Do you really need an office manager?

Key Points

One reason to have an office manager in a medical office is to have someone to whom patients-and staff-can complain without interrupting the doctor. If the quality of service in your office results in a lot of requests for the manager, then having a manager might be worthwhile to you, but it's probably not the best long-term solution to the issue of complaints. Maybe what you need is better management.

"Management" is not synonymous with "having a manager." You can have good management without a manager and bad management with a manager. You can have a good manager under bad management, but it is far rarer to have a bad manager under good management. Often, when we find a bad manager, we also find physician leadership that has abdicated management responsibility.

Other than fielding complaints, there are a number of good reasons for a medical office to have an office manager. An office manager's duties fall primarily into three main categories:

1) Interpersonal. Your office manager is an intermediary with the people surrounding your practice. He or she manages-or supports-relationships with patients, your staff, hospital staff, vendors, advisers, outside services, and colleagues. He or she acts as a symbolic figurehead liaison and leader, whether he or she has been granted any real authority. The office manager should inspire staff members to do what is necessary to please both patients and providers with great performance, and to look for ways to improve.

2) Informational. Your office manager is commonly the custodian of your office's information, both internal and external. He or she is the person to whom others turn to for data and answers. Office managers have informal and scheduled reporting to the leadership. He or she often has previously worked in every staffing position in a medical office, even if not in the current employer's office. He or she understands and transmits information between outsiders, staff, and leadership; for example, employment policies and office rules to staff, billing and financial guidelines data to patients and accountants, and practice management data to the physicians. He or she organizes, files, and retrieves the practice's nonclinical data and personnel records. The office manager also may ensure a practice's compliance with the Health Insurance Portability and Accountability Act, the Occupational Safety and Health Administration, Medicare and Medicaid, managed care organizations, and labor laws.

3) Decisional. Office managers make and implement decisions so the physicians don't have to. Many office managers have responsibility for finding, hiring, training, and firing staff and vendors. They might decide where and when to recruit new providers. They handle disturbances and crisis with staff and patients and between providers. Office managers also allocate resources, decide staff schedules and vacations, and may decide whether a practice can afford a new electrocardiograph or an electronic health records system. Office managers often have entrepreneurial authority to negotiate leases, contracts, and add ancillary services. They commonly decide agendas and lead meetings. Office managers make decisions that affect the business-health of the practice.