By Evan Leepson, MBA
The following is the fifth in a series of articles looking at quality improvement issues at two fictional, and distinctly different, radiology practices. Each installment will examine a different clinical or socioeconomic issue, and will show how each practice solved the problem. Hopefully, their examples will provide lessons that real-world radiology practices can use to improve the way they deliver medical imaging services.
"It was the best of times…it was the worst of times."
Charles Dickens, 1859
One of the many problems facing Reactive X-Ray Partners is the lack of effective administrative support. I was going to say lack of administrative leadership, but this radiology practice would never let an administrator take a leadership role in the management of the practice. After all, the administrator’s job is merely to support the radiologists. So, let’s take a peek from the administrator’s perspective, and see what a typical day looks like for Reactive X-Ray Partners and its more progressive counterpart, Proactive Imaging Associates.
The beginning of each week at Re-X is affectionately known as Black Monday. Senior partners have had all weekend to think up ways to improve the practice, enhance revenue, and change the way things are handled. This adds up to a major staff panic on Mondays.
The panic is twofold. First, anticipation of a major change increases the staff’s anxiety level. In the coffee room at Re-X, a typical Monday finds plenty of buzzing and speculation about what may happen. Second, the actual announcement causes even more angst. These unplanned and frequently misguided suggestions are presented to the business manager. The partners usually insist they be implemented immediately. What’s a business manager to do?
Re-X’s business manager, Ralph, has noticed an increase in clerical staff absences on Mondays over the past six months. The partners brush off the news: "Those are just disgruntled employees … they’re a dime a dozen to replace."
Ralph acts as Re-X’s concierge, while his counterpart at Proactive Imaging Associates actually has administrative leadership responsibilities. The concierge model of management can work only for groups with no more than four radiologists. The concierge’s main function is to be at the beck and call of any superior. The concierge is constantly in motion, doing everything from responding to patient-related crises to fixing computer viruses.
It is important to remember that business managers generally do not deal with partnership issues. The president or managing partner handles this delicate responsibility.
Back at Re-X, Ralph is dealing with the latest crisis du jour. It’s an unexpected telephone call from a collection agency. A local radio station apparently hasn't been paid for a mammography advertisement that aired recently. The radio station is demanding payment, and Ralph feels caught in the middle. He's not authorized to sign off on any invoices.
Should he discuss this with the managing partner on Black Monday? Should he negotiate a payment plan or a reduced fee? Ralph decides to simply wait for another call from the collection agency: Maybe the problem will go away if ignored.
Meanwhile, PIA’s business manager is updating job descriptions for all clerical staff and developing bonus and incentive plans. As he works away, the phone rings. It’s the office manager at their imaging center -- the on-site radiologist was just rushed to the hospital with an attack of kidney stones. The business manager immediately pulls up his computerized schedule and determines which radiologists are available. Using their new cell phone/two-way radio system, the replacement radiologist is on the job within 45 minutes.
At Re-X, Ralph is already exhausted and dreads the next encounter with the practice partners. "When in doubt," says Ralph, "hide." So Ralph takes a slow walk over to the hospital to commiserate with the radiology department manager. As soon as he arrives there, the senior partner calls about a meeting. Welcome to Black Monday.
Evan Leepson, MBA, is a nationally known author, speaker, and strategic planning and marketing consultant. He can be reached at [email protected]. Check out his Web site at www.leepson.com.
June 29, 2000
(Click on the headlines below to view previous articles in the "Tale of Two Practices" series.)
A Tale of Two Practices, Part IV: Marketing is not going to the supermarket
A Tale of Two Practices, Part III: All in the family
A Tale of Two Practices, Part II: When family ties are binding
A Tale of Two Practices, Part I: An ongoing saga
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