Are Oncology Practice Managers Still Having Fun?

September 2016, Vol 6, No 9
Dawn Holcombe, MBA, FACMPE, ACHE
President, DGH Consulting, South Windsor, CT

I speak with practice managers all across the country. Most practice managers got into oncology through a circuitous route (often from nursing, billing, or other specialties) because of a passion and a drive that still keep him or her in the field.

Being a practice manager is a draining job. You are not one of the staff, no matter how close you are to your team. You are not one of the physicians either. You bring good news and bad news to both groups. You often spend hours before and after the practice opens running reports, figuring out solutions, and trying to anticipate the next barriers to caring for your patients and providers.

Practice managers enjoy and embrace the successes of finding coverage for a worried patient; tracking down that elusive drug vial that has been in short supply; negotiating a new model payer contract; being selected to participate in new pilots, such as the Centers for Medicare & Medicaid Services (CMS) Oncology Care Model; or hiring that new oncologist who took months to find.

You also have your share of frustrations and disappointments in the denials for treatments that were already administered, friends and colleagues who have been newly diagnosed with cancer, payer restrictions and edits that add hours of staff time and delays in care that affect patients, fielding political accusations of “perverse incentives” in oncology practice, and trying to explain the complexity of oncology to media, and perhaps even to congressional staff and elected members, who appear to think in soundbites and misperceptions.

Practice managers are a close family. When practice managers get together at local, regional, or national meetings, they share stories, commiserate, laugh, and often cry in frustration, because, at heart, you are just trying the best you can to help patients battle cancer.

A Complex Set of Skills

The skills practice managers need have changed greatly. Oncology is evolving from patient treatment to patient management. Managing the finances of running practices and helping patients navigate complex benefits packages and costly treatments have become much more complicated than in the past. The management of drug inventory is critical, and one missing vial could result in a loss of thousands of dollars.

Practice managers need to market and create outreach and patient management outside of the practice: your teams can no longer just counsel patients to call when they have questions—now you have to manage your processes so you can anticipate issues and reach out directly to patients before they have complications. These new processes take different skill sets from your staff, your physicians, and your practice managers. Practice managers now have to manage risk and patient complexity, as well as adjust the resources within the practice to meet those new needs.

You also have to be financial wizards and negotiate complex insurance contracts that are transferring risk to your practices, which is a very scary concept. What degree of risk will be manageable? How do you cover catastrophic circumstances? Can your hospital cancer center or private practice survive an adverse year?

And you need to watch for upcoming trends and try to convince your physicians that the world as they know it will not exist next year, without losing your jobs. If you do your job too well, your physicians may wonder whether the practice would still run as well without you. At a time when strong practice management is essential and critical, good practice administrators have inexplicably been let go. Financial practice instability and fear can outweigh logic and reason.

Share Your Story with Your Colleagues

Sometimes with the tightening of financial resources, it gets harder to make meetings, recharge our batte­ries, and maintain our lifelines with other administrators. Reliable, regular resources such as Oncology Practice Management become even more important as lifelines, harbingers of trends and challenges, and solutions to issues that may not have even hit your individual practices yet.

Each one of our readers has life and practice-related lessons and stories from the front that are valuable to share with colleagues and our readers. We need to connect with, share with, learn from, and teach each other.

Some of the practice managers I speak with are scared, just hanging on, feeling buffeted by circumstances seemingly beyond their control, and worried for their staff, their doctors, and, most of all, their patients. Others are rising to the challenge, considering new opportunities, and taking many different opportunities to navigate the change and chaos that is oncology in 2016.

Are practice managers having fun still? Many are. This is a new approach to cancer care, and you are part of the cutting edge of that change. Yes, oncology practices may look different in 2 years. Yes, you may all have to rise to the challenge to lead staff and doctors through the change. But you also have an opportunity to shape that change. You can take charge of your analytics, use data from CMS and private payers to shape what makes sense in oncology management, and embrace and develop a new era of patient management in addition to patient treatment.

Our team at Oncology Practice Management strives to reflect and share your transitions. Thank you for your support, and please keep sending us your stories, successes, challenges, and commentaries. Our editorial team welcomes your input at This email address is being protected from spambots. You need JavaScript enabled to view it.. Will you be one of our published authors this year? I hope so!

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