Nicky Of Oz

A series revealing practice management wizardry from Nicky’s health industry experience of 30+ years

Introduction

Being a Practice Manager in General Practice is challenging, rewarding and frustrating all at the same time. Protocols are consistently changing along with Medicare item numbers and new initiatives which are thrown onto General Practice at the last minute. Don’t get me wrong, it is an exciting profession to be in and you are constantly learning. It also helps if you have a good sense of humour and thick skin.

I have been in the Australian health industry for over 30 years. I migrated from the UK and started working for an ENT surgeon in Sydney. He was also new to Australia and setting up a new practice. It was also the first time that computers were used in general practice. I can still remember going in for a typing test for my interview. I was tapping away and nothing was happening. Both the ENT surgeon and I were complaining about the typewriter as it was new and appeared to be broken already. It turned out that the typewriter was not plugged in. Those were the days. Plenty of laughs over the past 30 years and many friends and colleagues made.

The aim of this blog is to supply as much information as I can to you as it currently stands in 2022. I hope to retire in the next few years and have learnt so much. It is a shame to retire without passing on what I have learned. You will also read some funny stories – all anonymous of course, but refreshing and real. I hope you enjoy reading these blogs.

Chapter 1 : Where Does A New Practice Manager Start?

I get asked this question all the time. Sometimes it is from managers new to the health industry and sometimes it is from managers who have taken a new job at another general practice. Let’s start with someone who is new to the health industry and wants to manage a general practice.

New to the health industry

There are many courses you can take. The one I did in the 1990s was the Practice Managers course through the University of New South Wales (UNE). If you Google Practice Management Courses, an array of institutions is listed including TAFE. The reason I chose UNE is because they are in partnership with the Australian Association of Practice Managers (AAPM) and I believe that the partnership does give credibility to the course. I specifically did the Diploma of Practice Management. However, there are many UNE related management courses now including one for an Office Manager, Medical Assistant etc.

When considering a course, you should also think about what you have studied already. These courses will teach you about the “business” of the practice but they won’t really teach you about the operations of a practice. Most of that needs to be done by reading articles from people in the industry or joining social media groups. There are many Practice Manager Facebook pages. I would recommend joining them all. Practice Managers ask questions or share their management tales on the sites and many practice managers apply from around Australia. It is a good learning tool. I still learn something new each time I hop on and have a look.

I would also look at the accreditation sites. Most General Practices are accredited. What this means is that they have policies and procedures written for the practice and adhere to the RACGP 5th Edition Standards. Most General Practices get accredited through either Australian General Practice Accreditation Limited (AGPAL) or General Practice Accreditation (GPA). There is a lot of information on both of these sites and they also have great webinars. When your practice is going through accreditation, you also have access to a lot of other resources. General practices do not have to be accredited. However, to receive government grants, the practice has to be accredited. Some small practices do not feel the need for this process as it can be quite expensive. Personally, I love the accreditation process. It keeps general practices in line and can really help staff and doctors understand risk. However, I won’t go into accreditation too much in this chapter. That is going to be given its own chapter.

The one thing to keep in mind with this industry is that the rules change all the time. During the Covid pandemic, Medicare items changed on numerous occasions and also the rules for offering Telehealth to patients. Even experienced practice managers have been tearing their hair out. So don’t beat yourself up if you are struggling at first. Some of the best practice managers I know are those who are new to the industry and constantly updating themselves with education.

Taking over the management of an existing practice

I have done this many times throughout my career and also as a remote practice manager. There have certainly been some situations where I have raised my eyebrows at the thought of streamlining (sometimes a big mess) and getting on top of everything. So basically, what I do, is go through the filing system whether it be paper-based or on files in the server. During this process, I check documents like insurance policies i.e., make sure they haven’t expired, staff folders etc. I also prepare the practice as if it is going through accreditation. During this process, I usually find where “all the bodies are buried” and start putting items into place and establishing new protocols.

HR issues with staff can also be quite time consuming when taking over management. It is a bit like changing the government. Staff are usually sceptical about what changes you are going to make and also some think that they could have done the job instead of a new manager. Whatever the staff reaction, my advice is to be upbeat and friendly. Ensure staff that nothing is going to happen overnight and you are going to work with them to ensure they understand what is happening. Communication is key. In saying that, don’t let yourself be intimidated by staff or doctors. You are employed as a practice manager because that is your skillset. The other staff cannot do the job or they would have been hired. So, stay professional and friendly and take things slowly.

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