Look at bigger picture for career advancement
Grass is greener’ whichever direction you look
When it comes to the life and work of an access manager vs. that of a health care consultant, the grass truly is always greener on the other side, says Beth Ingram, CHAM, director of patient financial services at Touro Infirmary in New Orleans.
Whatever direction you’re going, experience in one job brings valuable skills to the other, adds Ingram, who has come full circle in the access/ consulting loop: She spent 25 years in patient access and business office positions, worked as a consultant for two companies between 1994 and 1999, and recently returned to the world of hospital management.
"The experience that you get being a hospital department director or manager in assessing, implementing new systems, and working through problems positions you very well to go into the consulting field," Ingram says. "It puts you at an advantage over people who have more technical experience on systems but don’t understand the overall hospital process as well."
Her message for access managers and directors looking to expand their horizons: "Do as many different things as you can; volunteer for as many committees as you can, particularly those that cross multiple departments, so you can learn how things fit together."
In both her consulting positions, Ingram points out, she acted as a project manager, with involvement in a lot of process engineering. One company outsourced and ran medical records and admitting departments, she says. "As the professional services director, I supported the director [at the client site] and even served as interim director if there was a vacancy. We were trying to re-engineer to the savings we had promised the client."
At Detroit-based Superior Consulting Co., she says, she managed a wide range of projects, depending on the client’s need. "There were nine or 10 [cases] where I was helping the hospital implement a new system of some kind. Process improvement is part of that — make sure they’re maximizing use of the system, automating as much as they could."
One important trait often missing in access managers but invaluable in consultants is objectivity, she says. "It’s the ability to separate yourself from your narrow corner of the world, look at the organization from the big-picture standpoint, without just thinking of your piece, and ask, What is in the best interest of this organization? How would this process work to support the overall goals of the organization?’"
A frequent pitfall for access managers is becoming fatalistic about what they can accomplish, Ingram says. "They begin to get complacent about what they can do, what they can affect." It’s true that some problems are out of one’s control, she adds, "but you can always keep trying to address the issues you do control.
"The real key is to look at facts, not feelings," she says. "When you get buried in details, you get to the feeling level. Step back and collect the data that is required, and do that without it being a seven-month project."
For example, an access manager who gets calls every day from the emergency department saying there aren’t enough staff should plot for two weeks what time patients come in and what time employees are there, she suggests. "You will find you’re staffing to the needs of the employees and not the patients. Shift one person’s hours by three hours and make all the difference in the world."
As a consultant, she worked in dozens of hospitals where that approach was not taken. The barrier to that kind of critical thinking, crucial in the consulting arena, is often that managers think data collection has to be a big, formal process, she says.
"What people frequently don’t do well at hospitals, but that is taught very well to consultants, is documentation," she says. "[In consulting], you have to document everything you do all day long every day. That’s how the company demonstrates value to the client. You also have to make sure you’re documenting decisions and the steps you’re taking to go through a process, so when you’re gone, [the client] will know how to carry on."
Although her current employer does require such documentation, including monthly reports from each director, that isn’t the norm at most hospitals, she says.
Returning home
Coming back into a hospital setting, she has drawn on a "toolbox of information" gathered during her time on the road as a consultant. "I’ve seen things done a million different ways — how people worked through processes — and it’s so much easier to deal with the issues than it was before."
The biggest choice Ingram faced in considering a return to a hospital director position had to do with people management. When she left, "I was ready not to manage people anymore, not to have that responsibility. That part of consulting is very nice."
The tradeoff in returning, she says, was regaining the camaraderie and sense of family that working at a hospital provides. "It’s not that the [consulting firms] don’t help you feel part of the company, but it’s different from being in a facility with people interacting face to face."
Her consulting experience, meanwhile, has strengthened those people-management skills, she says. "When you go back to [hospital management] after having been out of it, you have seen the best and worst of management styles and really are positioned to do things a different way [and] be more objective.
"I remember agonizing over having to tell somebody they’re not doing a good job," Ingram says. "Now, while it’s not pleasant, it’s just a matter of business. We have a job to do. You’re doing what you’re doing because it’s the right thing to do for the organization that pays your salary. It deserves the same level of commitment and drive that someone would give who was there as a consultant being sold as a value-added product."
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