:: Effective Delegation ::

In today's volatile and competitive healthcare marketplace, a competent business manager or administrator is vital to the success of your practice. However, if you do not effectively delegate the operations of your practice to your manager, most likely it will be very difficult to attain maximum profitability and whatever goals you have set for yourself. Effective delegation involves trust, confidence, responsibility with authority, empowerment, clarity, checks and balances, and communication between you, the delegator, and your manager, the delegate. Effective delegation is not dumping operations and then hoping all goes well.

Most physicians are actually very competent when it comes to clinical delegation. In a busy practice, you cannot do everything yourself. You rely upon a clinical team, which may include physician assistants, nurse practitioners, nurses, lab and x-ray technicians and medical assistants. Physicians effectively delegate authority and the responsibility to members of their clinical team. It's clear what these team members can and cannot do. They are allowed to do their jobs with minimal oversight by the physician. There are adequate checks and balances and there is communication so that everyone is on the same page when it comes to a particular patient. Consciously or not, physicians are probably good clinical delegators because they are in their comfort/knowledge zone.

Unfortunately, this effective delegation on the clinical side does not always transfer over to the business side of the practice. Ironically, this is the very side of your practice that requires effective delegation just because it is outside the comfort/knowledge zone of most physicians. Effective delegation is evident when the administrator is empowered and entrusted by the partners to manage the resources of the practice, freeing the physicians to concentrate on the clinical aspects of the practice.

I have found that effective delegation to the business manager/administrator has occurred in a medical practice when all of the following are evident.

1. There is an acknowledged physician leader or at least a managing partner.


2. The partners meet on a regular basis with the manager who prepares an agenda.


3. The manager has a written job description.


4. The partners evaluate the manager every year.


5. The manager evaluates the support staff every year.


6. The physicians treat the manager as a partner.


7. There is a business plan or annual budget.


8. Partners approve policies and procedures and allow the manager to enforce them.


9. The practice's outside accountant works with the manager.


10. Partners don't micromanage the manager, but hold him/her accountable.


11. Partners support the authority of the manager when it comes to staff and policies.


12. Tough issues are addressed and decisions are made on a timely basis.

Everyone defines "success" differently. It has been my experience that physicians who have effectively delegated the business side of their practices tend to be more content, work smarter and earn more than their colleagues who tend to either micromanage the business side of their practices or completely disregard the business side. If you are uncomfortable with the business side of your practice, or you are not achieving your goals, it might be a result of poor delegation. If you are uncomfortable resolving this, you may want to consider bringing in a practice management consultant to work with both the partners and the manager on effecting the changes necessary to achieve success.