Despite looming predictions about the economy, employment rates have still not stabilized in the health care industry. Medical practices remain challenged by staffing shortages – and high turnover rates. There is no end in sight, so it pays to brush up on recruitment and retention tactics to ensure you’re taking advantage of every opportunity to get – and keep – the best employees.
Find the best. Locating talent is tough because every hospital, health system, nursing home, etc., is searching for the same employees you are. Climb up the hiring ladder by getting closer to the applicants’ decision point. Months before a potential employee completes their education or training, they look for a job. If they have had on-the-job training, they typically look for employment there first. Why? It’s familiar – and hopefully, they liked the environment. The training site typically makes offers to the best trainees, letting the rest go to the market. Serving as a training site is optimal for recruiting and provides an opportunity for an employer to review the skills of trainees and hire the best candidates. Look around for a program, and volunteer as a preceptor, externship site, etc. For administrative employees, don’t be shy about hiring from other industries. Someone in hospitality or retail can make a great receptionist. While it may take some time to educate a new employee in the steps to schedule an appointment or post a charge, it’s impossible to teach someone to smile. The “fit” of a new hire can be more important than experience.
Be creative. Historically, medical practices have hired employees for on-site, forty-hour work weeks. The pandemic has changed the traditional work environment. Are there tasks that don’t require an employee to be on-site? It’s difficult to hire and start someone in a remote position, however it’s a great opportunity for a trusted employee who must leave because their spouse was transferred out of state for work, for example. They can schedule appointments from California, just as easily as they can from your physical office. Before a star employee walks out the door, consider making them an offer to work remotely.
Another area of creativity that is rarely used in medical practices is part-time work. Consider hiring two employees, 20 hours each. Why? It lessens the blow to your operations if one leaves (because one is still there); it opens a pool of potential employees who can’t or don’t want full-time work – and are often highly educated and skilled; and you can more easily adjust the hours for the practice’s peak times (e.g., hire both part-timers to work on Mondays[!]). Finally, two part-timers are often less expensive per worked hour because of the reduced benefits offered.
Clean house. There’s never been a better time to take a good look at your team. Do you have the best employees – or are you keeping employees who are no longer contributing (or never did)? Given the staffing shortages, some employees have taken advantage of the situation. They are a “butt in the seat,” as one office manager put it to me. They are not, however, effective at their duties. It’s not uncommon for an under-performing employee to be tolerated by a practice owner who considers the employee to be bad at their job, but rationalizes that at least they show up for work. However, the negative ripple effect reaches far beyond that employee’s workstation. Because a medical practice requires a team approach for basically every function provided – from scheduling to rooming to orders to payment – an ineffective employee drags everything (and everyone) down. If necessary, hire someone else for the position before letting go of the poor employee. Pre-hiring is a technique that is used in many businesses; it costs a little more but is certainly worth it if the situation dictates.
Keep the team motivated. Money has traditionally been the go-to reward for good employees, however research has demonstrated that workplace flexibility, personal well-being, and professional development should be the focus of retention strategies. While an hour off on a Friday afternoon may not excite you, paid time off is a great reward for employees. If you can’t afford an hour off, consider allowing employees the ability to swap time. Let’s say one of your receptionists needs two hours to attend their child’s middle school graduation next Thursday; provide a Google spreadsheet that allows them to place the request for the time and another employee to pick it up for a swap. This exchange system requires some administration, but the flexibility can be terrific for retention. Look for means to deliver workplace flexibility. Well-being is another key pillar for retention; small appreciation gifts may include bringing lunch into the office or having family-sized casseroles delivered for employees to take home for dinner. Tickets for the movies or a local sporting event are likewise appreciated. Consider ways to provide for the employee inside the workplace, but also opportunities to support them holistically without crossing personal boundaries. Finally, seek out training opportunities for employees. It helps them and supports your practice with higher-skilled employees.
Great employees make great medical practices. It’s an opportune time to evaluate your team – and make sure that you’re delivering the optimal environment to create, nurture, and maintain the best employees.
We encourage you to check out SVMIC's very helpful HR Toolkit to help with your staffing challenges.
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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