Practice Management
July 2021

by Corinne Wohl, MHSA, COE, and John Pinto

Hiring a new employee can be like bowling. You eye the distant pins with a mixture of confidence and hope. You set your intention to knock all the pins down at once for the best score. You align your body, take intentional steps toward the line, steer the ball toward the pins, release your control, and wait to see what happens. Sometimes it is a strike, sometimes a few pins were missed, or it could be a total gutter ball.

What do you do next? The same as bowling. Figure out what went right and wrong and do it again.

The lingering pandemic has not made recruiting and hiring easier, no matter where you are located. There was a brief moment in spring and summer 2020 when experienced technicians and front desk staff who were not quite able to return to their practices when they reopened and thus left their employment were looking for jobs.

How unusual it was, albeit briefly, to find a lot of experienced people on the job market. But that opportunity passed quickly, and we are now back to the challenges of staffing shortages and finding desired candidates.

Finding and hiring great employees has always required the ability to balance the “mostly science” of recruitment and the “mostly art” of selecting a finalist. Adding in a pandemic has shaken up the process further, as we see many frustrated administrators and practice owners already blasting past 2019 patient volume baselines but lacking the staff needed to reach for the next practice goals.

Below are a few thoughts on the science and the art of recruiting and hiring well.

The science

1. Reevaluate the function, responsibilities, and experience required for this position. This is not a quick skim. Considering all past experience and planned future changes in the practice, will this role and its responsibilities as it has existed still meet your future needs? For example, if you are hiring a practice administrator and your goal is to grow the practice 10% annually, ideally you want an experienced administrator who has worked in a practice that achieved high growth rates. They will know not only what steps work to drive increased patient volume but also how that will impact day-to-day operations. In this example, hiring an administrator without that experience is taking a big risk that you won’t meet your future goals.
2. Update or renew the position description. Once the position has been reevaluated based on the expectations and future goals of the practice, prepare the written documentation and share it with the owners and management team. Having the knowledge of what is expected from each position in the organization sheds light on how best the departments could interact. For example, if the primary goal of hiring receptionists is to find ones with a strong customer service background and a delightful demeanor, it may be expecting too much for everyone in that department to be perfect at memorizing all the insurance copays due. It might be reasonable for this practice to provide written procedures and cheat sheets to compensate for different skill sets. Or make the decision that you will only hire a receptionist who can fulfill both of those expectations equally.
3. Have a more intentional interview process. Prepare in advance. Who do you want to include in the interview process? What do you want each interview to focus on? Do you prefer individual or group interviews? Share all the hiring information (position description, resume, timelines) with each interviewer.
4. Develop a robust, clearly defined onboarding process. Too many practices find themselves in a time crunch when a new hire arrives. The written documentation (department operations manuals, training checklists) is incomplete or non-existent. Current short staffing means that no one has time to train. Multiple hires at the same time are challenging and new hires are assigned to shadow staff members who are well intended but not necessarily competent teachers. Preparing well in advance to onboard in each department is the way to avoid coming up short when a new employee joins your practice.
5. Assign a mentor for at least 6 months. The better your practice onboards and supports a new hire, the higher the chances are that they will become an employee who performs well and be someone who you retain. Unfortunately, we see all too often a competent employee who leaves within their first year of employment because their initial impressions were that they were thrown into their position with poor training, were held to high standards without support, and they just don’t feel cared enough about to stay. In this situation, employees are easily drawn to competing practices after being trained by yours. Assigning a mentor to a new hire for at least the first 6 months provides a comfortable haven for them to learn new tasks from an experienced person and even ask questions that they may not want to bring directly to their formal supervisor. Your mentors must be trained for this critical role and know what you expect of them.

The art

Now we take the solid hiring steps listed above and add the nuanced approaches that help lead to successful hiring. As client stories and our direct experience suggests, approximately half of all candidates hired with great expectations end up not performing as originally hoped. Not all of this failure can be eliminated, but the most experienced and intuitive managers add a bit of art to the science of hiring new staff.

1. The interview and nuanced success factors. Create a formal recruitment committee for each position. Provide the position description in advance so each member fully understands the actual role (and not their imagined role) for the position. Spend time teaching the recruitment committee the success factors of interviewing. Examples include listen more than talk and avoid over selling the practice when you get excited about a candidate. You want to hear them talk. Avoid the trap of “I like them so the skills they have matter less.” That feeling that the candidate will fit into the practice culture is important, but it can lead to disappointment if it causes you to overlook experience and/or skills gaps.
2. Don’t shelve the position description; make it a live document and tool. Harness all that time you spent developing the position description. Review it quarterly, to be proactive, and confirm that your expectations for that position are aligned with the actual tasks being performed. Without this ongoing oversight, it is common to have to play catch up at an inopportune time and repair the damage of this misalignment between your expectations and each new staff member’s incomplete understanding of them. Don’t let staff drift away from your standards and vision for their position.

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About the authors

John Pinto
President
J. Pinto & Associates
San Diego, California

Corinne Wohl, MHSA, COE
President
C. Wohl & Associates
San Diego California

Contact

Pinto: pintoinc@aol.com
Wohl: czwohl@gmail.com