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Problem Patients
May be:
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Complainers
Angry
Needy
Demanding
Violent
Nonpaying
Noncompliant
Drug-seeking
Reschedulers
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Burnout
Managers should take steps to help employees
avoid burnout. Some causes of burnout are:
 Stress
 Disorganized workplace or home environment
 Poor human relations skills
 Feelings of being out of control of one’s life
 Excessive expectations
 Long work hours
 Not being able to relax at home or work
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The Interview
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Make the applicant feel at ease.
Ask open-ended questions that cannot be
answered with “yes” or “no.”
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The Interview
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Avoid questions that involve the applicant’s
privacy.
Review the job description with the applicant.
Ask relevant interview questions.
Give the applicant the opportunity to ask
questions.
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Follow-Up Activities
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Make notes about the employee when he or she
is fresh in your memory right after the interview.
Carefully check references.
Determine the best candidate for the position.
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Orientation and Training
Training the new employee is critical if he or she
is to succeed.
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Acquaint New Employees
with the Office
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Staff members and their names and
responsibilities
Physical environment and layout of the office
Nature of the practice and specialty
Types of patients seen in the office
Office policies and procedures
Long-range expectations
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Staff Development Training
Continuous training and staff development are
vital aspects of any medical office.
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Delegation of Duties
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Assign duties to the employee who will perform
them in the best way.
Be flexible in the assignment of duties.
Use employee strengths.
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Use Performance Evaluations
Effectively
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Probation periods are usually from 60 to
90 days.
Set a definite date for the evaluation.
Review both strengths and weaknesses.
Develop a plan with the employee for
overcoming weaknesses.
Set the next date for review.
Expect improvement and compliance.
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Peer Evaluations
Peer evaluations allow employees to evaluate one
another and provide input into one another’s
performances.
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Poor Evaluations Made Easier
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Open the discussion frankly
Have good documentation
Never allow an argument, but be willing to
listen
End the discussion if the employee becomes
abusive
Motivate the employee to improve
performance
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Terminating Employees
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Have plenty of documentation of behavior that
led to the termination.
Conduct the session at the end of the day.
Do not allow the employee to be abusive.
Collect keys immediately.
Never leave a terminated employee alone in the
office.
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Immediate Termination
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Embezzlement
Insubordination
Violation of patient confidentiality
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Fair Salaries and Raises
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Employees expect fair salaries and raises if
they are performing as directed.
Merit raises are increases based on an
employee’s commendable performance.
Raises should not be offered strictly because an
employee has worked for a certain length of
time, such as a year.
Raises must always be earned by performance.
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Staff Meetings
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Staff meetings must be held regularly.
Meetings help the staff to stay informed.
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Staff Meetings
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Meetings give employees a chance to offer
input and resolve grievances.
Recognize employees for outstanding behavior
during staff meetings in front of physicians.
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Staff Meeting Agenda
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Reading of the last meeting minutes.
Discussion of unfinished business.
Discussion of problems in the clinical area.
Discussion of problems in the administrative
area.
Discussion of problems in common areas.
Discussion of new business.
Adjournment.
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Patient Information Folders
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Explain the basic operations of the office to
patients
Easily compiled and designed
Decrease the number of calls that come to the
office
Can reduce misunderstandings about policies
Great for introducing patients to the practice
and mailing before first visits
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Financial Policy Folder
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Explains financial policy information to patients
May be included in a larger patient information
folder or brochure
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Patient Instruction Sheets
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Clearly stated instructions for patient use for
various procedures and treatments
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preparation for x-ray examinations
 preoperative and postoperative instructions
 diet sheets
 wound dressings
 care of casts
 many others
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Moving and Closing Practices
Moving and closing practices require much
advance planning and coordination among all
staff members.
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Moving a Practice
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Plan the new quarters.
Establish a moving date.
Notify utilities and mailers.
Notify patients.
Pack.
Devise a moving day strategy.
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Closing a Practice
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Notify patients.
Avoid abandonment charges.
Publicly announce the closing.
Prepare for patient transfer and records
storage.
Address financial concerns.
Properly dispose of controlled substances.
Address liability insurance.
Dispose of furnishings and equipment.
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Summary of Scenario
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Always be fair when administering office
policies and procedures.
Use employee strengths when making
assignments.
Always be friendly toward the staff.
Remember that your success depends on
employees’ success.
Be honest but fair in evaluations.
Encourage teamwork at all times.
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Closing Comments
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Successful office managers care about their
employees.
Promote the office mission statement.
All office managers must be strong leaders.
Be fair and open-minded.
Treat employees as you would want to be
treated.
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