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As the practice grows, practitioners often become unable to perform the routine duties which once gave them control over their business. This lack of control can place the entire practice in jeopardy. Appointing competent personnel will assist the practitioner in ensuring that all duties are performed and that the practice is thus run effectively and accurately. 

Roles in the practice 

We suggest that the following minimum roles be defined in the practice. Please note that you do not need to recruit each of these roles. One person can cover more than one of these roles, depending on the size of your practice. When recruiting staff, you can use these role descriptions to ensure that the person has all the necessary skills to make your practice successful. 

The practitioner 

As a new practice grows, it becomes necessary to appoint more practitioners to support the growing demand for healthcare. The essential functions that a practitioner must perform are not limited to patient care but also entails practice management and administration. In addition, practitioners must liaise with other healthcare professionals and hospitals. 

The practice manager 

The practice manager plans, coordinates, directs and supervises various elements of a medical practice. This role ties all the loose ends together and oversees the general processes of the practice. This role is vital to oversee billing and collections, design patient services, and implement employee workplace policies. Daily interactions with employees and patients require that this person has excellent people skills. In addition, this person must analyse and interpret reports, provide feedback to the practice owners and implement strategies to ensure that the practice's finances are healthy and profitable. 

The receptionist 

The receptionist must have excellent communication skills since they are the face of the practice. In addition, this person must have the ability to optimise patient satisfaction, the practitioner's time, and treatment room utilisation by managing the scheduling effectively. Finally, proper record-keeping must be done meticulously to ensure that the practice is both POPIA compliant, efficient and profitable. 

The billing expert 

The billing expert creates invoices based on a proper knowledge of medical coding for each consultation and procedure. This role checks the claim history report to make sure all rejections of claims are dealt with timely and effectively. The Billing Expert processes corrections, submits claims for payment to medical aids or administrators by electronic data interchange (EDI) and then ensures that payment is received. This role also issues private patient invoices and statements to clients. 

The cashier 

The cashier must accurately and efficiently operate cash registers, ensure that there is sufficient cash in the cash drawer and maintain correct cash balances at cash registers. In addition, this role must process cash and card payments and reconcile these payments at the end of the day. Finally, the cashier must see that no patient who owes money leaves the practice without settlement of the outstanding account. 

The credit controller 

The credit controller must maintain strong relationships with all clients to ensure they pay their invoices. They must manage the effective collection of all outstanding accounts and negotiate payment plans where necessary. Payments must be allocated, and electronic remittance advices (ERAs) imported daily so that reports can verify which accounts are outstanding. Timely debt management will result in few write-offs and good cash flow. 

The stock controller 

The stock controller manages medical stock to prevent overstocking or running out-of-stock. The role also oversees the storage of products, particularly fragile items, and coordinates regular stock takes and audits to prevent and manage stock losses. 

The bookkeeper 

The bookkeeper records all financial transactions in a double-entry accounting system and ensures that regular reconciliation of all accounts keeps the practice's records without error. In addition, the bookkeeper manages purchases and payments of medical supplies, equipment, and office supplies and manages the assets and cash flow of the practice. Regular reporting makes the management of the practice easy and stress-free, and the bookkeeper assists owners to interpret reports so that they can make good decisions. 

Some final points to consider 

1. It is essential to appoint competent personnel who can adequately fulfil the critical roles in the practice. If you find that a person you are trying to recruit has most of the skills but not all, you can upskill them by sending them for practice management training. Providing proper training to staff will significantly benefit the practice and eliminate unnecessary problems. For example, a billing expert must be skilled in medical billing or take medical billing courses presented by the different healthcare associations and universities. Failing to bill correctly will result in severe financial losses 
2. Ensure that all employees know their roles in the practice and what is expected by documenting the requirements. A lack of proper role division and work definition can result in needed tasks not being completed 
3. Ensure a proper separation of duties to prevent fraud in the practice, eg, choose carefully who may create write-off journals 
4. Ensure that there is proper software access control in place so that personnel cannot perform unauthorised transactions or actions (eg, generate reports with confidential information in them) 
5. Establish a monthly meeting to discuss difficulties, solutions to past problems, operational or employee issues, and allow employees to make constructive recommendations about the operational scope of their functions. If controls are not established with the direct involvement of the employees, they will become passive resistors instead of enthusiastic supporters. Make sure that your employees understand the importance of the controls and implement them.