Your day might not be anything like what I’ve described below, but the point of the post is to suggest that most administrators put out fires all day long and juggle meetings, email, and employee and physician issues and have very little time for planning and thinking. Depending on how long you’ve been with your current group, how well trained your staff are, and how many supervisors you have working with you, you might have a much easier day than described below, or a much harder one!

7:00 – 8:00 a.m.

An employee calls you at home before 7 a.m. to say they will not be in. You check the schedule to see how staff can be re-arranged to cover all needs.

8:00 – 9:00 a.m.

As you arrive, two employees have been waiting for you and have things to discuss with you – one wants to reschedule her vacation for the third time and the other wants information on FMLA (Family Medical Leave Act.) You tell the first you’ll look at the schedule and get back to her and hand the second a packet of info on FMLA to review.

You check your schedule and note that Nurse’s Day is coming up soon and you need to make plans to celebrate their day.

You check your email and see that your state listserv has some interesting information that you forward to your billing manager, asking her to look into the issue and tell you if it applies to your practice.

9:00 – 11:00 a.m.

You handle a patient complaint. You round on everyone in the practice, checking to make sure everyone has what they need and checking on their weekends. On your way back to your office, a nurse mentions that the exam rooms are not being cleaned as thoroughly as they should be; you make a mental note to speak with the cleaning company.

Your 9:30 a.m. meeting is with a broker who has some quotes to share with you in anticipation of your June 30 benefits year-end. Your senior physician has asked that the group consider cutting benefits this year if health insurance rates go up again.

You listen to several voice mail messages that came in while you were meeting with the benefits broker. The first is your EMR project manager calling to say your go-live date might need to be changed; please call him back. Another is a payer asking to schedule a chart audit sometime in the next three weeks.

11:00 – 12:00 p.m.

A physician lets you know that she’s using the last of the Rx pads – could you order some more ASAP?

It is payroll week and you spend most of the hour finishing the payroll and checking with the four employees whose payroll record is missing a punch. You send the payroll file out and move money into the payroll account, checking the bank balance and noting the Electronic Funds Transfer that came in since you checked it on Friday.

12:00 – 1:00 p.m.

You meet with a physician who has concerns about the compensation schedule. He asks for a report showing his charges, receipts and work RVUs by month for the past two years.

You receive your mail, put bills in the to-be-paid file and note that an employee that you terminated is appealing her unemployment denial and there will be a hearing next week.

You call your printer and put a rush order on Rx pads.

1:00 – 2:00 p.m.

You look at your calendar and remember the accountant is coming for her quarterly visit today and you don’t have everything ready.

You realize lunch is out for today, grab a soft drink from the break room, grab a packet of crackers from your drawer and review your email. You’ve been advertising on craigslist for a medical records clerk and you take a quick look at the responses you’ve gotten and see there are two that look like they have possibilities. You call both candidates and leave messages that you’d like to speak with them about the position.

You get the rest of the information together for the accountant and clear a space at the desk where she works when she comes.

2:00 – 3:00 p.m.

The accountant arrives and starts working, and you know you’ll need to stay close to answer any questions she has.

You start working on the reports that the physician has asked for.

You call your EMR project manager but get his voice mail and leave a message. You call the payer and ask for a list of the charts needed for the chart review with a request letter detailing the type of audit.

You start reviewing the report from the benefits broker to see where you might be able to change other benefits to afford to continue the same health insurance plan.

3:00 – 4:00 p.m.

One of the medical record candidates calls back and you talk with her at length, then invite her to interview with you in two days.

You review the staff vacation schedule to see if you can change the schedule for the employee who has changed her mind about her dates.

You round on everyone in the practice again, checking to see that everyone got a lunch and that things are running smoothly.

When you return from the bathroom you have five voice mails (!), one of them the EMR project manager calling you back again.

4:00 – 6:00 p.m.

Your billing manager arrives for her standing weekly meeting and reviews the previous week’s dashboard numbers for charges, receipts, write-offs and accounts sent to collections. She tells you that one of the check posters has noticed that a payer is not adhering to the contract on payments. The manager wants to know what to do about it. You ask her to track back the payments and identify exactly when the payments started going off-schedule. You call the payer representative and ask for a meeting later this week.

You receive a call back from the second medical records candidate and after speaking with her on the phone, you decide not to invite her to interview.

The employee asking about FMLA stops by and makes an appointment to speak with you tomorrow morning. She tells you that her mother is ill and she will need to miss work to care for her intermittently.

The cleaning crew arrives and you walk through several exam rooms with them, talking about the level of cleanliness that is required. You make a mental note to touch base with the nurse who is monitoring the rooms and see if there is improvement in a few days.

You check your email, straighten your desk surface, notice the to-do list you started the day with that has nothing crossed off. You add two more things to the list, turn off the lights, and leave the office. There’s always tomorrow.