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Who's on First?

Updated: Apr 2, 2019


One of the most rewarding things PMI does on a regular basis is to visit Pediatric practices around the country to help identify opportunities to improve their practice. This is the third of a 5-part series of emails detailing some of the most common things we recommend to our clients. Knowing Who’s on First

  • When PMI is called in to assess a practice, we find that too much of the day-to-day responsibility is handled by a single person. Worse yet, when the physician who has been responsible for everything is no longer with the practice (retirement, disability or death), there is no one left in the practice who understands how all the moving parts interact within the practice. For a practice with a single physician, it is expected that he/she will assume most, if not all, practice management responsibilities. Regardless of whether there is one or ten physicians, there is an opportunity to share the workload so that everyone in the practice is engaged in the running of the practice.

  • One of the founders of PMI, Dr. Bryan Sibley of Lafayette, LA, has often commented at various PMI Conferences that "just because someone may not be an owner of the practice, they need to take ownership in the practice". As such, allocation of practice responsibilities is not limited to partners within a practice. Individuals assigned certain duties may include staff, employed physicians and/or the office manager. By assigning things to more people, it splits the workload up into manageable chunks while providing an opportunity for more people to take a vested interest in the practice.

  • Allocation of responsibilities allows the managing partner to function as an executive overseeing the practice instead of being a cog in the wheel to keep the practice going. This allows them to focus on the bigger picture and leverage their expertise across the entire practice. More importantly, if done right it may even allow that person to see a few more patients- generating more revenue for the practice. Below is a link to a sample “Responsibility Matrix” that PMI provides clients after an assessment. This is a list of the first 90+ items that someone needs to be responsible for in the practice. This list is not designed to be all-inclusive. Rather, it is to serve as a starting point to the following exercise:

  1. Make a list of all the items that need to be tended to within the practice. Everything from dealing with patient complaints to Human Resource issues.

  2. After every single item is listed, the practice should assign specific people responsible for each item on the list. Consideration should be given to group similar responsibilities together and assign them to the same person (Human Resources, IT, etc).

  3. Once all the responsibilities have been assigned, everyone should be held accountable for their new responsibilities. More importantly, if someone has concerns about the practice website, they should be directed to whoever is responsible for it. Nothing undermines this orderly process more than one individual tending to responsibilities assigned to another person.

  4. PMI clients who are most successful with this effort take the time to review the list on a periodic basis to ensure that responsibilities are evenly distributed as well as rotating various responsibilities each year. By rotating such responsibilities, it reduces anxiety when one of the people who has always tended to certain responsibilities is no longer with the practice.


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