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Being “in the know” isn’t easy.  Knowing all of the elements that go on within a private practice, or any small company for that matter, can appear to be a daunting task, if not impossible.  As such, delegation takes a prominent role in the management of many important matters responsible for the sink or swim of small healthcare practices, replacing owners’ “in the know” with “in the dark.”

For any practice owners that think that there are aspects of their businesses that are above (should be taken care of by other partners, practice administrators, consultants, etc.) or below (should be delegated to lower paid or more specialized staff) them, they’ve got another thing coming…and it’s likely not good.

Not knowing how money is spent, decisions are made, or customers are treated can only lead in the wrong direction.  It is not above or below us in the role of practice owner, CEO, or VP to know these things, and it is quite important that we do.

Here is a great example from the Atlanta Journal-Constitution, of the new Grady hospital CEO who has taken it upon himself to be “in the know” within the first few weeks on the job.  He’s charged with a large task – turning around a $740 million budget to save the failing health system that’s been in the red for years – and he’s addressing it not behind a pencil, podium, and PowerPoint presentation that speaks of great vision and execution (well, he might be doing that too, actually).  But he’s doing it by sifting check by check through expenses made during a single week in July.  “‘The best way to figure out what’s going on is to look at the checks,’ he said, noting that he now has made this mini-audit a weekly practice.”

Let’s not forget that if we own the business, it’s ours.  And knowing what’s going on in our business is our responsibility, no matter how far above or below us the tasks may seem.

Good luck to Michael Young and Grady Memorial Hospital.

This is not the usual work of a hospital CEO, especially one overseeing a medical megalopolis like Grady Memorial Hospital. Grady operates a 600-bed hospital, 60 specialty clinics and its own nursing home. It has 4,800 employees and serves as metro Atlanta’s top level trauma center and last refuge of care for the poor.

The Grady health system also runs deficits of up to $40 million a year, so saving money is a priority of the CEO, who officially started work Sept. 2.

Young hit upon checks that shocked him, such as the $100,000 one-week payment for temporary employees, including nurses and X-ray technicians. Not only did Grady have to pay the temp agency — some of the temp nurses made more than a staff nurse, he said.