What’s Keeping Medical Practices Up At Night?

As I was recently thinking about the future of healthcare, I started to wonder how my own thoughts of what’s happening in healthcare aligned with those in the trenches. Rather than just think about it, I decided to reach out to a bunch of people to get their perspectives on what challenges they face. In this two part series, I’m going to share the responses from a medical practice perspective and then from a hospital and health system perspective.

First up is the medical practice perspective. I sent a number of practice managers and those involved with practice managers the following two questions:

  1. What are the major areas that are keeping practices up at night?
  2. What challenges are coming that practices aren’t paying enough attention to?

Here are the responses I received:

Eric Dalton, FACMPE, CPA, MBA, Chief Administrative & Financial Officer, Physicians’ Clinic of Iowa

Speaking only for Physicians’ Clinic of Iowa, P.C., I would say that our biggest challenges include the following:

  • An aging population relative to a growing shortage of physicians
  • The continued decline in reimbursement compounded by rising costs
  • Navigating the ever changing and speculative healthcare reform waters
  • Staying independent while participating in partnerships and joint ventures
  • Continuing to grow by creating new service offerings while adding new physicians to existing service lines
  • Coordination of care with other providers in the community

With regards to challenges that practice managers perhaps aren’t paying enough attention to, I would say the following:

  • Utilizing a “slow to hire” approach and ensuring new staff are successfully trained and mentored
  • Recognizing the need to work on changing the culture of the organization
  • Changes in technology that can make processes more efficient
  • Listening to what their customers (patients) are telling them
  • Changes in the marketplace

Shereese Maynard, MS, MBA (@ShereesePubHlth)

  • What are the major areas that are keeping practice managers up at night?
    • Data practices. Mining, aggregation, and how to ensure it’s actionable. Merit-based programs are keeping docs up at night. I hate to say it but hospitals are still struggling with interoperability.
  • What challenges are coming that practice managers aren’t paying enough attention to?
    • Healthcare organizations are not paying enough attention to long-term security strategies. We’ve seen more “pinches” this year which is always a prelude to larger security issues.

Joy Schwartz, RN, DNP, MBA, HCA, Practice Administrator, Atlantic Surgical Group, P.A.

  • The major areas/challenges keeping me awake as a practice manager are declining reimbursements, participating in the government programs such as MIPS to avoid any penalties, staffing with the right people, staying complaint with HIPAA and OSHA and trying to deliver quality care to our patients. So many areas to worry about however, these are the top areas that appear to impact our practice the most.
  • The challenges that are definitely coming that I believe practice managers are not paying enough attention to are the merging of hospital systems and the forming of specialty and multi-specialty groups. The merging of hospital systems has a ripple effect on our physicians and practice, and what these newly formed systems expect from the private practice physicians. The larger group formations offer an interesting alternative for the physicians to consider instead of becoming hospital owned.

Adam Jones, CPA, Chief Financial Officer, NEW Health Program Association

  • What are the major areas that are keeping practice managers up at night?
    • Labor shortages for almost all of the positions we recruit for in healthcare.
    • Wages increasing faster than revenue/reimbursement
    • Uncertainty with long-term healthcare reimbursement and political risks
  • What challenges are coming that practice managers aren’t paying enough attention to?
    • Reskilling staff for efficiencies gained w/ automation and/or leaner workflows
    • Ensuring staff are trained/skilled and updated w/ the constant changes we are going through to ensure their data knowledge is complete (specifically for managers/executives)
    • Price creeps from vendors (nonpayroll expenses)
    • To view IT as overhead rather than a solution
    • HR analytics

Cristy Good, MPH, MBA, CPC, CMPE, Senior Industry Advisor, MGMA

  • What are the major areas that are keeping practice managers up at night?
    • Staffing
    • Meeting quality and productivity metrics
    • Patient volume/panel size which goes along with productivity in a way
    • Keeping costs down and revenue up
    • Physician and staff satisfaction
    • How to make sure the culture in the practice is positive and leads to great patient care
    • Time management – how to get everything done that needs to be done
    • How to stay current on what is going on in healthcare and how to be proactive instead of reactive
    • How to stay current with all of the legislative and credentialing requirements
    • How to get done more with less (that includes the financial aspect as well as the staffing aspect)
    • All the paperwork from hiring, onboarding, credentialing, etc
    • Risk and compliance – etc medical chart documentation, OSHA, HIPAA
  • What challenges are coming that practice managers aren’t paying enough attention to?
    • Panel size
    • Making sure they stay competitive in the market through the services offered and how they are offered – SWOT
    • Telehealth and how it can impact their practice and increase revenue and patient satisfaction
    • Culture of the practice and staff satisfaction
    • Reduced reimbursement and increase in quality metric requirements
    • Staff education and training
    • How to incorporate AI to improve patient outcomes
    • Doing things smarter instead of just “how we have always done it”
    • Building relationships with others in the community
    • Risk and compliance – esp possible cyber attacks
    • Shortage of physicians

A big thank you to the team at MGMA who helped connect me with many of these practice managers.  They suggested these additional resource might be of interest to readers as well:

While I was familiar with many of the challenges mentioned above, what was most eye opening to me about these responses was the vast number of challenges they face.  Taken individually, each challenge can be managed.  However, in aggregate, it’s pretty daunting to consider what medical practice managers face.

What did you think of these responses?  Is there something missing from the above that you think is challenging for medical practices?  Which of these challenges do you think is hardest? I’ll be interested to hear your thoughts and to discuss these at the MGMA Annual Conference we’ll be attending next month.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

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