Administration . . . Not Such a Dirty Word

Administration . . . Not Such a Dirty Word

David L. Graham, MD, FASCO

Aug 16, 2015

Sometimes, it seems like the easiest way to raise some physician’s hackles is to bring up something that “administration” is doing. Maybe it’s a practice change felt to make things run more smoothly. Maybe it’s a new iteration of the EMR. Maybe it’s data monitoring or asking the physicians to look at performance reviews. Maybe it’s another survey (this coming on the heels of receiving an email from our Cancer Center Head acknowledging that we may all feel “surveyed-out”).

It seems easy for us, at times, to simply see “administrators” as people who add “busy work,” stress, and problems to our practice life without having any beneficial aspects to counterbalance those detriments.

Let’s look at things honestly and see if that is true. Most of us have had little business training other than that we received in medical school. In other words, essentially none. As a result, we mostly choose practices in groups if not larger systems. Part of my rationale in making that choice was because I had neither the skill set nor the interest in managing all the business detail involved in running a modern practice. The last thing I have interest in is making sure that an insurance/Medicare reimbursement form is filled out correctly even though that bears directly on my getting paid.

In general, our nurses and other professional staff are fantastic at what they do. Their skill sets can complement what we do in the best ways. They do, however, have a different set of requirements to show they have the skills they need. I don’t know what those requirements are. I don’t know how to make sure they stay up on their requirements. In all honesty, I don’t want to have to know that. I want to know that they are appropriately trained and that someone is keeping track of that.

When a patient has a concern about their care, accurate, justified, or not, do we want to be the one who is the initial receiver of those calls? Do we think it would be better if someone spoke to them and filtered out those that are spurious and without merit on their face? The same with intra-staff squabbles . . . or intra-physician squabbles.

What if there are things that can be done to actually supplement the income coming into the practice? Which of us has the time or inclination to keep track of all the revenue-enhancing initiatives that are out there and to evaluate how appropriate they are for our work? For all the grousing about EMR requirements, the correct implementation can lead to additional compensation to the practice in the tens of thousands of dollars per physician.

Realizing there is more than this involved, let’s take these examples and think how much less time per day we would have to do what we came into this business for—seeing patients—if it were not for administrators. All of these are ways that administrators make our practice lives better. The best administrators can be nearly invisible but always available to you. I’ll be the first to admit, there are people who seem to do little more than attend meetings. They are far from the norm and, in most reasonable organizations, do not last long in those positions.

At some point in our careers, many of us will be asked to consider some role that would have administrative aspects to it. It could involve being Principal Investigator on a trial, performing oversight duties for a tumor registry, being involved in a practice/hospital committee, or even having a position of authority in your group.

Does accepting a position like that mean you have “turned to the dark side”? Hopefully, no. You should recognize that you are trying to make things better and quickly develop, if it’s not already there, an appreciation for how much behind-the-scenes work your administrators are doing.

So, the next time you feel that urge to grumble about “administration,” take a step back and really think about all the less-desirable things they take care of so that we can be the best for our patients.


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