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Practice Management: The Art of the Job

by Cheryl Fuchigami, RN, Practice Administrator, Pediatric Partners, MPC

I sometimes liken practice management to being a parent – you’re responsible for the medical practice’s overall well-being, you have a ton of responsibility and you wear a lot of hats. But it wasn’t until my pediatric practice grew from two offices and three providers to 10 offices, 17 physicians, three mid-levels and a staff of 75 (whew!) that I truly understood the art of my job.

When practice managers and administrators take a step back and assess our daily routines, we can identify areas where we might take off some of those hats, pass them on to other staff, and focus on the tasks that truly require our personal touch.

With that in mind, here is a glimpse into the art of my job, and the art of the technology I rely on to keep me delegating properly and keeping my eyes on those high-value tasks. Welcome to my day...

5:00 a.m. Tuesday (back to the grind after a 3-day weekend)
I’m already online and working – reading through more than 100 personal emails, deleting the 30% trash and then checking my messages and task lists in athenaNet (athenahealth’s cloud-based network). Then I answer patient portal appointment requests for same-day appointments and send messages to offices for follow-up.

5:45 a.m.
Wake up my three daughters and get them ready for school, feeling pretty good that I’ve already tackled some important tasks at home (hey, it’s athenaNet, so I only need my laptop and an Internet connection.)

7:00 a.m.
I walk through the office door to start the work day, deciding exactly which hat to grab from the rack first... This particular day, it’s Operations Manager.

Sign into athenaNet. How do our office schedules look for the day? Are they full? Get a quick snapshot of our last month via the athenahealth Practice Performance Review, and our current productivity through "My Reports" in athenaNet (6,332 visits were completed last month, our days in accounts receivable is holding steady at 26.4.) Our providers have improved their coding – more 99213s, fewer 99212s, almost at benchmark.

7:30 a.m.
Time to review staffing: There is an employee transferring from our Hemet, CA location to the Menifee office, and her replacement is transferring over from the Redhawk office. Send an email via athenaNet to see how the three employees hired over the past month are adjusting to their new workplace. Review 20+ resumes for qualified Medical Assistant candidates. Oh, and I need to post new and changed labor laws in all offices.

8:00 a.m.
Are all employees present for work today? Did any staff, managers or providers call in sick or late? Our employee training mentor is ready to greet a new staff member with a warm welcome and begin orientation via the athenaNet Learning Portal – no more training a new employee for two days. Also, today is payroll, so we work with all our office managers via email to ensure employee pay is processed properly.

8:20 a.m.
Field a phone call about a billing service that promises potential financial benefits. Let them know we are already on athenaNet (and are very satisfied.)

8:24 a.m.
Get a phone call from MediBag about renewing a marketing project with a pharmacy. Work out details and request the contract be sent via email.

8:30 a.m.
Credentialing needs a photo of one of our providers for a hospital. Do we have photo paper? Yes. Copied. Done!

8:35 a.m.
Receive an email with our quote for employee medical benefits’ renewal – review the numbers, see the 18% increase in premiums, notice the contract has errors. Back to our broker...

8:45 a.m.
Review a notice from our property manager, stating that our office location in Temecula has a scheduled power outage tomorrow... from 8 a.m. to 5 p.m. GREAT! Call to verify the power outage, only to learn "it should not affect the Temecula building." Prepare office staff anyway. What if no power? Have our relocation plan ready for our $250K vaccine stock, and make sure our wireless laptops are charged and ready.

Next, meet with our administrative assistant so I can take over her tasks when she goes on vacation at the end of the month. Review a few questions about our current financial status and use our Practice Performance Review to see year-to-year performance comparisons and trends.

Wait, have I had a cup of coffee yet this morning? Time to keep moving!

9:15 a.m.
Check athenaNet to see if our clinics are checking in patients on time... looks like they’re off to a great start! ...

As practice managers and administrators, we relate to these minute-to-minute demands that guide our day. We are patient advocates and educators, team members and leaders. We are fair and non-biased heads-of-staff, challenged with situations that can affect an employee’s future. We are held to a higher standard of performance from every patient, parent, employee, provider and Board member — as well as each other — and are continually balancing work and home life with precision.

The ability to be flexible and move gracefully between thoughts and actions are well-honed skills that many practice managers possess. This can’t be taught and can’t be learned from a book.

All of this is what makes me who I am as a practice administrator, and I’m thankful that we have the necessary set of tools to help keep my focus on those many "hats" and leave the more arduous administrative work to our services and their technology.

My hope is that others in this field can realize the value of their worth and the value in leveraging the right technology. That is the true art of the job.

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For those interested in learning more about how I have incorporated athenahealth services into my everyday activities, I’ll be at the athenahealth annual User Conference this spring and would love to connect with you! Feel free to leave me a comment here if you’d like to meet.

Also, for those who have never attended the UC, I can highly recommend that practice managers make the trip to Boston. Personally, I've learned from the experience of others who have been through implementation, to those who created and use best practices and workflow stages to understand all that athenaNet can do. And I've left the UC ready to apply those teachings to my job back in Temecula, CA.

Cheryl Fuchigami-Bost, RN, is Vice-President/COO of Pediatric Partners, MPC, a private practice with 25 caregivers, 10 managers and 62 staff members working in 10 locations throughout Northern San Diego, Southwest Riverside and Inyo-Kern counties of California.

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