The medical practice management body of knowledge (BOK) in question aims to elaborate in detail the role of the medical practice administrator, and the knowledge and skills they need to possess to be able to effectively handle their responsibilities (The American College of Medical Practice Executives [ACMPE], 2003). This paper provides a critical analysis of the BOK, discussing its limitations, the theoretical divergences between it and the scholarly literature, and the issues in which there is a consensus between the BOK and the journal articles on the topic of medical practice management.
Limitations of the BOK
Even though the BOK provides quite comprehensive information related to the role of a medical practice manager in a health care organization, there are several limitations of the information provided. For example, the classifications offered in the BOK may not always be consistent, and the information given may not always be comprehensive.
Lack of Clarity and Consistency in the Classifications Provided in the BOK
The authors of the BOK propose to differentiate between the five general competencies that medical practice administration specialists ought to have; these core competencies comprise a) professionalism; b) leadership; c) communication skills; d) analytical and organizational skills; and e) technical/professional knowledge and skills (ACMPE, 2003, p. 6). At the same time, the last competency also consists of eight components, or preference domains; these are as follows: a) financial management; b) management of human resources; c) marketing and planning; d) the administration of information; e) the administration of risks; f) organizational dynamics and the governance of the institution and/or its particular departments; g) clinical operations and business; and, finally, h) professional responsibility (ACMPE, 2003, p. 6). One can easily notice that this classification lacks both clarity and consistency. For instance, human resource management, which is one of the components of the technical and professional skills and knowledge that medical practice managers need, is not independent of the competencies of leadership and communication skills; governance, as well as planning, are related to organizational and analytical skills; and, finally, the whole competency of professional knowledge and skills is related to the professionalism (ACMPE, 2003). In other words, the classification of skills of medical practice administrators that the BOK provides (ACMPE, 2003) is not mutually exclusive, and, quite possibly, is not exhaustive. Of course, the guidelines that one can find in the BOK can be of great help to practitioners, but the named drawbacks might adversely affect their utility.
The incompleteness of the Information
Even though the BOK is not supposed to be a detailed account of all the aspects of the activity of medical practice administrators, it might be possible to state that the document could benefit from adding some more details to it. For instance, a considerable portion of the document consists of long lists without any further elaboration. Of course, it is clear that this allows for greater brevity and avoiding unnecessary nuances in cases where they are not needed. On the other hand, this means that in many cases, users will have to look for additional information elsewhere should they need it; in other words, the degree of comprehensiveness of the BOK suffers due to this focus on brevity.
Divergences between the BOK and the Analyzed Scholarly Articles
On the whole, the divergences between the BOK and the information that the authors of the scholarly sources present are not significant. Mostly, the discrepancies are related to the activities and areas of expertise of the medical practice managers, but these differences are not strict contradictions.
Discrepancies between the Areas Activity of Medical Practice Managers Outlined in Different Sources
On the whole, medical practice managers “plan, direct, and coordinate medical and health services” (“Medical and Health Services Managers,” 2015, para. 1). The BOK provides a more detailed account of the roles and responsibilities of medical practice managers (ACMPE, 2003). However, these roles and responsibilities are not the same as those which the scholarly literature lists.
For example, in his article, Longest (2014) supplies a brief overview of medical practice management, and outlines the areas that these administrators need to take care of and activities in which they should engage. In particular, the author stresses that a medical practice manager ought to execute such actions and processes as developing and creating a strategy, providing leadership for the members of the health care faculty, and designing (these are the key activities of an administrator); in addition, a manager needs to communicate, make decisions pertaining to a variety of areas of the medical practice, to oversee the quality of the service, and to perform marketing and evaluating (these are the facilitative activities of an administrator) (Longest, 2014).
According to the BOK, however, the key professional areas of knowledge and the main skills that a medical practice manager needs to have are related to the financial administration, human resource management, marketing and planning, the control of information, the management of risks, organizational dynamics and the overall control over the medical institution, business and clinical operations, and the professional responsibility of the members of a health care institution personnel (ACMPE, 2003).
Therefore, it is possible to state that there is a discrepancy between the areas and skills outlined in the BOK and the activities that Longest (2014) claims to be critical for a medical practice manager. It is easy to see that the key activities named by Longest (2014) can be classified as belonging to the areas mentioned in the BOK: the creation and development of a strategy, as well as designing, may be considered to be a part of planning and the overall control (governance); the provision of leadership is a component of human resource management (ACMPE, 2003). Simultaneously, the facilitative activity of decision-making can be a part of human resource management or governance, as well as of risk management; communicating is a component of human resource management; managing quality and assessing may be considered a part of control of the professional responsibility; marketing is a part of the planning and marketing category (Longest, 2014; ACMPE, 2003).
It is easy to see, however, that not all the areas that the BOK mentions are addressed in the “nutshell” that Longest (2014) provides. Therefore, Longest (2014), in fact, does not include in his article any substantial activities which are directly related to certain areas of professional knowledge and skills that ACMPE (2003) discusses, namely, information management and clinical operations.
Main Points of Consensus between the BOK and the Analyzed Scholarly Articles
Financial Management and Handling of Embezzlement
According to the BOK, one of the areas that medical practice managers are responsible for is the financial management of the organization that they work for (ACMPE, 2003). In particular, the BOK mentions that medical practice managers are supposed to design and monitor “systems of checks and balances and internal controls to safeguard practice assets” (ACMPE, 2003, p. 20). Researchers support this position; in particular, Shorr (2015) states that it is also within the competency of a medical practice manager to watch out for employees who may engage in the practices of theft or embezzlement. The author also mentions a number of the hazards associated with such malpractice, some of which include improper treatment of patients with deconcentrated medications, charging the patients more (and thus possibly decreasing the number of clients), and so on (Shorr, 2015). Therefore, Shorr (2015) highlights one of the important aspects of the medical practice management which the BOK also outlines (ACMPE, 2003).
Reducing the Spending of the Medical Institution
In his article, O’Connell (2016) discusses another issue pertaining to the financial management of a medical institution. The author stresses that it is within the responsibility of a medical practice manager to “constantly investigate ways to improve value and reduce cost in the medical practice” in a manner that does not reduce the quality of the medical service and does not worsen the patient outcomes (p. 380). The researcher also explains an array of practices that a medical practice manager can employ in order to reduce the spending of a health care organization without negatively affecting the quality of the supplied service (O’Connell, 2016), thus providing concrete guidelines that medical practice administrators can use while attending to their duties of financial management.
Providing Effective Leadership and Human Resource Management
According to the BOK, human resource management is one of the core professional skills of a medical practice manager, whereas leadership is one of the key general competencies of such an administrator (ACMPE, 2003). Several scholarly articles also view the areas of leadership and human resource management as crucial for a medical practice manager, providing a diversity of recommendations about the ways in which it might be possible to improve a manager’s performance in these areas.
For example, Hills (2015) discusses the helpfulness of rituals in strengthening the connections between different members of a medical practice team, and describes a wide array of practices and methods that can be utilized in order to make these rituals a part of the health care personnel’s everyday routine. The medical practice manager is to plays the role of a person who introduces and implements these rituals among their staff (Hills, 2015). Therefore, Hills (2015) elaborates on a method that medical practice administrators can use while performing the duties of human resource management.
At the same time, Hills (2016a) describes a variety of ways for enhancing the commitment of employees of a health care institution, as well as some questionnaires for assessing the existing levels of commitment of workers. The methods that the author proposes can help make the members of the personnel more committed to their cause, to their patients, and to the organization that they work for, via the practice of leadership. In this case, a medical practice manager also needs to play the role of a leader in order to improve the results that the members of the health care staff achieve (Hills, 2016a).
Some other recommendations that the authors of scholarly articles offer are to address the situation that leaders and employees may find themselves in as a result of their professional activity. For example, Hills (2016b) discusses the issue of loneliness that leaders often face and offers several ways which these leaders can use to address this problem. This advice may also help medical practice managers. On the other hand, Friedman and Baum (2016) discuss some methods of positive psychology which medical practice administrators can employ to battle the negativity and pessimism, which are common issues among doctors and health care staff in the U.S. These methods are very simple, such as writing thank-you notes (see Fig. 1) and helping the employees. Therefore, these studies also support the perception of a medical practice manager as a leader of health care personnel, along with the chief physician.
Therefore, the medical practice management BOK provides an account of knowledge and skills that a medical practice manager requires to be able to efficaciously perform their duties, and supplies a list of activities they need to take care of.
Limitations of the BOK
There are some limitations to the BOK; for instance, the classifications that it gives are not mutually exclusive, and the information offered in the lists is not comprehensive, which might confuse the readers.
Divergences and Points of Agreement between the BOK and the Scholarly Articles
There are few divergences between the BOK and the scholarly literature that was analyzed; some discrepancies exist, but they are not strict contradictions. On the other hand, there are many points on which the authors of the articles agree with the information from the BOK; the articles often provide additional details and concrete practical advice for a medical practice manager, filling the informational gaps resulting from the brevity of the BOK.
- Friedman, S. E., & Baum, N. (2016). The role of positive psychology in the modern medical practice. The Journal of Medical Practice Management, 31(5), 287-291.
- Hills, L. (2015). Using rituals to strengthen your medical practice team. The Journal of Medical Practice Management, 31(2), 121-125.
- Hills, L. (2016a). Increasing medical practice team commitment: Twenty-five strategies. The Journal of Medical Practice Management, 31(4), 223-228.
- Hills, L. (2016b). Loneliness at the top: Ten ways medical practice administrators can manage the isolation of leadership. The Journal of Medical Practice Management, 31(5), 292-296.
- Longest, B. (2014). Medical practice management in a nutshell. The Journal of Medical Practice Management, 29(4), 227-231.
- Medical and health services managers. (2015). Web.
- O’Connell, M. (2016). Thirty cost savings for the medical practice. The Journal of Medical Practice Management, 31(6), 380-382.
- Shorr, J. A. (2015). Top ten embezzlement risks in your medical practice. The Journal of Medical Practice Management, 31(3), 191-193.
- The American College of Medical Practice Executives. (2003). The ACMPE guide to the body of knowledge for medical practice management. Web.