Learn what your staffers want from their employer. Give them opportunity to grow and be empowered on the job. Then develop a management structure that that supports productivity and profitability, based on choice, effective communication and shared values. If that sounds like advice from corporate management training designed to build success at a Fortune 500 company, that’s not far from wrong.
But management principles based on contemporary communication techniques, work-life balance and the latest compensation approaches can also work in relatively small physician private practices, as well as big corporations, according to Justin Holtzman, MD, MHSA. He is medical director of the Holtzman Medical Group in Brookline, Massachusetts, a multispecialty practice with three MDs and three physician assistants (PAs).
Dr. Holtzman recently presented his approach to physician private practice staff management in as part of the AMA Private Practice Simple Solutions, a series of free, open-access rapid-learning cycles designed to provide opportunities to implement actionable changes that can immediately increase efficiency in private practices.
On the path to success
Dr. Holtzman’s interest in staff management began early in his career—during his first employment with a large medical system in 2016 where he was hired to work as an internist.
“Within a week or so, a few very strange things began to happen,” he recalled. “The support staff came up to me and started telling me about how unhappy they were.”
The staff members told him they didn’t get paid enough, only receiving a 35-cent raise at the end of the year and a small gift card at Christmas. But most of all, “they felt that what they did on the job didn’t matter. They would never have the opportunity to take ownership of their work. They said they didn’t feel valued.”
The staffers said they were not empowered to make any changes in their work.
“There was no sense of accomplishment among the staff. They had no control of their environment. There was minimal communication between the back office and the front office,” he said. “And certainly, minimal communication between the medical staff and the support staff.”
This experience sent Dr. Holtzman on a path to the research-management literature and to use what he experienced to develop his own practice, which would be “a great place to receive care, but also be a great place to work.”
The result was an organization based on staff values, including excellent compensation, a helpful, collaborative culture, employee empowerment and decentralized decision-making.
“They want to be able to problem-solve. They want transparency and communication. They want equity and autonomy in the practice,” he said.
How did the Holtzman Medical Group execute its vision? “We pay well. Our pay starts at $22 an hour for college students,” he said. The practice pays 100% of health insurance and disability insurance premiums, even for part-time employees. The practice also provides high-end coats and jackets branded with the practice and employee names.
Management layers to minimum
The practice structure has minimal layers of management, Dr. Holtzman said. “We made sure that everyone had the ability to design new processes to get the job done more efficiently,” while operating in a flat, no-chain-of-command structure.
“We make sure we have regular meetings to implement new ideas and deal with concerns,” he said. The practice also has a social budget for each location to promote good staff relations.
“At the end of the day, nobody works for me. They work with me—and each other.”
Does this enlightened system work to make the practice profitable and productive? In five years, the practice has grown from one doctor and one assistant with $17,000 in gross revenue to a multispecialty group with three locations, $2.9 million in revenue from three MDs, three PAs and one nurse practitioner, he said. The practice plans to hire seven more clinicians in the next two years.
It takes astute clinical judgment as well as a commitment to collaboration and solving challenging problems to succeed in independent settings that are often fluid, and the AMA offers the resources and support physicians need to both start and sustain success in private practice.
Find out more about the AMA Private Practice Physicians Section, which seeks to preserve the freedom, independence and integrity of private practice.