Six months into merger, problems are evident
Six months into merger, problems are evident
Three strikes but not out
[Editor’s Note: This is the second of a series following a practice through the merger maze. The practice management company profiled in this story has presided over further mergers for practices which it manages. See the November issue for part one.]
Jim Haught, MBA, has been through many mergers in the last few years. First, as practice administrator of Resurgens, an Atlanta orthopedic practice, and then as regional vice president of Ortholink, a practice management company formed by Resurgens.
But even after more than a dozen mergers of various sizes, Haught sees the same problems arise over and over. Listed below are some common problem areas as well as potential solutions:
Problem.
Physicians don’t make a real commitment to the merger.
One recent case which Haught says illustrates this is the merger of four groups into a 12-physician practice. "They each had their own internal structure and made no attempt to change that," Haught says. "There were four different autonomous operations."
The managers continued to operate their own fiefdoms, he adds. "There were more than 10 scheduling templates in use; there were both alphabetical and numerical filing systems. It was just a mess."
If physicians don’t make a "heartfelt commitment" to a merger, says Haught, this kind of mess will result. "You need more than a verbal commitment. If you don’t have it after six months, you have to go back and start again."
Solution.
To get this particular merger back on track, Haught went back to each committee operations, finance, and administration. He asked each to talk about where they thought changes were needed. Once they made suggestions, these were brought to the executive committee. By bringing the process back to the beginning, Haught says he was able to get more buy-in from the physicians. That ownership meant that the physicians were more likely to take an interest in the success of the new, merged practice.
Problem.
Ineffective management leading the practice.
The four practices had chosen two of their managers to co-administrate the practice. This was a big mistake, he says. "The physicians didn’t want to fire anyone, so the hand manager and the sports medicine administrator shared the role, but the employees didn’t know who was in charge, and neither had large group experience."
The result was a harried team. One of the managers eventually quit, leaving one person with inadequate experience to handle a situation that was increasingly chaotic.
Solution.
For most situations, hire a new administrator. "In most cases, a smaller practice moving into a setup with 10 or more physicians really needs to hire an administrator from outside," Haught says. New managers are better able to recognize the strengths and weaknesses of other managers, as well as of procedures. "The problem isn’t the rank-and-file employees," he says. "If they are kept informed and have someone they trust as a manager, they will follow along nicely. But without effective management, you are lost."
Problem.
Disparate personalities, disparate processes.
Related to the lack of cohesion in a merged practice is the tendency for there to be as many ways of doing things as the number of individual practices prior to the merger.
Solution.
Ask for input. Rather than impose one set of procedures, Haught says the best way and one which will increase the good will of employees is to ask staff who do a particular job how to do it better.
Once you overcome these three big problems, Haught says the rest is details.
Haught says previous experience with mergers isn’t always enough to anticipate problems. "Due diligence won’t show you these things, particularly if it is done early in the merger process," he says. But rather than complain about a situation, he says it is important to move on. "If things aren’t working well after six months, then you have to go back and start from the beginning.
Make the physicians tell you why a merger is a good idea, make sure your managers are up to the job, and make sure everyone is working as one practice."
Subscribe Now for Access
You have reached your article limit for the month. We hope you found our articles both enjoyable and insightful. For information on new subscriptions, product trials, alternative billing arrangements or group and site discounts please call 800-688-2421. We look forward to having you as a long-term member of the Relias Media community.