Valerie Neff Newitt
January 2021—A CAP Practice Management Network will be online Feb. 9 for CAP members and their practice staff who want to share problems and best practices and learn from the practice management insights of others.
It will be a “no-judgment zone, a safety zone, a neutral territory,” says Brian H. Le, MD, MBA, co-coordinator of the network and vice chair of the CAP Practice Management Committee, developer of the network.
“A lot of practices and new-in-practice pathologists encounter a competitive spirit that sometimes doesn’t serve us well,” says Dr. Le, a pathologist based at Novant Health in North Carolina. “We may feel that it is not in our best interest to directly ask for help from a competing group. Because of that, many practice managers are caught between their desire to promote and advocate for their own practices and their need to make network connections in their industry. With this new network we are creating a non-threatening environment where people can feel more comfortable sharing ideas, but without naming names or giving away trade secrets or strategies that are considered proprietary.”
The network is needed, he adds, “because if no one ever openly communicates, there is always going to be a knowledge gap.”
Karim E. Sirgi, MD, MBA, chair of the Practice Management Committee and founder and CEO of Sirgi Consulting, Englewood, Colo., says in his consulting business, he often begins his conversation with colleagues from around the country by emphasizing “how not unique” their practice is.
“By that, I mean that the great majority of us face common challenges and are hungry for common best practices and solutions. This network will be the perfect virtual place for the exchange of solutions and best practices for topics and challenges of common interest,” Dr. Sirgi says.
Participation in the network (join by registering at https://tinyurl.com/y2re766a) will be free for CAP members and for their practice management teams and appropriate designees in their groups.
[dropcap]T[/dropcap]ricia L. Hughey, of Denver, a co-coordinator of the network and a member of the Practice Management Committee, has been a practice management consultant for more than 40 years. She is well aware of the management difficulties that have dogged pathologists in the course of practice. Maintaining quality, maximizing revenues, mitigating risks, complying with regulations, managing costs, and staying strategically competitive are some of the larger issues she identifies.
“These categories have many subgroups, including coding and revenue cycle management, recruiting and retaining staff—physicians and others, recognizing regulatory thresholds when you cross them, and maintaining relationships with hospitals, clinicians, and payers so that you are necessary to the market you serve,” Hughey says. “There are many examples of stubborn challenges many practices share, for example workload balancing or workload leveling.” Being able to hear how other groups have managed these could prove helpful, she adds.
Other areas in which groups can collaborate are staffing metrics, policies and procedures, identifying when changes are indicated for a group’s compliance plan, employee handbooks, how to identify cost-cutting possibilities, when to in-source a test. “The opportunities are nearly limitless,” Hughey says.
Learning how to optimize payment from various payers is one of the biggest challenges, Dr. Le notes. “That requires some degree of knowledge and experience, not only regarding accurate coding and billing but also of revenue cycle management. Many newer practice managers are not necessarily experienced with the way a pathology practice or a laboratory practice works. It’s not quite the same way an internal medicine practice or obstetrics and gynecology practice runs. There are nuances to the revenue cycle and the revenue stream of pathology that are not typical of many industries.”
Until now, the typical way to gain that practical knowledge specific to pathology has been on-the-job training.
“My own story is an illustration of that point,” Hughey says. From her first job as a transcriber for a solo pathologist in a rural area, Hughey worked her way up the career path to the role of CEO of a metropolitan super-group. “Had there been an available network of colleagues and foundational resources along the way, I’m certain I would have been able to support the employing pathologists at a more efficient and effective level,” she says. “Learning along the way is good but not always great. It takes years and years and you make mistakes. And that can be expensive.”
[dropcap]I[/dropcap]ncluding non-pathologists in the network is essential, Dr. Sirgi says. “While pathologists are very much involved at the tip of the leadership iceberg, everything else that happens beneath that tip that is essential to the running of the business is usually assumed by non-pathologists.”
“Most pathologists have an intuitive understanding of the mechanics of their business,” he says, “but few are aware of, or understand, the full complexity of it. Few are equipped with the foundational knowledge and appreciation of how these pieces of the business puzzle fit together. Pathologists may rise to the role of chief executive officer or executive manager, but they seldom concern themselves with everything else, like human resources, billing and accounting, and client relations.”
Although it is easy for the CAP to build databases of pathologist members, it is more difficult to build similar databases of the non-pathologist professionals who are central to the success of pathology practices, Dr. Sirgi says. Among them are senior executives and other professionals whose areas of focus are, among other things, human resources, accounting, logistic supervision, recruitment, sales, and client relations. “We are interested in capturing as many members of that potential broader audience as possible, as they are key to the success of our pathologist members’ businesses,” Dr. Sirgi says. “We want their full participation, but with the clear understanding, from a CAP standpoint, that anything we offer is first and foremost directed at our pathologist membership.”
Pathologists need to stay engaged, Hughey notes. “They are the business owners. But these other people can get a lot of the data and decision-making tools to them so they can help guide decisions, or they can make them together.”
Asked how the network will roll out, she says, “We’re asking the CAP members to join, or sponsor someone—or a team—from their practice so they can join this national network of pathology group business managers.”
Topic experts will be invited to the network to participate with members in virtual roundtables on time-sensitive topics in addition to other topics considered more foundational. “We will bring in professionals of pathology practice management from all practice settings,” Dr. Sirgi says. “Some topics will be pushed from the committee to participants, whereas other topics will be pulled by closely listening to participants’ suggestions and topic interests.”
“Expectations are,” Hughey says, “that many members will have similar interests and needs regarding contemporary and routine topics. We expect there to be high interest in elements of practice that remain in flux—CPT coding, payer policies, hospital system mergers, clinicians’ behaviors, et cetera. And as practice managers retire and new ones take the reins, there is always a need for the basics of supporting pathologists—licensing, credentialing, negotiating contracts, human resource management, and practice governance.”
These live events will be scheduled periodically, possibly via Zoom, and likely will last no more than an hour.
[dropcap]W[/dropcap]ith this new network, Hughey says, “the CAP is recognizing there has not been a home for pathology practice group managers, those non-pathologists requiring a different skill set that has nothing to do with the practice of medicine. We’ve seen other organizations cover practice management in scattered bits and pieces, but never in a comprehensive fashion.” She lauds the Executive War College, billing companies, the American Society for Clinical Pathology, and others for the “great job they do,” but says some practice management information has been unavailable. “Pathologists are very busy behind the microscope and look to CAP to help them make sure their businesses are running well, too. They’ve asked for a resource like this network for a long time, and now we can provide it.”
The Practice Management Network will provide a forum “to help pathologists help themselves. That’s the best way I can summarize it,” Dr. Le says. “Participants will share the issues they encounter, the problems they see, the challenges they face. And, as a result of that, we can shed light, give support, and direct them toward resources they may not have access to currently. We may be able to create products or services via their feedback, to tailor to member needs. I would say to the pathologist membership that this is a way to advocate for your managers so that they can advocate for you.”
Valerie Neff Newitt is a writer in Audubon, Pa. Address questions about the Practice Management Network to practicemanagement@cap.org. Other practice management resources for pathologists and their practice managers are available at www.cap.org/member-resources/practice-management.