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G’day from a practice manager Down Under

1 September 2009

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Dip Prac Mgmt Cert IV WT&A

Practice Management Consultant
Wauchope, New South Wales

Tania has worked in the healthcare industry for almost 25 years, approximately 15 of those in general practice. As well as a diploma in practice management, she has qualifications in Workplace Training & Assessing, and is currently studying for her graduate certificate in practice management through university.  Tania serves as a committee member on the New South Wales branch of the Australian Association of Practice Managers, delivering education and support to practice managers and reception staff and also performs assessment visits to general practices applying for accreditation. As well as working as a trainer/assessor for the University of New England, supervising their medical receptionist trainees, she has a passion for delivering education and has given presentations for workshops, conferences and local Aboriginal medical services. Tania lives with her husband and two children on a two-acre block in rural New South Wales. In her spare time, she loves travel, cooking and gardening

It is Monday morning, the first day of the week, the first Monday of the month, and, being July, the first Monday of the new financial year here in Australia. A whole new business year ahead: many new challenges and a year of unknowns.

As I sit in the office with my morning cup of tea, trying to see the winter sun over the mountain of paperwork that is blocking the view through my window, I am starting to contemplate the concept of beginnings and recall my journey to this place and time.

I am sure I never aspired to be a practice manager – if indeed there was such a career when I was growing up. However, looking back, perhaps the idea of entering the health profession was planted by my careers officer in high school, who told me that all my vocational testing indicated I should study medicine.

Later, while studying a medical secretarial module for a secretarial/book-keeping diploma course I took after leaving school, I realised that working in the health industry appealed to me on two levels: one, it meant an opportunity to meet many varied people, with each day being different and unpredictable, and two, I could fulfill my vocational direction despite lacking the intestinal fortitude required at the queasy end of medicine.

I guess I have always been pretty much a “people person” and, although business and office work appealed to me, being confined in an office did not. So the direction of my career was set. Over the next 13 years, I worked mainly in the fields of radiology and CT scanning. Here, I not only gained people and financial skills, as well as experience in both hospital settings and private practice, but I was also fortunate to work for a group of doctors who allowed and encouraged me to move into supervisory roles and be involved in developing and setting up new practices.

As happens to most Australians, the travel bug bit in my late 20s, and so I put on my backpack and headed to the other side of the world, landing in London. For two years, I travelled and worked through temp agencies, gaining experience in a variety of office environments ranging from banking, social work, grocery wholesale and even brewing. I can truly thank the UK for honing and developing my skills in adaptability, organisation, communication and relating to people in various roles and responsibilities. I can also thank them for the wonderful husband I acquired along the way!

Practice and professional development
Upon returning to Oz, we decided to settle in a small rural community of about 7,000 people, 15 minutes from some of the most beautiful coastline in New South Wales. When I was appointed as the solo receptionist in the local general practice, another huge learning curve began.

In this position, I was fortunate to have the mentorship, support and encouragement of the practice owner, Dr Hain, and over the next nine-and-a-half years we led this little rural practice through computerisation, expansion to three GPs, and growth of nursing and admin staff, during which I eventually metamorphosed into an “office manager”.

As the practice and the healthcare environment in general evolved, I began to see the need for my GPs to be freed from what traditionally has been their involvement and control of the business of general practice, to allow them to focus on their clinical work (the money-making aspect) without the extra burden of business administration issues such as strategic and financial planning, human resource management, risk management, quality and accreditation standards, IT, marketing, etc.

Thankfully, Dr Hain again encouraged and supported me to attend workshops and conferences to develop skills in these areas. And when he decided to break from the practice to set up his own holistic general practice, he asked me to be his practice manager.

Despite having the job title, I felt the need to have some sort of relevant qualification, so I enrolled in the Certificate IV in Practice Management offered through the University of New England (UNE) in New South Wales. I found the knowledge and peer networking I gained encouraged me to continue to complete my diploma in Practice Management over the following 12 months.

During this time, Dr Hain had been acting as my “agent” and speaking about my skills to a GP who had just taken ownership of another local practice. I was approached by him and asked to assist him and his wife in managing the newly acquired business. This event was the catalyst to my current business situation. Again following Dr Hain’s advice and encouragement, I established my own business as a practice management consultant, Dr Hain’s Essential Being practice and Hastings Medical Centre being my first two clients back in 2004.

Since then, I have embarked on a quest to satisfy my thirst for knowledge about all aspects of management, and practice management in particular. Through my enrolment with UNE, I obtained information about the Australian Association of Practice Managers (AAPM), with which they have an alliance (see Resource).

I became a member of the AAPM and began attending the association’s conferences and education workshops, discovering not only the skills I required but also the combined knowledge, experience and friendship of a vast network of practice managers working in a myriad of settings: from general practices to specialist and allied health centres, through to corporate, group and solo practices. Furthermore, these settings ranged from innercity locations to rural and remote areas.

Through contacts, I also picked up more work, mainly in assisting practices that had management problems, setting up new practices or assessing a practice’s management needs. In the latter cases, I would either work to enhance the role of the current management or step in to assist in that role on a short- or long-term basis. In this capacity, I enjoyed the challenges and valued the experience and knowledge I obtained, as well as the many friends and colleagues I was lucky to work with. I also learned some valuable lessons in the difficulties that can be encountered when a manager and the practice owner(s) do not share the same vision for the practice.

Learning verve
This period also led to some self-discovery, wherein I realised the passion I had for education – not only for myself, but also supporting other practice managers and reception staff. I also developed a passion for “continuous quality improvement”: encouraging and assisting practices to develop and continue to upgrade, improve and monitor services to deliver the highest possible standard of care.

To satisfy my first passion, I accepted a volunteer position on the AAPM’s New South Wales branch committee, and became involved in developing, then delivering, workshops and education events in my own rural area, as well as promoting the role of practice managers. Having been involved with preparing for the initial rounds of accreditation in my first practice, I saw the accreditation process – which is conducted here by AGPAL (Australian General Practice Accreditation Limited) – as a good measure for delivering quality in general practice.

So, to satisfy my second passion for education, I trained as an accreditation surveyor and began working for AGPAL, doing survey visits across a vast area of rural New South Wales. These “extracurricular” activities add some interesting, exciting, challenging and sometimes funny aspects to my working life, but I will be happy to share that with you at another time (I have been asked by Management in Practice to write a series of blogs on the MiP website).

Reveries now are ended
With my teacup now empty, I must tackle the reality of the office. As I look at my weekly planner, I see some interesting times, some challenges, some exciting things and some mundane boring bits ahead.

Along with the initial task of finalising all the financial year-end reports, taxation and wage requirements, and assessing the cash flow, there is a locum doctor to organise, accreditation preparation to oversee for our upcoming visit, a staff behaviour issue to deal with, medical students to give a talk to, swine-flu pandemic planning updates to read and implement, a staff-training program to prepare (and deliver), some practice accreditation visits to book in, several meetings to attend, as well as everything and anything else that will walk through my office door. Then there is tomorrow, but that is another story …


Australian Association of Practice Managers