Hiring is a constant in a medical practice. According to the Medical Group Management Association, the employee turnover rate for surgical practices is 33 percent, 25 percent, and 30 percent for reception, nursing, and billing/collections staff, respectively. Although the rate varies by position, there is no doubt that recruiting an employee will be on your agenda sometime soon, if it isn’t at the top of the list today. Consider these steps to ensure that your practice performs staff hiring effectively and efficiently.
Tip 1: Host a Working Interview
Once you decide on your ideal candidate, invite them to come for a final “working” interview. Typically scheduled for four hours, if not the entire business day, this opportunity allows you and your team to see the candidate in action. Engage your team in the decision – an action that will surely boost their morale – by asking them for their opinion. Further, the working interview also gives the candidate a better understanding of your practice, often preventing that “this is not the job that I expected” departure after just a few days post-employment. The ability to conduct such a working interview on a pre-employment basis may depend on state law, as well as the candidate's exposure to protected health information (PHI), so please check with an attorney familiar with employment and privacy regulations in your area before implementing this idea.
Tip 2: Cover the Basics
Retention challenges often stem from a lack of training. From your receptionist to your nurse supervisor, provide orientation and basic training on all of the management information systems that you use. This includes the practice management, electronic health record, and telecommunications systems. Having a working knowledge of all three not only helps new employees in their roles, but it also ensures they can comfortably serve as team members. Although each individual is tasked with a specific job, it is this opportunity to work together as a team that ensures a successful practice.
Tip 3: Hold Departure Interviews
Losing an employee is never ideal since it leaves a gap in your practice’s administration or operations. However, understanding why that employee is departing can provide valuable insight. Ask for (at least) 15 minutes to sit down with the employee during his or her final days of employment and have a frank discussion about the employee’s decision to leave the practice. You may not agree with the reasoning, and often the issue comes down to money. However, with nothing to lose, this final meeting can increase your awareness about potential opportunities to improve your practice to ensure that it is a desirable place to work. Remember that it’s crucial to be non-judgmental and to listen with an open mind, rather than using this forum to argue at this stage. Consult with an attorney about the protocols for exit interviews; if there are any contentious issues related to the employee’s departure, consider seeking the advice of your lawyer as to whether to even hold such a meeting.
Tip 4: Engage a School
Educational institutions involved in educating medical assistants, phlebotomists, radiology technologists, and many other skill-based positions incorporate a requirement for external training. Engage in a partnership with an institution – or more than one – to accommodate their externships. This has a two-fold benefit: your practice gains valuable labor at little to no cost, while providing you the opportunity to view first-hand the skills, experience, and work ethic associated with potential candidates. In other words, you gain access to the best and the brightest before they go on to the labor market. If you find the relationship draining – i.e. the students take more time and investment than any benefit to your practice – you can always discontinue the association with the institution.
Tip 5: Determine Fit, Not Just Function
Historically, practices have hired based on two criteria: (1) Have you worked in our specialty before and (2) Are you trained in our information systems (e.g., practice management and electronic health record)? If not, then the candidate is typically discarded from consideration with the notion that we are, of course, so unique that no one could possibly work here without experience in both areas. While every practice is different, this approach limits the pool of candidates, sometimes so much that the only option is rehiring the employees who were let go last year! Instead of specialty and system expertise, considering looking for loyal, hard-working team players who are service- and team-oriented. Remember, you can train someone to assist you in a procedure, but you can’t teach them how to smile.
Tip 6: Know Where to Look
Job postings in the newspaper are no longer an effective option; getting the word out about your new position takes hard work and a bit of ingenuity. Use posting boards and listservs based at local community colleges, universities, and training schools; try professional networking sites such as LinkedIn.com; and benefit from healthcare-focused job sites like HealtheCareers.com. In addition to posting positions, it pays to be on the lookout. This may include current employees who have a friend or colleague seeking a new position (consider paying a small “finder’s fee” if their recommendation ends up as a hire) or associates you bump into at a retailer who impress you with their skills.
Tip 7: Invest
Hiring is a key part of your human resources strategy, yet this area is challenging because humans are, well, human. You may find yourself in the position of an extreme drought of qualified candidates, followed by a rash of great ones. Consider introducing a little flexibility in your hiring practices. If you encounter two out-of-this-world medical assistants (MAs), for example, but only have one MA position open, hire both, cross-training them on needed front-office duties. While this isn’t always possible, making a small advance related to hiring “excess” staff, if expectations are set appropriately, may be the best investment you can make.
Tip 8: Recognize Appropriate Payment
Candidates won’t pursue your open positions if they don’t feel the payment is fair. Glean market data about salaries – for free – from websites like Salary.com or reference the U.S. Bureau of Labor Statistics (bls.gov). Because wages fluctuate, double check this information every six to 12 months to ensure that you’re not only able to hire the greatest but also retain the best. As you well know, wages are only a portion of the investment you make into an employee. Yet, most of your staff focus only on that element of their compensation. Why? That’s what employers post about the position – “$14.50 per hour,” for example. Sometimes the term, “plus benefits,” is added, but it’s nebulous. Create a spreadsheet with all employee benefits listed with a description and the associated value. Sum the “actual” hourly wage at the bottom and provide a professional-looking compensation statement to all candidates. This will certainly boost interest in your practice and may even sway the best candidates to join you.
Tip 9: Start Retaining from Day One
Extending an offer of employment may be routine for your practice, but it’s a life-altering opportunity for candidates. Avoid leaving voicemails or texting; rather, call or meet with the individual to make the offer. Use positive terms like “welcome,” “team,” “value,” and “opportunity” during your discussion, providing the candidate with a strong impression about your culture. On the first day, create a written agenda for the day or week with a “thank you for joining our team” message at the top. Have the employee’s nametag ready, avoiding the label stuck on top of an old employee’s tag scenario, and provide the uniform (or be prepared to take the measurements to order it). You want the employee to feel engaged with your practice from the very moment they start. For a special touch, consider sending flowers to their house with a message of welcome.
Hiring employees for your practice is never a one-time occurrence. The more prepared you are when it comes time to hiring, the more likely you are to find the best candidate for your next open position.
Elizabeth Woodcock is the founder and principal of Woodcock & Associates. She has focused on medical practice operations and revenue cycle management for more than 25 years. She has led educational sessions for a multitude of national professional associations and specialty societies, and consulted for clients as diverse as a solo orthopaedic surgeon in rural Georgia to the Mayo Clinic. She is author or co-author of 17 best-selling practice management books, to include Mastering Patient Flow and The Physician Billing Process: Avoiding Potholes in the Road to Getting Paid. Elizabeth is a Fellow in the American College of Medical Practice Executives and a Certified Professional Coder. In addition to a Bachelor of Arts from Duke University, she completed a Master of Business Administration in healthcare management from The Wharton School of Business of the University of Pennsylvania. She is currently a doctoral student at the Bloomberg School of Public Health of Johns Hopkins University.
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