HR Management for the Physician Practice Manager

Understanding the responsibilities of being a human resource (HR) manager involve not only the hiring and firing of employees but knowledge of the medical practice’s mission statement and the goals trying to be achieved. More importantly, legal issues with laws such as Discrimination and Wrongful Termination, Americans with Disabilities Laws, Occupational Safety and Health Act, Fair Labor Standards Act, and the Family and Medical Leave Act. For detailed information and current regulations, it is best for the Physician Practice Manager (PPM) to reference the laws at Web site: www.dol.gov. The United States Department of Labor offers full descriptions to assist the PPM maintain a legal environment. Don’t ignore this area of managing the practice. Violation of labor laws typically result in civil monetary penalties as well as imprisonment.

Employees have rights, and labor laws have set standards to protect these rights. In addition to federal laws, PPMs should contact their state’s labor commission to be knowledgeable with applicable state laws.

So let’s begin with “hiring” an employee. An important role for the HR manager is finding the “ideal” employee for the job. Being able to find an employee with skill sets as well as the personality that meshes with the philosophy of the practice can be challenging. However, it is worth the time and effort to locate someone with the skills and congenial personality to work for the practice because it not only creates successful relationships, but high productivity rates and overall satisfaction between managers, employees, and healthcare providers.

To recognize the most qualified person for the job, you will need to write a very specific job description identifying the requirements of the position – that means including as much detail as possible to provide a clear picture of what is expected in the job. By having a job description in place, the PPM can use the information as a performance measuring tool for evaluations. A job description holds new hires accountable for their actions.

When recruiting for a job position, PPMs can often hire within a large organization or from the outside. In larger organizations, jobs are typically posted in an area where all employees can see what jobs are currently available and shows value to internal candidates. If jobs are listed outside of the practice, interested parties can find information on the organization’s Web site, or job posting websites such as www.careerbuilders.com, www.monsters.com, and www.indeed.com. In addition to Web site job locators, companies such as the Medical Group Management Association, www.mgma.com offer leads and don’t forget www. and www.aapc.com for leads as well. Depending on how you find your new hire, fees may come into play so be conscious of what companies charge for helping you recruit a skilled employee.

Discriminatory questions for employment must be avoided at all costs. Some of the areas that cannot influence an employment decision are: age, race, religion, national origin, or disability. Questions that are appropriate to ask in an interview can be about prior work history, if the person is related to anyone within the organization, what level of education they have earned, if they are an American citizen, been convicted of a crime, or worked under another name.

It is wise to perform preliminary interviews on the telephone to weed out unqualified prospects. When actually interviewing a candidate, listen carefully to their responses to assess their knowledge and abilities on how to handle specific job responsibilities and how they would work with the current staff.

Effective questions should focus on the specific skills the candidate can bring to the practice. In a medical practice, specific questions regarding front desk operations, coding, or billing will indicate the level of knowledge the candidate has. Mini tests or keypunch skills are also a good way to determine the skill level required for a specific job. It is also very important to see how a candidate would handle a situation that might arise within the practice. It is very important to foresee future behaviors of a potential hire. Do they work best alone or in a group? How have they handled a problem co-worker? What types of situations cause you stress on the job? Depending on the type of job you are posting, it might in the practice’s best interest to provide aptitude tests, proficiency tests and even psychological tests. Do not take chances on candidates either. Do your background checks and check references.

Human Resource Management for the Physician Practice Manager

Before you develop a list a questions for your interview, know exactly what qualifications you need for the job. Inform the candidate of their probationary period and re-evaluation. If the employee’s performance is not meeting expectations, the PPM should set up a time to go over her concerns and determine a Performance Improvement Plan with an additional 90 days of assessment.

Once an employee becomes permanent, it is best to perform employee evaluations that are not tied to compensation or other payment incentives. PPMs also want to be sure that they keep their employees motivated since it affects production and quality service.

In a medical practice employees must possess exceptional patient service, clinical skills if required, and quality documentation. Many of these skills can be offered through medical coding courses at www. and www.aapc.com. Once an employee becomes certified in a certain area of a medical practice, recognition is essential.

Sometimes an employee just doesn’t work out or they make the decision to leave. In cases such as this, PPMs MUST know the labor laws and should conduct exit interviews, have the employee return all keys and equipment used for the job, deliver final payroll and discuss benefit delivery from the time working in the practice. The exit interview should contain a series of questions that can be asked verbally or on a form. A “few” examples of exit interview questions include:

• What is the primary reason for leaving?
• What triggered your decision for leaving?
• What did you like most about the job?
• What did you like least about the job?
• Did you receive enough training to do the job as expected?
• Do you have any suggestions that would improve the workplace?
• Would you consider working again for this practice in the future?

There are so many facets to the termination of an employee that training and knowledge in this area is important. The last thing a PPM wants is a red flag against her because of discrimination against the employee whether they quit, get laid off due to work force reduction, or are fired.

Part of the role of a PPM in Human Resources is providing employee evaluations. It is best if evaluations are not tied to compensation or other payment incentives. PPMs want to be sure that they keep their employees motivated since it affects production and quality service.

In a medical practice employees must possess exceptional patient service, clinical skills, and quality documentation. Many of these skills can be offered through courses at www. and www.aapc.com. Once an employee becomes certified in a certain area of a medical practice, recognition is essential.

HR skills also require accurate document keeping from performance reviews to Employment Eligibility forms. Compensation is a worker’s salary, benefits and paid/unpaid time off. A pay rate should be assigned to each job description.Employee Handbooks are essential and should explain all aspects of the medical practice as a business, to include information on holidays, insurance coverage, Worker’s Compensation and unemployment.

PPMs can also be involved with the credentialing and reimbursement of healthcare providers, as well as the recruitment of physicians and mid-level providers. Compensation for physicians can vary from productivity and seniority to productivity and quality measures. They can be paid on a salary basis, a production basis, or a combination of both. Understanding how the Relative Value Unit works for each service provided is important as well.

Revenue coming into the practice is based on each provider, refunds, shared ancillary services, and expenses associated with the practice. That is why, as a PPM, knowing Human Resources is vital to the entire practice management job description, as well as understanding accounts receivable management, and the financial reports and tools that make the entire practice flow smoothly.

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• AAPC – Considering Certified Physician Practice Manager