Are administrators, office managers, and practice managers the same?
By Laurie Morgan
Recently, my consulting group helped four specialists start up a new practice. When it came time to hire the practice’s management leader, we created a recruiting plan for a practice administrator. The doctors wanted to advertise for an office manager instead. “If we say ‘administrator,’ we pay $20,000 more,” they argued.
The doctors had a point. A quick Indeed.com search shows that here in San Francisco, medical practice manager salaries average $89,000, while practice administrators average $97,000. Medical office manager salaries are significantly lower, at $67,000.
Yet the doctors weren’t entirely right, because they believed that the job and the skills implied were more or less the same, regardless of the title. The administrators, they supposed, had just been lucky enough to begin their careers in a larger or more formal setting, such as a health system or a hospital. The doctors assumed the title mainly reflected a difference in setting – not role or skills.
In our experience, professionals who hold those better-compensated titles typically have been striving to acquire higher level skills as well. And those skills can bring value to a medical practice – especially one that wants to be independent.
Aiming high
We interviewed more than 30 candidates for the new practice’s management position. The differences were striking – and predictable. The candidates who described themselves as “office managers” asked for lower salaries, but saw themselves primarily as payroll and expense gatekeepers and staff taskmasters. They didn’t see planning for future opportunities or challenges as their role – that was the partners’ job.
The practice managers, on the other hand, were keenly interested in optimizing revenues. They had clear ideas about developing staff, utilizing technology, and grappling with the changing insurance landscape. They also were more interested in continuing to develop their skills.
The candidates with administrator titles stood even further apart from the office managers. They saw practice growth and profitability as their responsibility. They expected to negotiate contracts, and had experience doing it. They were analytically oriented. Most had advanced education through a degree program, or certification through an organization like MGMA.
Why does this matter? In the case of our start-up physicians, they were planning a multi-service practice with lab, bone scans, clinical trials, and infusion therapies. Their specialty is also in short supply locally – suggesting they could negotiate higher reimbursement from payers and be choosy about contracts. An “office manager” might well be able to watch staff overtime and pay the bills on time, but typically would not know how to lead contract negotiations – or guide the practice’s organizational design, complex building plans, equipment leases, or business modeling.
Having the right management partner
Physicians often ask us, “Is it still possible to succeed as a private practice?” In many specialties and markets, we believe it is. But having the right management partner is absolutely critical.
Investing $20,000 or $30,000 per year in a leader with higher level business skills – and a bigger vision of their role – will often pay off many, many times over. Conversely, saving $20,000 by hiring for a less ambitious role will often cost a practice significantly in the long run.
When we’re hired to help a practice with a problem, the manager’s title often gives us a hint about the skills and perspective they’ll bring to our project. The same could be true for you. An office manager focused on gatekeeping may not immediately see the value of your offering, and could stand in your way. You may have to pass much tougher scrutiny with an analytically minded manager or administrator – but if they can see the value, they could be your partner in closing the deal.