leadership Archives - Medical Association of the State of Alabama

Posts Tagged leadership

Practice Culture is a Reflection of Leadership

Posted by admin on March 8, 2019

This article is a continuation of the leadership series started by Jim Stroud in 2018. As many of you may know, Jim retired from Warren Averett in December 2018, after serving for many years as an advisor in our health care division. Practice administrators and physicians would seek his advice related to dissension among the physicians, leadership struggles or resistance to change in a changing environment, and more. Jim would communicate the issue, engage our team to assess the details, and resolve the crisis. We often provided ongoing advisory services to foster physician leadership or assist the administrator in facilitating change.

At times, the problems had resulted from governance issues within the practice. A small practice usually relies upon a physician owner to set the practice goals. The practice can only grow and evolve if he or she stays abreast of changes. Every group practice started small and grew over time due to the consistency of the leadership and a clear vision. Most groups employ an administrator to handle most of the day-to-day decisions and lead the practice through strategic goals. Occasionally, we see a practice that grew through the addition of physicians, but there is still no strategic plan for the future.

Communication Is Key

The practice culture is a result of key behaviors of the leadership. Better performing practices have a clear vision statement and review it during all strategic decisions. These practices hold regular physician meetings and keep the practice moving in a strategic fashion. They communicate clearly and practice transparency in setting goals. Better performers value advisors to assist in key decisions and advise through strategic planning. The culture trickles down to how effectively the administrator communicates goals and engages the staff.

A positive culture fosters teamwork through effective communication. Think about how you want the staff and your patients to view your practice. The staff will showcase your culture through the performance of their jobs. I worked with a practice last year whose physician leader had fostered loyalty and success in the staff through “morning huddles.” The staff worked well as a team and supported each other as problems occurred each day. The culture should evolve by hiring staff that understands the goals of the practice and how their job is important to the success of the practice. A physician/administrator team that communicates vision, trains and engages their staff will grow leaders in every area of the practice.

Our practices will continue to face challenges; the regulatory changes alone will keep a practice on their toes. As technology evolves, our practices have many opportunities to serve patients through new platforms and initiatives. Leadership begins with the physicians. If they effectively communicate their vision, they build a practice that attracts new physicians and loyal staff.

Article contributed by Tammie Lunceford, Healthcare and Dental Consultant, Warren Averett Healthcare Consulting Group. Warren Averett is an official Gold Partner with the Medical Association.

Tags: administration, advisory, behavior, leadership

Posted in: Leadership

Patient Satisfaction: What Is It Really Worth?

Posted by admin on December 11, 2018

In previous years, patient satisfaction discussions pertained only to patient surveys and results. Some managers believe surveys are utilized by specialties, such as plastic surgery practices that primarily operate on a cash basis. However, consumerism is here to stay! Cost and quality will create a level playing field in health care and increase the importance of patient satisfaction. When working with a practice, I love to sit in the waiting room to see operations from the patient’s point of view. I also search the specialty online to review the competition and the effectiveness of the practice’s website. During my research, I may also see online reviews, which speak directly to the patient experience.

Every business is a function of its people. Choosing the right people, training them continually and providing ongoing communication is essential to creating an exceptional patient experience. A successful practice has an established culture through a mission statement that is expressed each day through the actions of the physicians, managers and staff. Loyalty and profitability follow when an organization makes a promise to a customer and delivers on the promise over, and over again.

As an administrator, I begin with a good job description and then hire the person with the desired behaviors and skills to perform the task or job. A consistent training program is a key to success, it is not simply assigning a new staff to another employee for training. The staff training should occur through various methods with a supervisor or mentor. Once training is complete, the employee’s performance is validated before they are released to perform the task unsupervised.

Patient satisfaction surveys focus on each aspect of the patient’s visit to assure each person is delivering great service and managing their responsibilities to complete the assigned tasks. Medical staff may be highly trained on a specific clinical task, but a customer service attitude is essential when dealing with patients. Defining a plan to act quickly on feedback from a patient survey is essential to mitigate a problem.

You cannot prevent all problems, but the way you handle a problem can salvage a relationship. Establish key behaviors for staff to protect the patient relationship. If you hired people with a genuine heart for service in a medical practice, a problem may arise but the commitment to patient satisfaction should preserve the patient relationship.

Technology is rapidly improving. We have the tools to measure every activity in our practice to ensure the patient experience is exceptional. Phone systems have the capability to measure abandoned calls, length of time on hold, and the number of calls going to voicemail. Our practice management systems include reports and options to monitor first available appointments, percent of patients utilizing the patient portal and patient flow.

There are many tools to promote better patient engagement, including online registration to eliminate paperwork or automated appointment reminders using text, email or call. The patient portal, if promoted and correctly utilized, can reduce phone calls and improve the patient experience. The portal allows for ongoing communication, as opposed to hours waiting by the phone only to miss the call, which increases the call volume. The portal gives the patient access to information to share with other providers.

The development of defined processes and policies is essential to effective training. If the policies are ineffective, or if management does not enforce the policies, then the patient experience is affected. Patients who have an exceptional experience will tell a few people. If they have a poor experience, they may tell the story over and over again.

If your practice relies on referrals from other physician practices, do not underestimate the power of the referring office. The referring provider can send patients elsewhere if the patient is not satisfied with your practice. You should be able to identify the top 20 referring physicians and track the volume of referrals to assure it is consistent. The manager should contact the manager of the referring practice to assure needs are being met and the feedback is good.

It is important to know what makes your practice thrive. It is comprised of multiple factors, including good physicians and loyal employees, which lead to strong referring relationships. A medical practice exists for the patients, so what is patient satisfaction worth? EVERYTHING!

Article contributed by Tammie Lunceford, Healthcare and Dental Consultant, Warren Averett Healthcare Consulting Group. Warren Averett is an official partner with the Medical Association.

Tags: consumer, leadership, manage, mission, patient, practice, result, satisfaction, survey

Posted in: Leadership

Lead From Where You Are

Posted by admin on May 31, 2018

After mastering self-leadership, the next step is to lead your physician partners and your office staff. Contrary to common belief, some aspects of this role should be filled by all physicians in the group. Yes, there may be a designated single leader for the practice, but that should not enable the others in the group to abdicate their leadership responsibilities. It is a common error to think “I will wait until I am the senior partner, or I will wait until I am the highest producing partner before I begin to lead our group.” Lead well from where you are, and the group will be better for it.

The respect the practice receives is not necessarily driven by how well your group is led, but a dysfunctional medical practice will impair the regard in which you are held by those outside your practice. As a physician, you wield great influence, and that opportunity is enhanced by a perception that all the physicians in your group are positive examples of excellence in patient care and of decorum. Your employees are also ambassadors for your group as a manifestation of the leadership they receive from you.

There are two aspects of leadership and one of them is often neglected in medical practices. First, there is your directed leadership. This is the willingness to make decisions about strategic or tactical matters. Some issues should be handled by your practice administrator and some must be discussed with the full physician group, but many decisions should be made by the physician leader. The issues which the administrator should defer to you from day-to-day matters, will depend on the experience of, and your trust in, your administrator. In today’s complex world of medical practice management, hire a capable person to manage the group, and let them do the job without any micromanagement. Spending too much M.D. time making or reviewing every management decision is unwise. For the bigger issues, the physician leader must make the call. Even if you prefer to seek group buy in, make the decision first and deliver it as a recommendation to the group. Letting a physician group deliberate until a decision is reached is a recipe for the paralysis of analysis. Do not give any physician a veto power about decisions unless your group is very small or it is a decision of major magnitude, like selling or merging your practice.

The second aspect of leadership, and most often overlooked, is your permissive leadership. These are matters which happen because you encouraged or permitted them to occur. Permissive leadership is a hands-off approach and works wonderfully when all members of your group share a common clinical, behavioral and ethical work philosophy. At Warren Averett, when our team is assisting clients in the recruitment of a new physician or in a merger of medical groups, we always steer the discussion away from the monetary issues until we feel that the physicians involved have a compatible clinical mindset.

Clinical compatibility could be perfect, but there must also be a behavioral agreement among the physicians. Are the staff deserving of courtesy and appreciation for their patient support efforts, or are they paid to do a job and that is all the thanks they should expect? Is profanity acceptable in the medical practice? How casually may a doctor cancel clinic in order to engage in last-minute recreational or travel pursuits? Are the practice policies regarding social media, taking vacations when other physicians are already off and fraternization with select members of the staff, hard rules which must be followed, or are they only suggestions? We have been involved in mediating physician disagreements on every item listed here, so we believe it is crucial to discuss these issues before physician employment.

If all in the group are clinically and behaviorally in synch, the remaining issues center on work ethic and most of those can be handled through the physician compensation plan. Physician start time, end time, pace in the work day, use of office talent, ancillary procedures performed, payer mix and procedure mix all impact revenue. In a production-driven physician compensation formula, differences in these factors will make great differences in resulting compensation. There must be some similarity in work habits and ethic, as well as agreement that differences merit variances in compensation.

Where clinical, behavioral and ethical consistency exists among all physicians, and one doctor has the group authority to make decisions, there is harmony, productivity and profitability. We see it time and time again.

Article contributed by James A. Stroud, CPA, D. Maddox Casey, CPA, and Sae Evans, CPA, with Warren Averett CPAs and Advisors. Warren Averett CPAs and Advisors is an official preferred partner with the Medical Association.

Tags: leadership

Posted in: Leadership