The ophthalmologist who acts as practice administrator must balance the management of financial stability, operational efficiency and compliance with legal and regulatory requirements while providing high-quality care—not an easy task. Striving for excellence in today's marketplace means developing and implementing marketing strategies, building a top-performing staff and keeping facilities and information technology up to date. In this article, I'll explain why the ophthalmology practice that wants to allow its physicians to focus on patient care may benefit from placing the bulk of day-to-day management into the hands of a professional practice administrator.

Need a Professional Administrator?
A professional administrator is responsible for the financial management and operations of the practice. In contrast to a practice manager or office manager, a professional administrator participates in top level decision-making and may have a financial stake in the practice.

To determine if an administrator could help, ask yourself these questions:

Daily Practice Operations
 • Do our current methods for overseeing daily operations meet the needs of physicians, managers, staff and patients?
 • Do we work well as a team to identify operational problems, determine feasible alternatives and implement changes on a timely basis?

Planning and Marketing
 • Have we developed and do we annually update a strategic plan that addresses long- and short-term priorities?
 • Do we have current knowledge of demographic trends, community dynamics, new laws and regulations and competition so our practice can respond to changes in the external environment?
 • Do we have a marketing plan that supports the objectives set forth in our current strategic plan?
 
Financial Management
 • Do our systems for billing, claims processing and collections result in accounts receivable management that meets benchmarks for our specialty?
 • Are we satisfied with our current systems for preparing and regularly monitoring our operating budget and capital equipment plan?
 • Does our managed-care strategy include review and negotiation of contract language and reimbursement rates, monitoring actual vs. expected payments and making sure that operational systems comply with managed- care requirements?

Human Resources
 • Are responsibilities and accountabilities for both clinical and nonclinical staff clear?
 • Do we use a performance review system to manage orientation, training, regular review and disciplinary action for managers and staff?
 • Do we have systems for physician recruitment, hiring, orientation and performance review?

Facilities
 • Does the size of our facility meet our current and projected needs?

Information Technology
 • Do we use IT to support the administration of our practice and the direct provision of patient care in ways that meet our needs and budget?

Quality Assurance
• Do we have effective methods for responding on a timely basis to inquiries about claims and patient complaints?
 • Do we use satisfaction surveys regularly to determine our ability to meet the needs of patients and of all those individuals, organizations and agencies with which we regularly relate?

Legal and Regulatory Compliance
• Is legal and regulatory compliance a priority for our practice?
• Are we satisfied with the ways that we learn about, meet and monitor requirements?

Relationships
 • Have we identified the external individuals, organizations and agencies with which we need to develop relationships? Examples are other physicians' practices, hospitals, managed-care plans, professional organizations and regulatory agencies.
 • Are responsibilities for maintaining these relationships clear?

Use of External Consultants
 • Do we use consultants to help us with tasks we can't perform internally?
 • Do we manage the consultants that we have identified as appropriate resources for our practice?

Will it Work?
If the responses to these questions identify aspects of your current practice that need improvement, take the next step and honestly assess the potential for acceptance of a new management arrangement. In many situations, a professional practice administrator can relieve physicians and other staff of responsibilities they ought not have. The important question is whether or not the other physicians and staff are receptive to change. Here are questions that can help you determine your readiness for hiring a professional practice administrator:

 • Are we are satisfied with the role that physicians now play in the management of our practice?
 • In our opinion, does the current practice manager have the vision and skill to make the practice flourish?
 • Are our physician leaders intellectually receptive to sharing power with a professional practice administrator in order to improve the practice?
 • Given the individual personalities of everyone in our practice, what is the likelihood that we can adjust to hiring a professional practice administrator?
 • Would we be willing to support a financial package for a professional practice administrator that includes salary, benefits and bonus? Here, in the Raleigh-Durham-Chapel Hill area, an administrator in a private-practice setting can expect an annual salary of  $60,000 to $150,000 plus benefits and bonuses. This will vary by type of practice, number of physicians and revenue.
 • When we look at the current distribution of management responsibilities, would hiring a professional practice administrator increase the time that physicians can spend on patient care, practice planning and professional education?
 • Would we be comfortable having a professional practice administrator work with us to develop a vision for the practice and assume responsibility for assuring that our operations support that vision?

The Search
If the responses to this second set of questions clearly indicate that your practice is receptive to hiring a professional practice administrator, how do you find the right one?

Begin the recruitment process by developing a job description that is part of a formal employment agreement that covers salary, benefits, profit sharing, bonuses, leadership development and professional education.

Newspaper advertising is suitable for local and regional exposure. If you decide to do a national search, one resource is the Medical Group Management Association (mgma.com). You may use an executive search firm to help you further refine the job description and identify and screen qualified candidates. If you take this approach, check the Internet to identify firms that specialize in medical practice management.

If you already have a practice manager who has some, but not all, of the skills required of a practice administrator, invite him or her to apply for the position. By using your structured job description, you can objectively match skills against requirements and minimize discomfort if your current staff person isn't qualified to do the job. Your current employee may just be willing and able to do the job with appropriate education and coaching, however.

By doing an honest assessment of your practice, determining the practice's readiness for a professional practice administrator and using a thoughtful and objective process for recruiting and hiring, you can make sure that the management of your practice meets the highest standards of excellence. 

Ms. Satinsky is president of Satinsky Consulting, LLC. Contact her at (919) 383-5998 or margie@satinskyconsult ing.com.