The clinician who founded the practice is still approving the stock order, chasing the HMO, arranging the generator service and writing the rota. They are doing it after clinic, tired, and it is the part of the week they resent.

The question is not whether that is a good use of a clinician's time. It plainly is not. The question is when it becomes affordable to change, and practices usually answer it too late.

The signals that you are already past the point

  • Administrative work is being done after hours as a matter of routine, not occasionally.
  • Money is being lost to unclaimed or rejected HMO claims that nobody has time to chase.
  • Stock runs out, or expires, because ordering depends on someone remembering.
  • Staff issues are handled late because there is no time to handle them early.
  • You cannot take leave without the practice degrading.
  • You do not know your own numbers, and finding out would take a weekend.

The last two are the clearest. A practice whose administration depends entirely on one clinical person has a structural fragility that no amount of individual effort fixes.

What the role actually covers

Be specific before advertising, because "practice manager" means very different things in different clinics. Typically it spans:

  • Rotas, leave and day-to-day staffing
  • Supplier relationships, stock and equipment maintenance
  • The revenue cycle: billing, HMO claims, chasing outstanding payments
  • Compliance, licences, registrations and inspections
  • Patient complaints, up to the point where clinical judgement is needed
  • Reporting: what came in, what went out, what is outstanding

What it does not cover is clinical decision-making, and the boundary should be written down so that neither party has to negotiate it later.

Hire for judgement, not sector experience

Healthcare-specific knowledge is learnable. Judgement, discretion around confidential information, and the ability to have a difficult conversation with a supplier or a staff member are not. A capable administrator from another sector often outperforms someone who has worked in clinics but never had to decide anything.

Hand over properly

The common failure is hiring someone and then continuing to approve everything, which produces the cost without the relief. Delegate whole areas rather than tasks, with a defined limit on spending authority and an agreed reporting rhythm.

Expect the first few months to feel slower. You are transferring knowledge that currently exists only in your head, and that transfer is the work.

Write down what only you know

Before they start, spend an evening listing the things that live nowhere but your memory: which supplier is reliable, which HMO always queries, when the licence renews, who services the equipment. That list is the single most valuable document in the handover.