All practices share a basic need for infrastructure and governance, because this has direct implications on success. Regardless of the type of practice or location, there should be processes in place to monitor the execution of the entire business operation. Although not everyone in the practice will need to be proficient in this area, it’s important for physician managers and practice administrators to be held accountable as leaders.
What is organizational governance in a medical practice? Organizational governance in a medical practice consists of developing long-term strategies and a strategic direction of the practice. This involves the ability to simplify the legal structure, enhance the policies and procedures, as well as define the culture of the organization.
This should be an integral part of a practice’s plan for development and growth. Having a functioning governance system will allow a practice to be able to effectively deal with important issues that drive performance, in areas such as how to grow the practice, what new services to offer, or even how to develop affiliation partners. Although several or most decisions are made by the physician, creating an organizational dynamic that fosters group development can make a difference in the culture and success of a practice.
Practices need an administrative position to handle the day-to-day management, which includes work assignments for staff, as well as other billing and business issues. Depending on the size of a practice and its operational needs, creating a committee or group to review the governance structure and process can foster a turning point in any organization. This group will have the privilege of reviewing the key interests of the practice, focusing on the vision of the organization, creating consensus and building credibility for their recommendations. It is important for this group to have a transparent process as it works on the main issues that are important to address in the practice.
A review of governance structure and processes presents an important potential turning point for a practice. It is crucial for an effective governance structure to promote physician engagement in the process. This structure also provides leadership with the necessary tools to guide the practice through difficult decisions and choices that may not be popular among everyone. Ongoing communication with staff is critical to building the needed relationships so they understand the framework that is ahead. Physician leaders and management should be visible and approachable. Staff usually have valuable perspectives and ideas, and although they are not a part of the final decision-making process, they should always feel valued. Management of a practice goes well beyond making staff schedules, determining duty assignments and granting time off. Practices should have established means to ensure that interpersonal relationships among colleagues are valued.
Practices should have established means to ensure that interpersonal relationships among colleagues are valued.
The importance of governance should be evident because the structure and processes for governance set the tone, internally and externally, and this is how the practice is perceived and how it operates. The approach to governance demonstrates how the practice leaders exercise their authority to provide direction and oversight to the staff and to be involved with what is being done.
The practice administration should design objectives of the organizational governance performance, which should include:
- Demonstrating the knowledge to facilitate the organization’s corporate legal and governance structures; and
- Demonstrating the knowledge to integrate the corporate mission, vision and values statement into the organization’s culture.
These objectives help with defining the strategic direction of the practice and providing the roadmap to success. A unified practice will work together to ensure that all the moving parts are functioning in sync and reinforcing the duties of everyone involved. When analyzing a practice and the governance structure, it is necessary to:
- List the administrative positions and who fills each;
- Determine the process used in establishing leadership roles; and
- Create a process by which each of these practice leaders interacts with the practice associates, seeks input and gets feedback.
Lastly, each practice should have a predetermined schedule of meetings to address practice governance, personnel issues, conflict resolution, quality improvement and future planning. To be successful in this venture, the organizational governance should provide a framework for joint decision making and to facilitate collaboration and teamwork. Leaders need to drive success, have a vision, be interested in operational and clinical performance and focus on operational efficiency and effectiveness.
To learn more about organizational structure and practice management, attend the ACR practice management pre-meeting course, Transforming Theory into Practice, on Saturday, Nov. 7 in San Francisco, as part of the 2015 ACR/ARHP Annual Meeting. To register for the meeting, or contact Antanya Chung, ACR director of practice management, at email@example.com or 404-633-3777 x818 for the complete course outline.