Your staff is one of the most costly and important investments your practice will make. You must not only pay competitive wages and offer attractive benefits to attract qualified staff, but also provide a nurturing environment to retain great staff. By doing so, employees will be less tempted to change jobs for a nominal raise after you have invested precious time and money in on-the-job training.
In addition, studies have shown that patients often judge the skill of a doctor by the friendliness and apparent competence of his or her staff. The expertise of your employees is the key to the perceived quality of care you provide. As physicians or managers, you cannot be successful without the help of good employees.
Here are four guidelines that have helped me in my efforts to develop a team of excellent employees:
1. Hire the Best People
The decision to hire is one of the most important decisions you make in a practice, but many doctors and managers do not give it the attention it deserves. You need to pay the price in time, effort and money to hire the best people. Important steps include:
- Post well-worded job postings to attract a qualified pool of candidates.
- Review all resumes carefully and look for red flags, such as sloppiness and misspelled words.
- Call the best applicants and do a short interview over the phone to see how they present themselves.
- Narrow the pool down to a few candidates and arrange for several doctors, managers or employees to do in-depth personal interviews. It is important to have more than just one or two opinions.
- Ask each candidate to fill out an application while waiting for the interviews so you can review the legibility of handwriting, as well as reviewing their work history (without the “packaging” of that contained in the resume).
- Ask questions such as, “Why did you leave your previous jobs? What did you like best or dislike most about your previous jobs? What did you do in your previous job? What kind of job are you looking for now?”
- Call to check references.
- Have a package with reasonable pay and benefits for employees.
2. Keep Good Employees
Once you hire and train good people, you need to do all you can to avoid losing them. Loss of one employee usually costs more than $5,000. And the problems caused by losing an employee include:
- Bad morale in the office.
- Extra time and energy used by other employees to try to keep up with the work load
- Extra costs due to overtime wages.
- Loss of referrals or collections due to being understaffed.
- Extra time used by employees hiring and training a new employee.
- Extra work time necessary due to inefficiency in the office.
3. Be a Coach, Not a Taskmaster
No one can be forced to do his/her best. Effective motivation must come from the employee. The personal satisfaction of doing a good job motivates far better than any punishment.
A skilled manager gives an employee “ownership” of each job or project. The employee should be encouraged to set his or her own goals and the manager should provide coaching by providing feedback and encouraging completion.
Some doctors and managers think that employees are “paid to do as they are told.” That, however, is the job of a computer. Employees should think, feel and do what is best in each situation. If the doctor or manager is the only one thinking, it is not a healthy situation or a strong practice.
You should always be encouraging to staff. Your employees should hear one of two phrases from you regularly: “Wow! You have done a great job!” or “How can I help you?”
4. Avoid the Cycle of Fear
The cycle of fear in an office often starts with the doctor or manager micromanaging the job of employees. Employees become fearful and begin making mistakes. The doctor or manager corrects the mistakes and is seen as being critical or judgmental. This leads to more fear and more mistakes. The employees work to hide the mistakes. The doctor or manager then feels compelled to micromanage more closely and thereby sets up more fear and more mistakes.
The way to break the cycle is for the doctor or manager to avoid micromanaging and focus on learning, rather than judgment. Start with the assumption that you have assembled the best possible employees. If an employee makes a mistake, start by assuming it is due to a situation or process in the office that allows or encourages mistakes.
If a mistake is made, you shouldn’t care much who made the mistake, since the assumption is that anyone could have done it. Instead, learn what mistake was made, what situation precipitated the mistake, why the mistake occurred and how can you avoid similar mistakes in the future.
If you focus on quality improvement in the traditional way — reprimanding or getting rid of weak or mistake-prone employees — you do very little to improve overall quality. If, instead, you focus on improving all procedures and all employees, even the best employees can improve. This brings a much greater improvement to overall office quality.
Problems will always exist in the office whether you know about them or not. You should encourage employees to come to you with problems they see.
When they do, be careful not to “shoot the messenger” by criticizing them or making them uncomfortable in any way. Instead, encourage or reward them for their courage and openness. It is difficult to go to the boss or manager with a problem. If you do not do all you can to make it easy and pleasant, employees will not take the risk of coming to you, and problems will be kept hidden.
When someone comes to you with a problem, turn the tables and ask the employee to share his or her suggestions on how to solve the problem. The employee will be encouraged to take a step back and look at the bigger picture. As the employee helps solve the problem, he or she will gain understanding, compassion and respect for the challenges the manager faces.
Employees will never give their best unless they know that the doctor or manager has their best interests at heart. We need to always remember the “golden rule” — treat people the way that we would want to be treated.
Treating employees well costs the practice less in the long run. Training and keeping good employees is usually the most important thing a practice can do.
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About the author: Gregory S. Brinton, MD, MBA, completed his residency at the Bascom Palmer Eye Institute and his retina fellowship in Milwaukee. He later started Retina Associates of Utah and obtained his MBA degree. He is an expert in office efficiency and has spoken throughout the country on this topic. He joined the AAOE Board in January 2008.