Those two words can strike dread into the heart of a physician running a busy practice. Finding, hiring, and retaining good staff can be a real challenge for physicians already swamped with all the details of operating a successful practice. And the tight health-care job market in many parts of the country makes it even tougher.
“Doctors have to take care of all the aspects of running a business, including hiring, and of course they have to be out there treating patients—it’s not easy,” says Chris Forman, the president and CEO of AIRS, an employee training and consulting firm in Wilder, Vermont. “The reality is, many doctors are not professional managers. One of the things that happens in the health-care environment is you have an individual doctor or a group of people forced into being small business owners.”
Forman knows the challenges firsthand. His wife is a physician and a partner in a family practice. Yet he also believes it is possible to hire and keep great employees. Forman, along with other human resource specialists and successful physicians, says the key is to use fresh tactics that deliver better results than placing traditional help-wanted ads in the newspaper. These six strategies can help you attract—and keep—staffers that will be an asset to your practice.
1. Enlist your employees
A rich resource for finding good employees is already in your office—your existing staff. Physicians looking to grow their practice should make employees aware that they can play a key role in finding new talent.
“You should create the mindset that everyone is always recruiting,” says Forman. “Let employees know that you want them always to be looking for good people who might add value to the organization.”
Your employees probably know other people working in the same field and will most likely only recommend friends or acquaintances who will be solid performers. In addition, your current staff will likely share with potential candidates an honest assessment of what it is like working there. That helps weed out the people who might not be a good fit before you put the time and effort into the interviewing process.
The most successful employee referral programs offer cash bonuses to employees for a referring someone who gets hired. Depending on the market and the complexity of the job being filled, referral bonuses typically range between $200 and $1,000.
Charles E. Crutchfield III, MD, a dermatologist and an associate professor of dermatology at the University of Minnesota Medical School, has grown his practice from a handful of employees five years ago to 42 full- and part-time employees today. Crutchfield has made several key hires through employee referrals. He offers his staff a $500 bonus for a referral that results in a hire that lasts at least one year. One hundred dollars is paid at the time of hire, followed by $200 after six months and the remaining $200 at the end of the year.
“It’s been a successful way to motivate our existing staff to recommend someone they know who might be a good fit with our practice,” says Crutchfield, who is the sole physician working at the practice. “No one knows your office as well as your employees, so it takes a lot of the guesswork out of the hire.”
Yet, Chris Carmon, the CEO of the Carmon Group, a search firm in Cleveland, cautions that employee referrals can sometimes be problematic.
“You have to be careful that an employee doesn’t become too focused on making side money from referrals,” Carmon says. “And if someone makes a referral that is rejected they could cop an attitude. Employee referral programs are great, but it needs to be defined up front that simply making a referral doesn’t necessarily mean the person will be hired.”
2. Sell your strength
Large hospitals and corporations are constantly focused on their “corporate culture.” Physicians running a practice should follow that lead and define what type of atmosphere and culture exists in their office. That makes it easier to look for people who might be a good fit.
“There is nothing a small practice can do on the advertising side to compete with the big hospitals,” Forman says. “The one thing they have to play on is how they practice and the atmosphere they have created in the office that might be attractive to some health-care professionals. There are plenty of RNs who don’t want to work in ICU anymore. They want to do community outreach or work in a family-oriented practice.”
Neil Baum, MD, a urologist working in New Orleans, has worked to create a family-like atmosphere in his office. He gets to know his employees personally, and he publicly recognizes their achievements. He sponsors fun activities outside working hours as well. After Hurricane Katrina hit, many of his loyal employees returned to work for him.
“I treat them like family,” says Baum. “Whenever they have a medical problem, I help them solve it. If they’ve had blood work done, I call and get the results right way. You have to ask yourself this question: ‘Would you want to work in your own practice?’ You should be able to answer ‘yes’ to that.”
An interest in the practice’s focus or mission sorts the field of applicants for some employers. Boris Volshteyn, MD, a plastic surgeon in Reno, Nevada, looks for employees who have a keen interest in cosmetic surgery and are close to the same demographic of many of the patients coming through the door.
“You need to look for staff that can bond with your patients,” Volshteyn says. “As a physician, you have to sit down and ask yourself, ‘What is my demographic and who will relate to my patients the best?’
“I try to get people who are really interested in what we’re doing. If they are not interested in fashion, and not interested in beauty and cosmetic surgery, they are probably not interested in working in a plastic surgeon’s office.”
Also when you’re looking to fill a position, think about someone who might already know the culture in your practice—former employees. Good employees can leave for a range of reasons, but it’s important to let them know clearly that you would welcome them back at a later time. When you hire a former employee, you get a known entity who will require less training.
“We’ve had several employees come back to us after learning the grass wasn’t greener on the other side of the fence,” Crutchfield says. “When they come back they have a better appreciation for what we do here.”
3. Never stop recruiting
Baum is always on the lookout for potential employees. And he looks beyond the health-care field. If Baum encounters an employee who smiles through a hectic morning at a checkout counter at an airport, he leaves his card. He also tells that person to contact him if he is interested in a career change. One of his best hires was initiated when he was eating dinner at a restaurant one night.
“She was a nice waitress with a great smile and I noticed she never wrote anything down even though she was taking orders for six people,” Baum says. “We got to talking and ultimately she came in for an interview. The only thing she knew about working in a doctor’s office was that she had been a patient. We trained her, and she developed a tremendous amount of knowledge about insurance, working with patients, and other issues. She was a great employee.
“I can teach people the skills they need to work in the office. I can’t teach them to be nice. I can’t teach them to be gentle and caring and all the things that I look for in someone on my staff. Pay attention to the person who takes your ticket, smiles, and says, ‘Have a nice flight.’ That’s different than the person who takes your ticket and says, ‘Next.’”
Crutchfield takes a more direct approach to identifying potential candidates in the health-care field. A couple of times each year he offers a lecture to nurses or nursing students. He delivers the lecture at one of the “nicest restaurants in the twin cities.” He buys dinner for the nurses and their spouses, and also delivers a brief lecture in which he shares some information about his practice.
“It ends up being a win-win,” Crutchfield says. “Nurses get a lecture on what they need to know about dermatology at one of the nicest restaurants around. I get to do a mini-commercial for my practice that usually results in us hiring a nurse or two every year. It works out great.”
4. Work your contacts
Baum also has his own recruiting corps—they’re called pharmaceutical reps. When he is looking to make a hire, Baum’s staff informs pharmaceutical reps to get the word out at other offices they are visiting.
“The reps love this office and know that people who work here have a good time and are well paid,” Baum says. “They are a terrific resource that I have used several times. The last receptionist we found was working in a high-pressure office and couldn’t handle the stress. We found her through a pharmaceutical rep, and she’s been a good fit here.”
Contacts who might know a potential candidate are everywhere. When you’re looking to add someone to your staff, tell everyone you know: fellow doctors, nurses, friends, and neighbors. If you are new to an area, join the local chamber of commerce or business or service clubs.
Even patients can be a potential resource. Many offices simply put a help wanted sign in the waiting area. Crutchfield places a small, tasteful ad in the newsletter that he sends to patients, who may either apply themselves or refer other people.
Carmon, the recruiter from Cleveland, says a potentially effective approach is to send a survey to patients asking for their views on the service and care they receive at your office. In the same questionnaire you can ask them if they know anyone interested in pursuing a career with your practice.
“That way you’re getting valuable feedback about your office and also letting people know you are looking to grow and looking for great people,” he says. “When asked, people generally feel good about recommending someone they know who might be a good employee.”
5. Produce a profile
What are the common traits and background experiences of your best employees?
Being able to answer that question can lead to making good hires in the future. Carmon recommends developing a profile of your ideal employee. The key is to develop a bio-data profile that identifies the traits, attitude, and life experiences of employees that thrive in your practice. Establishing the profile can provide some good guidelines when it’s time to hire. The idea isn’t to design the perfect person as if you were ordering from a catalog, but merely to have put some thought into the characteristics typical of your best employees.
“What you’re trying to do is look at everything a person has done to this point in their life—sports, music, activities,” Carmon says. “Research has shown that past behavior is a very good indicator of future behavior.”
For example, Carmon helped develop a bio-data profile for a tree service company that had high turnover. The profile revealed most successful hires for the firm were those people who, among other things, had participated in outdoor team sports in high school or who had military backgrounds. After learning that information, the company refocused its hiring efforts and retention rates increased significantly, Carmon says.
It’s a good idea to contract a consulting firm to help develop the profile as few—if any—physicians or office managers have the time or training to determine what hobbies or past experiences correlate with the personality characteristics you’ve determined are essential to your employees. One place to start, however, is a survey of your current employees about their interests, experiences, and accomplishments.
“Let your employees know why you’re doing this so everyone clearly knows why you’re collecting this information,” Carmon says. “Let them know they can successfully impact your practice. The information will be used as a tool to help grow with the best possible people.”
Finding employees that are compatible with your practice is essential because of the high cost of turnover. The Society for Human Resource Management estimates that the cost of replacing an employee is estimated at one-third of her annual salary. For hard-to-fill specialties, that cost can be even higher.
6. Bump up benefits
Crutchfield freely admits that if he ditched his flexible hours benefit “some of my staff would probably start quitting on me.”
Crutchfield offers employees the option of working four 10-hour days each week. He also allows them to take one unpaid afternoon off each week to run errands or simply have time away from the office.
“They absolutely love it,” Crutchfield says. “You’re always going to have some turnover, but this is part of keeping my employees happy. We pay them in the 75th percentile of the community standard and offer a bang-up perks package. We offer good health and dental, yearly bonuses, and yearly outings. All those little pieces go into the puzzle of retention.”
Indeed, studies on workplace satisfaction have consistently shown that money ranks about fifth or sixth among the most important factors contributing to job satisfaction. Low-stress levels and recognition for a job well done, and benefits such as flex-time and fully paid health care often rank high. New research from the National Opinion Research Center at the University of Chicago found that jobs in which workers care for, teach, or protect others are the most satisfying.
Forman, the CEO of AIRS training and consulting in Vermont, adds that doctors should not underestimate the power of getting people fully engaged with the running of their practices. Forman advocates keeping staff in the loop about the realities of the health-care business so they fully understand the challenges a physician faces running a modern-day practice.
“Figuring out a way to see an extra two patients a day could be the difference between a bonus at the end of the year and no bonus,” Forman says. “A lot of job satisfaction is getting employees involved in creating the day-to-day work environment. It sounds like common sense, but often doctors or those running a small business won’t give employees ownership of that. Nothing ticks off a staff more than a screwed up procedure when they know how to get things done.”
Freelance writer Scott Westcott writes frequently for national magazines. He lives in Erie, PA, with his wife and two children.