Your Chain of Command

When a practice creates a workplace where departments are answerable and responsible to each other, they not only have the ability to double check the accuracy of the work, but also to reinforce the idea that the practice functions as a single unit with a team mentality.

Your chain of command will appear as follows:  The Medical Director or senior partner establishes the mission statement for the practice and all employees are directly answerable to this individual.  He or she  will meet each month with their department heads and should expect a full report on the functionality of the department along with a listing of any emergent problems so that they can be immediately addressed.

The Administrator or office manager assures that each department adheres to the practice guidelines in order to realize the mission statement goals.  The administrator will staff the practice with employees that promise to excel in their job descriptions, keep true to the idea of a team mentality and practice in an atmosphere of courtesy and professionalism where patients are the number one priority.

Department managers, including those assigned to the clinical staff will report to the administrator, supervise and evaluate their employees and form relationships with each department within the practice.  Their goal is to make sure that each department is equipped with the resources and skills that are needed to realize both individual and practice goals.

Professional Staff :  Members of your professional staff should be contracted employees with job descriptions and practice expectations clearly outlined.  Any professional contract should also include a request for generous notice should these employees terminate their agreement.  Losing an echo technician or a physician assistant without adequate time for replacement can result in months of lost revenue and a disruption in the patient schedule.

Prepare your practice with adequate coverage in the event of illness or family emergencies.  There are a number of temporary agencies that can supply you with per-diem employees in cases where a member of your team will be absent.  You will want to familiarize yourself with these agencies long before an emergency presents itself.  Check to make sure that your office insurance policy provides per-diem coverage for this situation or that the agency has its own coverage that can apply to your facility.

Vacations and sick-personal time should be clearly noted in the contracts of your professional employees.  In some cases, you may be willing to offer additional vacation time as leave without pay if you find that there are quarters during the calendar year where your practice has less visits.  A well qualified health care attorney should prepare all of your employee contracts and you should have a clear notion of any bonus structures prior to hiring.  Often new physicians entering an established practice are more interested and eager to meet the bonus structure requirements and will entertain a smaller base pay for their first year or two.   The bonus structure offered, should be dependent not only on the performance of the physician but also on the annual practice overhead.  With constant changes to reimbursement and the rising cost of maintaining the practice, overhead can fluctuate drastically from year to year.  Most physicians are less than optimistic about the immediate future of healthcare so structuring your bonus package to balance earnings minus shared overhead has proven to be the formula that works best for most offices.  Providing this information to new physician hires well in advance will alleviate unnecessary resentments and disappointment.

Tomorrow:   Reinforce the Message