Office managers

[PMG03470]

This may seem like a silly thing to post about, but I don’t think it is talked about enough. A lot of you on here don’t work in PP, for those who do or did I’m curious what your experience was…

If you saw my previous post you would know I had a rough first year out of residency. But one thing that still bothers me is the fact that the office manager at my first PP job thought she was my boss. The hierarchy was (owner-office manager- long time office staff- associates - new office staff). Even the MAs who had been there for years tried to tell me what to do all the time. This is something I never really thought of when I was look for jobs the first time around. However, since this really bothered me the second time around I started asking more when interviewing about what the office managers role was.

To my surprise some places very openly told me that the office manager had full control over everything and they would be the ones to tell me what to do and dictate my schedule etc. Other practices (like where I joined) the office manager mostly manages the staff and schedules, but anything that needs to be discussed would be between me and the practice owner. For example when I need a day off I ask the owner not ask the office manager for permission.

So, I’m curious what everyone else has experience and what you think is right. Do you think an office manager should be the “boss” of the associates?

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[Sweatshirt]

When you say office manager do you mean the owner podiatrists wife?

 

[PMG03470]

When you say office manager do you mean the owner podiatrists wife?

I asked everyone about that too and the 1 practice who had that set up I quickly declined.

My previous position it was the owners friend from high school, but she was one of the worst people I have met in my entire life. She was over all a terrible miserable person.

 

[heybrother]

Its pretty clear to me from reading job postings that at many jobs your clinical judgement will also be subsumed to the interest of the practice. If you've ever seen a job that talks about "learning our system" or anything like that you will be pushing and dispensing laser, creams, customs, etc in the manner that they tell you regardless of what you or the patient wants to do. If a job talks about a "training period" - same thing, run.

My presumption is that the office manager is routinely in charge of associates at malignant practices. You are just an employee after all. This is especially relevant if you are a place with multiple associates, a history of associate turn-over etc.

The price of freedom is ownership. I highly recommend it, but it comes with its own costs.

My wife doesn't currently work for my practice as I have young children. At some point I intend to get her involved though only for the purposes of pursuing denied claims. Guess I'll have to be very clear with future hires what her role is.

 

[dtrack22]

My wife doesn't currently work for my practice as I have young children. At some point I intend to get her involved though only for the purposes of pursuing denied claims. Guess I'll have to be very clear with future hires what her role is.

It’s smart to have your spouse as an employee for tax and retirement purposes. That’s assuming they are productive in what they do and they don’t have their own career path that would provide income/retirement. Nothing wrong with having wife or kids do stuff for the practice. But having your spouse run the practice will end up driving off staff/associates in almost every case.

 

[dtrack22]

So, I’m curious what everyone else has experience and what you think is right. Do you think an office manager should be the “boss” of the associates?

No. It should feel like the office manager works for you. You tell them when you are going to be out so they can make the appropriate staffing arrangements and facilitate scheduling changes. They ask you for documentation so that they can get you credentialed with a new facility. You tell them if there are issues with workflow or staff and they work on the solution.

The office manager works for you, even as an associate. You are paying their salary with whatever % of collections the practice is taking from your revenue to cover his/her salary.

All of that being said, it absolutely will not work that way in a vast majority of podiatry practices you interview at. The office manager is above you in the practice hierarchy in most cases and even though it shouldn’t be that way, it will be.

 

[CutsWithFury]

Its pretty clear to me from reading job postings that at many jobs your clinical judgement will also be subsumed to the interest of the practice. If you've ever seen a job that talks about "learning our system" or anything like that you will be pushing and dispensing laser, creams, customs, etc in the manner that they tell you regardless of what you or the patient wants to do. If a job talks about a "training period" - same thing, run.

My presumption is that the office manager is routinely in charge of associates at malignant practices. You are just an employee after all. This is especially relevant if you are a place with multiple associates, a history of associate turn-over etc.

The price of freedom is ownership. I highly recommend it, but it comes with its own costs.

My wife doesn't currently work for my practice as I have young children. At some point I intend to get her involved though only for the purposes of pursuing denied claims. Guess I'll have to be very clear with future hires what her role is.

I'm never working at your practice if your wife is employed there.

 

[CutsWithFury]

Agree on what has been said above. If you are in private practice and they want you to learn their system then they are trying to groom you for their most profitable practice management styles. Which border on fraud vs medically unnecessary. Podiatry is such a terrible profession I would hang myself if I worked in private practice. The only peace of mind I get is working for a hospital where they at least pretend I am a real person and physician.

In hospital based practices the practice managers literally have no say over the doctors. I've never seen it. The hierarchy in the hospital system is that the doctors ass blast the manager who ass blasts the MA/nurses working in the clinic and the schedulers.

 

[heybrother]

Haha, "podiatry grooming". Its real.

 

[heybrother]

It’s smart to have your spouse as an employee for tax and retirement purposes. That’s assuming they are productive in what they do and they don’t have their own career path that would provide income/retirement. Nothing wrong with having wife or kids do stuff for the practice. But having your spouse run the practice will end up driving off staff/associates in almost every case.

I've seen both sides of the above. My wife actually worked for a company where the owner's spouse worked "just enough" (they didn't) to earn a full 401k match. The final version of my associate contract actually included an overhead based payment structure, albeit it of course landed during the pandemic. The office manager let me look through the finances and one of the things I was definitely looking for was essentially payments/401k matches to people who weren't working that would be driving up the overhead.

 

[Pronation]

Agree on what has been said above. If you are in private practice and they want you to learn their system then they are trying to groom you for their most profitable practice management styles. Which border on fraud vs medically unnecessary. Podiatry is such a terrible profession I would hang myself if I worked in private practice. The only peace of mind I get is working for a hospital where they at least pretend I am a real person and physician.

In hospital based practices the practice managers literally have no say over the doctors. I've never seen it. The hierarchy in the hospital system is that the doctors ass blast the manager who ass blasts the MA/nurses working in the clinic and the schedulers.

I get what you’re saying but just as a teaching point to new hospital employed folks: you attract more bees with honey. Bring the practice manager (or whatever their hospital assigned title is) a box of cupcakes whenever you need have a conversation about work related issues. Same with everyone else that you deal with (nurses, MAs, scheduler).

 

[CutsWithFury]

I get what you’re saying but just as a teaching point to new hospital employed folks: you attract more bees with honey. Bring the practice manager (or whatever their hospital assigned title is) a box of cupcakes whenever you need have a conversation about work related issues. Same with everyone else that you deal with (nurses, MAs, scheduler).

No

 

[air bud]

No

Lol

 

[Boba Foot]

Agreed with what @dtrack22 said-- your collections pay the bills and keeps the door open. Very little of what office manager Karen does brings in actual direct revenue. You went to school/residency for ~10 years for the expertise to collect that revenue, office manager Karen did not. Don't let the lady with the big hair own you. Assert your dominance.

 

[Feli]

It's not a either/or thing... it's a cooperative relationship. Neither is above/below the other. We are all apes wearing cloth.

The doc(s) at the office are the producers... seeing patients, doing procedures, etc.

MAs are there to expedite with setups, supplies, doing notes. Front desk greets patients, puts the schedule together, fields the calls.

The office manager is the one who connects the dots and makes things happen... training, supplies, staff, scheduling, etc.

If you micromanage, they'll hate you (the manager or others). Just tell them what you need... and see what happens. Even in a hierarchical system, the people who bark orders or tattle on others or go around people to get what they want are simply laughed at behind their back. Do that stuff at your own peril.

State the goal ("I want to see about 25 patients per day," "it's important we have instrument X in every room," "med assist Y is having a tough time with ingrown setups and bandage setups and I need that to improve," "let's change the schedule to have last patient at 3pm on Tuesdays," "I've had a few patients tell me that the waiting room isn't getting cleaned enough for the COVID era"). If things you ask don't improve, ask again... or go to the owner (or the manager's manager if it's a big group with that sort of structure). If you are are the owner and the staffing, supplies, etc aren't going the way you're asking for, try a new manager.

The office manage should be your partner in PP or any situation. It's amaaazing what can happen if they like you. They see angles you don't... and you have goals and ideas for them to hash out how to implement. If you happen to get an incompetent one, you need to replace them or make it very clear to the ownership. If you get or create a good manager and have a nice relationship, that's the main ticket to a sweet job and a fun workplace. It does not matter who gets the credit; you'll both look like rockstars. I get gifts or give bonu$es to my office manager even more than the others since the manager makes or breaks my productivity and job quality. You will be surprised what good things happen if you stick to your role and help others to look good by giving them suggestions or subtle ideas or encouragement.
"Our chief want is someone who will inspire us to be what we know we could be."

 

[Scrantonicity]

I second that it's important to be in a partnership with the office manager (as an associate). Stay on their good side, and maybe even be friends if possible.

Mine will tell me the gory details/office gossip (things the owner or owner's wife say or do that I'm probably not supposed to know). I do caution to be careful though--cause chances are she's doing the same on the other side (telling owner or owner's wife things you do/say--after all, the owner signs their paycheck).

Anyways, play nice and they can make sure your life is a little bit easier. They really shouldn't be over the doctors in the hierarchy, but the reality is that they can make your life a living hell if they want to--so that naturally puts them above you in many ways.

 

[PointyNippers]

In my private practice, the owner has full power over the direction of the practice, such as office hours, when to close during holidays, what products to keep in stock, etc. The staff also loves him since he does take everyone's opinion into consideration as well. The office manager has a strong advisory role (she's pretty smart and great at what she does, esp with billing/coding); and we definitely listen to her whenever she has input. There's no malicious intent, and everyone knows their role. I am able to tell the practice manager if I need days off or to block my schedule, she doesn't dictate what I do. I also come to her with advice/questions often since I know that she knows way more than I do when it comes to practice management. Everyone's also aware of the fact that the more the practice succeeds, the better everyone's life will be lol

I guess this is a relatively rare situation from what I've been hearing from other private practices, but I feel like this is how the dynamic should be.

 

[PMG03470]

In my private practice, the owner has full power over the direction of the practice, such as office hours, when to close during holidays, what products to keep in stock, etc. The staff also loves him since he does take everyone's opinion into consideration as well. The office manager has a strong advisory role (she's pretty smart and great at what she does, esp with billing/coding); and we definitely listen to her whenever she has input. There's no malicious intent, and everyone knows their role. I am able to tell the practice manager if I need days off or to block my schedule, she doesn't dictate what I do. I also come to her with advice/questions often since I know that she knows way more than I do when it comes to practice management. Everyone's also aware of the fact that the more the practice succeeds, the better everyone's life will be lol

I guess this is a relatively rare situation from what I've been hearing from other private practices, but I feel like this is how the dynamic should be.

This is similar to my current set up. The office I worked in last year was just a miserable place in general.

I never intended to make it sound as though I’m above anyone. But some places I was interviewing very specifically told me that I report the the office manager and she dictates what I do, and it just seemed strange to me.

I agree with above posters that there should be mutual respect, not one above another. But I also don’t think that the office manager should be the one to tell me what to do.

 

[GreenHousePub]

With office managers - the bigger, the better I always say.

 

[podwho]

Well yes, if you have a large enough practice (about 6+, but certainly over 10+ doctors), then yes the office manager should be in charge of you. They work for the practice, not for you, but are there to support you as well. They should be in charge of making sure the practice is doing all the right things to grow and be profitable, not your personal assistant.

The owner (assuming they also practice) has no idea what your vacation time, personal supply needs, MA needs, billing issues and schedule is. They dont care - its a waste of time that distracts from seeing pts aka making money, which is why they hired a manager. If you cant resolve a problem then sure go to the owner, they hired you (maybe). But the relationship should be mutually beneficial. Inter-personal office relationships is a profesionalism problem everyone has to address as professional adults.