From good to great in 2021: For practice managers looking to lift their game

Pandemic or no pandemic, running a general practice is increasingly complex, and responsibility for administration, finances, technology and people, lands with the practice manager.

Presenting for duty in 2021, practice managers must get the job done while also upping their game.

The key to the job is people, practice managers tell New Zealand Doctor|Rata Aotearoa.

In Lower Hutt, Ropata Health practice manager Adrian Tucker says a good habit managers should return to, or start doing, at the beginning of a new year is to make time to get to know their staff, and show kindness.

“As practice managers, we all want the best for our people,” says Mr Tucker, who last year won the ACC Supreme Award at the inaugural New Zealand Primary Healthcare Awards|He Tohu Mauri Ora.

“Put your team first: the team has to come before me, because they’re the ones who make the place.”

A practice manager for 10 years, he dedicates several hours each week to focus on individual training and development of the clinic’s 40-strong administration and clinical staff.

While training demonstrates to staff they’re valued, it also strengthens a practice’s performance.

Staff become invested in the success of the business, and eventually start making decisions for this.

Mr Tucker has no fear of strong candidates coming up to take over his role. “I’m continually looking to develop people that can replace me,” he says.

“You can’t be scared of somebody who can do the job as well; it just means you’ve got a strong organisation.”

DIANNE SHERROCK'S approach reflects Mr Tucker’s – at scale. Ms Sherrock, Green Cross Health’s learning and development manager, runs the com-pany’s Stellar Leadership Programme.

More New Zealand clinics are becoming part of large general practice groups such as Green Cross, which has over 40 practices treating more than 250,000 enrolled patients.

The group, which also owns pharmacies, developed its leadership programme to help its doctor, nurse lead, pharmacy and administration team leaders to “speak the same language”.

The NZQA Level 4 workshop and project-based programme helps define leadership, as well as teaching effective time management, delegating, communication and planning.

Ms Sherrock says leadership is dis-tinct from management.

“When people are training to be in clinical or administrative roles, often what is missing is training in people management.

“People are our biggest resource, but are sometimes the most challenging aspect in running businesses,” says this former pharmacy technician turned manager and trainer.

Successful leadership boils down to self-reflection, Ms Sherrock says.

“If things aren’t working [in a practice], then maybe it’s the leader that needs to change. That comes out quite a lot in the course, and for many, the penny drops.”

The proof is in the pudding for both Ms Sherrock and Mr Tucker. If patients’ needs aren’t being met, then the practice isn’t performing.

For Mr Tucker, perusing daily call logs to see if patient phone calls are answered in a timely fashion gives a good indication of whether the practice is on track. Ms Sherrock says that surveying patients works well as a way to gauge success.

Some practice managers are like the “meat in the sandwich”, employed by corporates like Green Cross that partially or fully own clinics. The practice manager should foster good relations with practice owners, Mr Tucker says.

As Ms Sherrock points out, there may be a management layer above for the practice manager to report to.

Between the likes of Green Cross and its 250,000 patients, and the 20,000-patient Ropata Health, lie about 80 per cent of the country’s 1100 general practices. These are one-clinic practices.

AT DODSON MEDICAL CENTRE on Auckland’s North Shore, practice manager Bethan Rajwer says the centre, with 7300 enrolled patients, is typical of small-to-medium-sized practices that lack the resources to provide internal training.

However, such clinics can turn to the Practice Managers and Administrators Association of New Zealand (PMAANZ) for help improving administrators’ performance, she says.

Ms Rajwer, the association’s education portfolio holder, says PMAANZ provides valuable networking and education resources.

Practice managers, many of whom have a wealth of experience but lack formal qualifications, will soon be able to gain a three-year diploma in practice management. New managers will be able to take foundation courses.

Again, fostering good relationships is key. Ms Rajwer says learning to enlist owners’ support, whether it be allowing time off to study, or perhaps help to fund study, is crucial for upskilling and improving performance.

As the number of general practices being bought out by ownership groups grows slowly but steadily, upskilling and gaining formal qualifications is also a way for practice managers to remain employable when a merger comes knocking.

It was a point made by PMAANZ chair Michelle Te Kira, when speaking with New Zealand Doctor early last year.

Shortly after that, COVID-19 saw telehealth and information technology brought to the fore in general practice.

Ms Rajwer says IT is an area practice managers must upskill in, or at least have a grasp of, in 2021.

Practising self-care through better time management is also a vital step for practice managers to take.

After 2020’s COVID-19 time-sapping stresses, Ms Rajwer made a New Year’s resolution to stick to her salaried hours by organising her time better to get more done.

Mr Tucker’s solution is to arrive early to work to buy uninterrupted quiet time to get important work done, meaning he can usually duck out before 5pm.

It’s the little things
Tips for being a better practice manager, from Kiwi experts:

• Write beginning and end-of-day to-do lists – this helps clarify and focus what needs doing.
• Delegate – frees managers to do what only they can do.
• Arrive early, finish earlyish – being first in to work buys quiet time to focus.
• Debrief your team(s) – after significant events; find out what went wrong and what went right.
• Survey – the proof is in the pudding; is the practice meeting patients’ needs?
• Network – become well informed by getting to know counterparts and health sector decision-makers.
• Self-reflection is key for understanding one’s own part in success or failure.