Administrator Corner: Patricia A. Brown           Patsy Brown, administrator for the 16-physician Internal Medicine practice of Summit Medical Associates (SMA), is widely recognized as an industry leader. In addition to overseeing operations of the large practice, she is also responsible for the management duties of Summit Medical Center’s hospitalist program, which SMA staffs. Brown has sat on the boards of the state and local MGMA affiliates and is a past president of NMGMA. She is also a member of the Tennessee Group Practice Coalition, the past president of Summit Medical Center Office Managers Council and a member of Nashville Medical Group Executives, a gathering of administrators from the area’s largest practices to discuss key issues. During her three decades in practice management, Brown has seen the administrative landscape become increasingly complex with continued government intervention. It now requires more employees to get paid less, which is an unsustainable situation, she noted. Brown added the best defense is a strength in numbers strategy. Organizations such as NMGMA and its state and national counterparts represent individual practices and allow the voices of their constituency to be heard by all levels of government. What is the best advice for effectively managing a practice? The key component to managing a medical practice successfully is effective communication with physicians and employees. When implementing new services, policies and strategic plans, it is critical that every team member understands their role and how it relates to the overall success of the practice. Additionally, annual physician retreats enable the group to focus on long range planning goals. As an administrator, what do you worry about the most? The threat of Congress cutting Medicare rates by 10 percent this month is a major concern. As reimbursement decreases and operational expenditures increase, managing the finances of a medical practice becomes more complex. We’re lobbying through MGMA National to educate and stop Congress. Our practice is also a member of the Tennessee Group Practice Coalition, which is made up of about 40 practices over the entire state representing 1,200 physicians. We have hired a lobbyist to work on the state level to be aware of legislative issues and oppose legislation that is not in the best interest of practices. Having a lobbyist has absolutely made a difference just having someone to stay on top of legislation, committee meetings and what bills could impact us is important. NMN Note: In addition to proposed Medicare cuts, which also impact private insurance contracts, Brown said another timely issue is transparency. We also have transparency concerns not the concept but inaccurate reporting of physician data and the inability of consumers to interpret and translate the data into useful information for physician selection. One concern is that cost averages are being reported for ETGs Episode Treatment Groups but these are very broad-based groups. For example, otitis media might have an average cost of $400, but some patients just need antibiotics while others need surgery. In that case, $400 might be too much for some patients but not begin to cover the cost for others. With everyone now searching for information online, how vital is a Web site in reaching out to patients? For Summit Medical Associates, the Web site is the window to the world. In today’s healthcare environment, it is an essential communications tool for existing and potential patients. It provides you with the ability to brand your medical practice, market your extensive services and profile physicians. Through secure portals, patients can utilize Web sites for convenient services such as online bill payment, scheduling appointments, requesting referrals, completing registration and health history forms, obtaining lab results, prescription refills and to obtain accurate medical information. This enhances workflow and efficiency within a medical practice. Web site development should be a high priority for any medical practice. NMN Note: Brown added that functions that can be safely relegated to online communication help streamline the process and free up staff time thereby allowing a practice to operate more efficiently, which is imperative in the current reimbursement landscape. What advice do you like to pass along to young practice managers? Practice administrators must be willing to embrace the ever-changing healthcare environment that we operate in today. Connections with other administrators and mentoring programs are extremely important for new managers and older ones, as well! July 2008