Author: Sparhawk Mulder
Interview with Denise Cordero, Practice Administrator for Brooksby Village
Most providers are affiliated with, if not directly a part of, a much larger hospital network or corporate partnership. Though a provider’s role is indispensable to a healthcare establishment, they are certainly not the only piece of the puzzle. There’s layers of bureaucracy above and below the provider, creating the day-to-day schedule, directing patients, and looking at the long-term direction of the business. We talked with Denise Cordero, the practice administrator for Brooksby Village, an Erikson Living retirement community, about working in health administration.
A practice administrator is in charge of the day-to-day operation of practice. This includes keeping expenses within the budget, making sure providers meet their model of care, organizing the other medical and office assistants, and taking and implementing patient complaints. They’re also in charge of making sure the practice as a whole remains “patient centric”, and conforms to regulations. The practice administrator also has to decide practice policy during crises, such as a blizzard, or a pandemic. It’s a big job.
But practice admins don’t do it all alone. Most of the boots-on-the-ground patient work is done by medical office assistants and medical assistants. Medical office assistants are the “first line of defense”; they’re the front desk person, and the person you call to reschedule your appointment. Medical office assistants organize patient appointments, create the daily schedule for providers, and therefore also triage incoming acute cases.
From there, the job gets passed to medical assistants, who “tee up the patient for the doctor” said Denise. This means they screen patients, ask them preliminary questions, and update their histories (“have you been to the hospital since your last visit?”). However, medical assistants also do much of the simple preliminary medical work too, and can draw blood, perform EKGs, and run all sorts of other tests. After they’re done, the doctor comes in and can focus on addressing the patient’s core issues.
The practice manager oversees all of this, and coordinates transitions smoothly. For example, how practices dealt with COVID-19 was the practice manager’s job. They had to acquire masks, lead the contact tracing programs, make sure the practice was following CDC guidelines, and stagger patient appointments to minimize “deconditioning” (the longer a patient goes without an appointment, the more problems they’ll show up with. This was especially relevant to Denise's practice specifically, because geriatrics requires twice to four times as many appointments per patient!).
The required credentials for health administration depends on the rank. Most health administrators have some kind of either medical or business degree, and usually have experience with both, regardless of rank. Denise, as a practice manager, has a degree in healthcare business management / administration, but has previously worked as an office assistant, medical assistant, and a biller / medical coder, and the wide range of experience serves her well in her job. She says that one of the biggest rewards of being an administrator is being proud of running a large, diverse team of highly skilled people. The provider might be the center of the practice, but a skilled administrator can make both the staff and patients’ jobs much easier.
However, Denise says that patients and doctors sometimes take that structure for granted. She says that if future doctors cooperated with the admin more readily, and were less of the “just let me do my job” type, everyone’s healthcare would be better. Furthermore, she thinks future physicians should do two things: learn a second language (definitely Spanish if you’re in the United States), and shift the paradigm away from pharmaceutical treatment and back towards prevention. She says that doctors could focus a little more on improving patient nutrition and lifestyle, because even though the pharmaceutical industry is huge and lucrative, prevention makes everyone’s life easier. As for her advice to patients, she simply says to remember that you have a choice in your healthcare, that you can talk back to your doctor and ask questions.
Thank you to Denise Cordero for answering our questions on administration.