In this episode of the MGMA Insights Podcast, host Daniel Williams, Senior Editor at MGMA, speaks with Michelle Mainord, RN, FACMPE, Practice Administrator at Cookeville Gynecology in Cookeville, Tennessee, and the 2025 ACMPE Forum Representative of the Year. Mainord discusses her transition from nursing to administration, the growth of her physician-owned practice in rural Tennessee, and her passion for mentoring healthcare leaders through MGMA’s American College of Medical Practice Executives (ACMPE) certification and fellowship programs.
Cookville Gynecology, Mainord explained, is a physician-owned practice that provides care across a large geographic area between Nashville and Knoxville.
“We’re halfway between Nashville and Knoxville,” she said. “We have one large hospital in our county, but we have a 14-county region, and not all the counties in that region have hospitals. So we see people that drive an hour, hour and a half to get to us.”
Under her guidance, the practice has grown from a single physician and one nurse practitioner to six providers and a patient base exceeding 20,000. Her experience underscores how healthcare leaders in regional areas must balance operational management with the mission of expanding access to specialized care.
Bridging the Front and Back Office Divide
Before stepping into her administration role, Mainord worked as a nurse — an experience that continues to inform her leadership style. She says that one of her early lessons as an administrator was addressing the friction that can occur between clinical and administrative staff.
“My experience, and from other people that I've spoken with, they have a similar experience a lot of times, where the front is against the back,” Mainord said. “You might say the front office people and the clinical people don't always see eye to eye, and there's a friction."
"So we worked very hard to make sure that that was not the case," she added.
Her strategy for solving this tension centers on communication and collaboration. “Walking a mile in somebody else's shoes definitely helps you understand where they're coming from,” she explained. “We also have relied on cross training. We have some MAs that work in the front and the back.”
For practice leaders, her message is clear: developing cross-functional understanding fosters unity and efficiency, particularly in small or midsize practices where teamwork is essential.
Connecting Clinical Work to Financial Health
Mainord’s dual background gives her the ability to help teams understand how administrative processes directly affect patient care and financial stability.
“It truly has enabled me to share what I know ... to make a difference for that person who's hearing what I'm trying to say,” she said. “[Using] ABN forms as an example: Medicare requires advanced beneficiary notice forms — on the clinical side when I had to deal with those, that’s not something that was always top of mind.”
By framing these administrative requirements as necessary to sustaining patient access and practice revenue, she helps staff stay engaged. “If you can explain something to a person in a way that they get, ‘Okay, we have to do this in order to get paid,’ then it’s more easily understood,” she said.
For medical group leaders, this illustrates the importance of contextual communication — connecting the “why” behind each policy to the realities of clinical workflow.
The ACMPE Journey: From Certification to Leadership
Mainord began her ACMPE certification process in 2019 and earned her credential in 2020 — a milestone achieved during the disruptions of the COVID-19 pandemic.
“When I actually became certified in 2020,” she said. “I had taken my first exam in the fall of ’19 and at that point we didn’t get automatic results. … I had to wait several weeks and got an email at dinner one night. I was sort of afraid to open the email … and I had passed.”
She later took her scenario exam remotely after the pandemic began. “That was a whole learning experience initially,” she said. “We look back now and having these Zoom meetings is just commonplace, but at the time it wasn’t.”
The experience deepened her appreciation for the mentors who guided her — and her desire to give back to others pursuing certification and fellowship. “People know more than they think they do,” Mainord said. “But it does require effort, for sure, so I just want to share that encouragement with them.”
Mentorship as a Multiplier for Success
Mainord now serves as Tennessee’s ACMPE Forum Representative, where she leads study groups and boot camps designed to guide members through certification. She finds her greatest satisfaction in seeing others reach their goals.
“I was so thrilled when one of the T-MGMA members achieved fellowship this year,” she said. “She had been working on it for quite some time … and she was able to have a presentation at our local chapter. It was just thrilling when she called up, just so excited, you know, to finally have achieved that accomplishment.”
For Mainord, mentorship isn’t a one-time act — it’s part of a cycle that sustains leadership in healthcare management. “It does seem like the ACMPE program and the fellowship, even though there’s an individual being recognized because you’re the one doing the work, it does seem like mentorship … plays a key role in the process,” she said.
Overcoming Barriers to Professional Growth
Mainord acknowledges that one of the most common challenges for practice leaders is finding time for certification amid day-to-day responsibilities.
“I think time is a big factor, because the responsibilities of a practice manager are so… we just don’t have enough of it,” she said. “We give so much to other people, we sort of put ourselves on the back burner sometimes.”
To address that, she recommends starting with the MGMA Principles of Practice Management Certificate, which provides foundational understanding and builds confidence. “It gives an overall view of the things that are going to be important, things that are going to be tested upon,” she shared.
Study groups also provide motivation and accountability. “We had our study group today, actually, and the topic was financial management,” she said. “People are sharing information in the chat and interacting, and it’s truly encouraging just to know other people are on this journey, too.”
Shaping the Future of Healthcare Leadership
As she looks to the future, Mainord is energized by how ACMPE continues to adapt to a changing healthcare environment.
“What excites me most about the future of ACMP is how it continues to evolve with the challenges that we’re seeing,” she said. “The field of healthcare is fast moving — new technologies, new care models, higher expectations for patient care — and I think we’re uniquely positioned to help leaders stay ahead, even in that type of environment.”
Her passion lies in helping members build confidence and leadership skills. “For me, I am passionate about mentoring, and the most rewarding part is supporting members on their journey, whether that’s starting certification, pursuing fellowship, or just building confidence in their leadership abilities,” she said. “I see my role as helping people connect the dots between where they are and where they want to be, and making sure that they feel supported and encouraged along the way.”
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