3 Reasons You Need an Office Manager

Does your practice have an office manager? You might want to consider hiring one. Here are the key benefits of an office manager, including points to help you decide if hiring one is right for your practice.

Recently we read an article that got our attention by making the following three statements about office management: (1) “One of the biggest costs in any business—medical or not—is employee incompetence,” (2) “Management is a learned skill,” and (3)” ‘Evidence-based management’ is as similarly important as ‘evidence-based medicine.’”

Let’s explore these three thoughts further.

Employee Incompetence
Employee incompetence is a common problem in many practices. We’ve all heard and seen things when walking through the practice that makes us wince. We thought staff was trained appropriately, but obviously, based on what we saw or heard, there’s a problem somewhere.

The most common drivers of incompetence are: laziness, poor communication (just because you’ve said something doesn’t mean the other person understood), lack of people skills and lack of training. So, who in the practice is addressing these drivers of incompetence?

Is the doctor the best person to handle these drivers? Not always. Often the doctor has a very distorted view of what is happening in the office. The doctor spends the majority of their office time in the examination rooms in back of the office.

A staff member bringing to the doctor a problem occurring in the front of the office often gives the doctor a perception of the problem which may not be an accurate description of what is really going on. It is the perception of that staff member. Other staff members may have different perceptions. If there is no office manager, the doctor must investigate to get an accurate understanding before making a decision. That takes time. Time that the doctor could be spending on patient care, or time the doctor has to add on top of patient care.

An office manager – one with time dedicated to management – is the best person to address the drivers of incompetence. The office manager is going to have the best understanding of what is going on in the office with both patients and staff. Rather than being reactive, a good office manager is proactive in handling the four drivers of incompetence because the office manager is managing in real-time, versus the doctor, who will hear about what happened in past-time.

Management Is a Learned Skill
One of the core tenets of any successful person is the drive to always become better. There is always something new that can be learned that enables you to do your job better. But some staff members (and some doctors) have plateaued. Learning has stopped. Performance improvement has plateaued. The office manager is no different.

Here’s a core question that needs answered: Have you provided targeted, effective and ongoing training for your office manager? In many practices the office manager is given the title, but no, or little, training on how to do the job. When this happens, beware the Peter Principle. “According to the Peter principle, employees continue to be promoted as long as they perform well in their roles; as a result, they rise to their level of incompetence: the point at which they fail to do a good job.”

The antidote to the Peter Principle is training. Even the office manager needs training. Training on how to do their job. Training on how to manage people. Training on how to move the practice forward.

Let’s make a list of what we want the office manager to accomplish, so we can see what training is needed.
Starting with the big picture, there are two primary things that we want from the office manager. They are to ensure the smooth functioning of the practice and to help grow the practice.

To ensure the smooth functioning of the practice, the office manager needs to manage at least these things:
1) Find, hire, train and fire staff and vendors
2) Keep and enforce office policies
3) Ensure that expenses remain as low as possible
4) Handle problems with staff and patients
5) Make and implement day-to-day decisions
6) Allocate resources, decide staff schedules and vacations
7) Supervise and manage employees in a fair and consistent manner

To help grow the practice, the office manager needs to manage at least these things:
1) Inspire staff members to perform better
2) Look for ways to improve the practice
3) Report to leadership
4) Plan with leadership
5) Implement the leadership plan

So, how does the office manager get the skill-sets necessary to ensure the smooth functioning of the practice, and to help us grow the practice? Training. This is not a one-and-done. Training is an ongoing activity, so the office manager is doing the job better and better. We need to make sure that we invest in training for our office managers.

Evidence-Based Management
In the 1990s, we began to hear about evidence-based medicine. Now the concept of “evidence-based” has expanded to include other disciplines, including business management.

“The starting point for evidence-based management is that management decisions should be based on a combination of critical thinking and the best available evidence. And by ‘evidence,’ we mean information, facts or data supporting (or contradicting) a claim, assumption or hypothesis. Evidence may come from scientific research, but internal business information, and even professional experience, can count as ‘evidence’.”

We believe that practice management rule number one is measure to manage. There are three things about a practice that need measured: (1) how are we doing now compared to last year, (2) how are we doing compared to other like-sized practices, and (3) how are we doing compared to our goals. This information is available in the office practice management software and from reports from vendors in our profession.

With a little work you can establish reporting systems that gather this information for you, or you can purchase dashboard management software that can do this for you.

Training your office manager on how to read the numerical evidence, and how to use an evidence-based management approach, maximizes the performance of your office manager. When done properly, this approach enables the office manager to do the job in such a way as to ensure the smooth functioning of the practice and to help grow the practice.

i. http://medicaleconomics.modernmedicine.com/medical-economics/news/modernmedicine/modern-medicine-feature-articles/do-you-really-need-office-man?page=full
ii. http://work.chron.com/causes-incompetence-workplace-2947.html
iii. http://whatis.techtarget.com/definition/Peter-principle
iv. https://www.cebma.org/faq/evidence-based-management/



Dr. Wright is the founding partner of a nine-partner, three-location full-scope optometric practice. As CEO of Pathways to Success, an internet-based practice management firm, he works with practices of all sizes. He is faculty coordinator for Ohio State’s leading practice management program.


Dr. Burns is the senior partner of a nine-doctor full-scope optometric practice that she built with her husband, Dr. Wright. She is also the COO of a state-wide nursing care optometry practice. Dr. Burns lectures nationally on practice management and staffing issues. Dr. Burns authored the Specialty Practice section of the textbook, Business Aspects of Optometry.


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