Leadership in interesting times: The practice manager often the linchpin for a team in crisis

Earthquake, volcanic eruption, terrorist attack, pandemic, cyclone, floods and fires and, to cap it all off, the transition to a new health system. It has been a heck of a few years.

But resilience and creativity rise out of chaos and trauma. Smarter and faster ways of running general practice have emerged and quickly become the norm, such as phone and video consultations and increased use of patient portals.

Perhaps there is no better time to move to a new health system – with our fresh agility to pivot and respond to change, especially with the Kiwi ability to apply ingenuity to make all things happen.

The American Psychological Association defines resilience as: “The process and outcome of successfully adapting to difficult or challenging life experiences, especially through mental, emotional, and behavioural flexibility and adjustment to external and internal demands.” This pretty much explains the role of the practice manager.

If practice managers weren’t already resilient, they have certainly learned it on the job. Alongside resilience, other factors influence how quickly we bounce back in the face of adversity. Most general practices are familiar with emergency and business planning, in fact, it features as a requirement in the RNZCGP’s Foundation Standard.

It is almost impossible to prepare for every type of incident. Emergency response and business continuity plans help practices get back to delivering healthcare services as soon as possible, and to do it as safely and well as possible under the circumstances.

Angela Mackenzie is practice manager at Hawkes Bay Wellness Centre, a Third Age Health practice in Napier. Ms Mackenzie says, “when it comes to mother nature, you can’t beat it” and describes her experience of Cyclone Gabrielle as “unprecedented”.

She says when local roads and bridges were closed after the cyclone, many staff couldn’t get to the medical centre. The practice team’s first thought was to “remote in” to their practice management system (PMS) so they could contact patients for wellness checks, but that was impossible – they had no data, no internet services and no power.

The whole community was cut off, there were no digital communication channels or access to information through the media. Nevertheless, the community responded quickly by checking on people door to door.

It took only a few days for Hawkes Bay Wellness Centre to get back to work; they hired a generator and opened their doors. Ms Mackenzie admits they were among the lucky few to get power back relatively quickly.

Next, they pulled together as a team, finding the best ways to serve their community, especially focusing on vulnerable patients.

Looking back, Ms Mackenzie points to a lack of community readiness. Many people lacked basic survival equipment, including radio, torch and batteries; these items were indispensable in Cyclone Gabrielle.

This is one of many stories across the country where a practice manager has led the team through an emergency.

If practice managers weren’t already resilient, they have certainly learned it on the job

Practice managers are often the linchpin of general practices, the unsung heroes, but lately many are weary, exhausted and sometimes demoralised. To add to these woes, healthcare is not attracting and retaining key members, adding to the existing burden on teams.

Keeping your practice managers happy and feeling inspired and appreciated is no easy task in these times, but there are some easy wins.

The Practice Managers and Administrators Association of New Zealand (PMAANZ) publishes a remuneration survey every two years. The survey report is free for members or can be purchased from the PMAANZ website.

The survey gathers information on the changing nature of our workplaces and provides PMAANZ, and other interested groups, with a current market remuneration guide for practice managers aligned with their scopes of practice. This year, 51 per cent of our membership responded. Salient points from the latest survey include:

• The percentage of practice managers who have over 10 years’ experience has decreased.
• Fewer practice managers are undertaking professional study compared with the 2020 survey.
• Only 6 per cent of respondents have PMAANZ practice management qualifications.
• Sixty-two per cent of respondents attended the PMAANZ national conference, with 94 per cent finding it beneficial.
• Twenty-two per cent of practice managers receive performance bonuses.

So, if you are wondering how to show appreciation for your practice manager or inspire and invigorate them in their work, we have some ideas below

PMAANZ, in collaboration with UNE Partnerships, offers a series of short courses and a diploma of leadership in healthcare practice. Scholarship opportunities are available.

Employers can consider supporting and encouraging their practice managers to extend their professional development to bolster their skills and job satisfaction.

Feedback from the conference tells us the educational content is on point, and the networking and social aspect are equally as valuable. If you are not already supporting your practice manager to attend, perhaps you may want to consider it.

PMAANZ believes all our practice managers are awesome, as are their teams. So, a huge shout out to you all for the good work you do.

To readers who believe their practice manager is amazing, there is no better way to show your appreciation and admiration than nominating them for the PMAANZ Practice Manager Specialist of the Year Award.

Ka kite.

Heidi Bubendorfer is national secretary of the Practice Managers and Administrators Association of New Zealand