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Restructuring – A Necessary Thing to Do for Growth

Over the years, Points has helped many companies grow. One of the common mistakes and major obstacles that we see neglected by healthcare companies is the need to restructure the company regularly. Often, companies fight the symptoms instead of understanding and fixing the underlying structural issues. Usually restructuring becomes necessary when your operational capabilities are outgrown by the volume of “business transactions” or by geographic expansion.

Common Signs That You Need to Restructure

So what are the indications that restructuring is a necessity? Here are some of the common signs:

  • You have a lot of great ideas for improving the practice, but don’t have the staff to do it
  • You keep telling your staff how to do certain things and they can’t/don’t act on your instructions
  • You have too many high priority projects where implementation or completion are moving at a snail’s pace
  • Implementing standardized processes across multiple locations is difficult
  • Your % of overdue collections is growing
  • Your % of collections is declining
  • Patient satisfaction is declining
  • Staff satisfaction is declining
  • You have office locations that seem to behave and act completely different or independently from other locations
  • Changing job descriptions is difficult, especially if job descriptions don’t exist
  • You keep adding new responsibilities to people’s list of duties, because everybody is too busy
  • Your staff-to-doctor count is too high

What restructuring will mean to your particular practice depends upon the situation, size of practice and issues you have. Regardless of the challenges you may be experiencing, there are a variety of things you need to do or should have done that are pre-requisites or crucial elements of any restructuring, such as:

  • Create an “As-Is” Organization Chart. The starting point of any restructuring is always the as-is. Draw your organization chart. The visualization of the organization on paper often reveals obvious issues with the structure
  • Create “As-Is” Job Descriptions. Creating job descriptions helps you detect problem areas (e.g., an in-balance of work tasks between people and positions or people that have a very diverse set of responsibilities)
  • Process List. Make a list of all your major processes. For each process, determine if they fit in the following categories: “works smooth”, “minor problems” or “major problems”. In the problem categories, list the issues
  • Create the “To-Be” Organization Chart. Based on the weaknesses of your organization and processes, create a new organization structure. Do this in conjunction with the re-engineering of your processes
  • Re-Engineer Your Processes. Document how the processes should work. Take the initial process assessment into account with the new potential organization structure
  • Create “To-Be” Job Descriptions. Once you have the new organization structure created and the processes defined, document the job descriptions for each of the positions. Ensure you don’t “build” new problems into the new structure and processes

As your operation grows, one of the critical parts of restructuring is the recognition that you might need to create new positions. Most of the time, these needs are driven by larger organizations where supervisors and managers are needed.

In addition, you always have to re-assess if your current management is capable of managing your grown organization. Don’t give this answer a default yes. Read my blog, Medical Practice Growth: Top 5 Mistakes Preventing Your Growth to learn more about the role of your practice management.

In summary, learn how to read the signs that indicate you may need to restructure your practice. Restructure regularly and make sure you document the changes to your organization, processes and job descriptions.