An administrator’s guide: Obtaining decision buy-in from a practice’s physician leadership

Radiology business managers help practices thrive in our challenging health care climate. They possess a level of sophisticated business experience sought out by radiologists who are being forced to take time away from patient care to attend to the business responsibilities of the practice. However, a business manager who steps in to handle these duties and alleviate the pressure on physicians still needs to approach them to obtain buy-in on various major practice decisions. The larger the practice, the more daunting this task can appear. David Myrice, director of practice management for Zotec Partners, walks us through the important steps in obtaining radiologist buy-in on important practice decisions.

The business manager works as a consultant to the physician leaders of the practice, and advises them on practice decisions and direction with recommendations based on expert business knowledge. His or her job is to ensure the practice remains viable financially, as well as continues to fulfill the needs and meet the goals of its physician leaders. Understanding the relationship between the business manager and physician leaders is key, according to Myrice, and each practice is different.

Prepare yourself

Despite the differences in practices, the steps to achieving buy-in from physician leaders are fairly universal. Before making any recommendation at all, make sure to be well-prepared to articulate the position and demonstrate its connection to the overarching goals of the practice. “The more effort you put into the preparation process, the better off you are,” says Myrice. “The key here is that you’re not trying to manipulate a decision, you’re trying to obtain a consensus in support of a particular issue, and that’s going to take some work.”

This first preparation step involves helping the physician leaders recognize the need for the change, or to help them understand the importance of the issue. Collecting data to support the recommendation strengthens the manager’s position, but it is also important to have data to show both sides of the argument. When the time comes to present the information, it is important to clearly explain the rationale behind the recommendation, and highlight the benefits with data and facts.

It is also extremely important to research the potential pitfalls of the recommendation, so there will be less opportunity for doubt-instilling arguments against it. Tie it into the bigger picture for the practice, and how it will support the practice’s long-term strategy.

“The biggest challenge I’ve seen,” says Myrice, “is when business managers try to get buy-in and have no back-up for their position. Lack of preparation almost always results in a failed attempt at consensus,” counsels Myrice.

Another important consideration when making recommendations to the practice is to think beyond the financial implications of the decision.

“It’s important to see beyond the balance sheet,” says Myrice. “Usually with larger practice decisions, there are both financial implications from the decision, as well as lifestyle implications for the radiologists. For example, if there is a recommendation to take on a new schedule rotation to accommodate more specialty reads to service a major customer, it may not be as simple as adding up the potential additional revenue that would generate. Take into account the implications that the new schedule may have on some of the younger radiologists who have small children, or even some older radiologists who may not want the added workload.”

The conversation

Balance is a constant struggle in obtaining buy-in. It’s critical to walk in with a certain level of empathy that will demonstrate understanding of the non-financial implications of the action. That involves knowing the audience. If the business manager can identify the people who will be most likely impacted by the decision, those people might be approached earlier for their thoughts on the situation and a chance to voice any concerns they have.

While this may appear to be a little political, it shows physician leaders the business manager understands the practice belongs to each one of them as individuals, and is approaching them out of an appreciation of that fact. Ultimately, the business manager may address some of the early concerns when the presentation and recommendation is made.

“This type of preparation takes time and communication, but will undoubtedly result in a well-built relationship and a solid level of trust between the manager and the physicians,” offers Myrice. “You really need to invest in understanding the dynamics of your group. The recommendation needs to be a financial, clinical and emotional conversation.”

Results not guaranteed

The steps outlined in this article may be universal, and a business manager might be incredibly skilled and articulate, but the outcome may not always be the one he or she was looking for.

“No matter how good you are, decisions won’t go your way every time,” Myrice says. “It’s important to know when to concede the decision to the physicians. Ultimately, it is their business and you are their advisor. The most important action you can take after that is to accept the decision they make, and make it work for them, putting forth the same effort as if it was for your own recommendation,” adds Myrice. “That’s the truest characteristic of a great manager—integrity.”