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Ten-point scorecard can assess administrator prowess
The success of your administrator has a direct effect on the success of your practice.
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“The greater danger for most of us lies not in setting our aim too high and falling short; but in setting our aim too low, and achieving our mark.” – Michelangelo
“What you get by achieving your goals is not as important as what you become by achieving your goals.” – Henry David Thoreau
John B. Pinto
Corinne Z. Wohl
In today’s complex and changing practice world, few factors are as critical to practice success as your administrator’s global fitness. We are joined in this month’s column by OSN Practice Management Board Member and Healio.com/Ophthalmology blogger Corinne Z. Wohl, MHSA, COE, an experienced hospital and practice administrator.
What follows is a simple “administrator’s scorecard.” It will help you answer one of the most common questions asked of practice management consultants: “How is my manager doing?”
This administrator assessment uses trinary scoring. “Zero” is for a frank absence of each trait or attribute discussed below. “One” is for a little of the trait discussed but probably not quite enough. “Two” is for a sufficiency or abundance of the trait discussed. As you read through each item and think about your current administrator, circle a 0, 1 or 2.
Raw career tenure in health care services management/leadership
It takes about 25,000 hours of hard work and a very heavy tuition bill to turn a bright high school graduate into a rookie eye surgeon. In another 10,000 hours or so beyond this, you have a 35-year-old ophthalmologist who most readers of this column would be comfortable having operate on a distant and not-too-favored relative. Not coincidently, 35 years is about the minimum age at which we could reasonably expect a practice administrator to not muff up a small and non-challenging practice. At 45 years and older, we typically see both surgeons and administrators at the height of their prowess. Score your administrator on this key factor.
Score: 0 1 2
An energizing spirit
Most people enjoy movies, concerts and stage plays, in part because they are so energizing. After 2 hours, you walk back out onto the street more pumped and powerful than when you entered the theater. In a tangible and non-manipulative sense, powerful and effective administrators are like effective performers. They add positive energy to each person in the practice. Where is your administrator on this trait? (Note: Sometimes in a misplaced effort to whip up the troops, an ineffective physician or lay leader will apply negative energy. This actually sets the organization backward.)
Score: 0 1 2
Close-to-perfect performance standards, but still human
Ophthalmology prides itself on a “perfect” performance standard. This is, of course, something of an urban myth. Half of all ophthalmologists perform below average surgery and half work in below average practices. However, the majority of both lay staff and providers strive for perfection. The best administrators are infected early in their careers by this institutional, ophthalmological striving for perfection, while tempering this with the knowledge that human staff will often fall short of this goal.
Score: 0 1 2
Communication excellence in all forms and situations
The especially effective administrator is lucid. They capture and convey both facts and moods in the fewest words possible. Whether writing, speaking or even sending nonverbal signals, they make themselves clear to others. They help team members who see things differently get on the same page. They translate the board’s wishes to the rank-and-file and the rank-and-file’s concerns back up the chain of command. How does your administrator perform in this area?
Score: 0 1 2
Numeracy: A visceral feel for, and enjoyment of, numbers
Effective practice leaders ask objective questions obliging numeric answers. Not: “How’s it going in billing this week?” But: “What percentage of our open accounts is still out over 90 days?” They have as memorized and integrated a grasp of your practice’s key performance indictors as you do of your favorite patient’s latest glaucoma statistics. They know when the numbers are favorable. They know when the numbers are off and corrective action is needed. And most importantly, like a great physician, they know their own limitations. When they are mystified by an adverse figure, they seek out advice.
Score: 0 1 2
Relationships with owners as a trusted peer-collaborator, not minion
This attribute is a two-way street. An administrator, to be effective, must have the board’s enduring confidence. But so, too, must the board — and especially the managing partner — enjoy the confidence of the company’s lay leader. Weak boards kill administrative performance faster and more completely than weak administrators kill practices. If you are disappointed in your administrator’s current performance, ask yourself how much of the gap flows in the form of distrust from the top of the company.
Score: 0 1 2
A builder of alignment among owners, managers and staff
Imagine dropping a fistful of 20 or 30 or 50 toothpicks on an empty table, with each toothpick representing one member of your practice. Would the resulting disarray represent your practice as it stands today, or is everyone aligned and heading in the same direction? Great administrators are natural “aligners.” They articulate a few chief goals and help to align everyone in that direction.
Score: 0 1 2
Multifocal: The ability to see both the big picture and the tiniest details
Because eye surgeons deal in such minutia, it is only natural that they should attract lay managers who are similarly obsessive. Such attention to detail is necessary but not sufficient in superior administrators. In addition to picking out the granular details, the effective manager can stand back and see how all the grains make up a beach, a boulder or a sandstone cliff.
Score: 0 1 2
Selection, training and delegation to middle managers
The biggest rookie mistake of young administrators is to not sufficiently develop and lean on their mid-level staff. In the truly great ophthalmology practices of America, the administrator, executive director or CEO could be absent for a month, and the department heads would keep their companies humming.
Score: 0 1 2
A company-wide role model as an efficient, keen, hard worker
The best practice leaders are the first to arrive and the last to leave. They walk just a bit faster down the hall than everyone else. When you watch them thinking about a problem, there is a furrowed-brow intensity that rivals the country’s leading surgeons. They multitask. They remember last year’s conversations as well as last week’s.
Score: 0 1 2