Ten Ways To Retain Top Staff

By Anthony Leone, Special Projects Editor

It would have been devastating to his practice if it happened. She knew the operation of his office and losing someone like her would have sent his professional life into a tailspin. Hal Ornstein, DPM, said one of his office workers felt that she could not grow anymore in his office and was thinking about leaving. Dr. Ornstein had just the cure for her: more responsibility in a leadership role. “It would have been bad if I lost her,” he states. Finding quality staff is hard for many podiatrists but keeping them is even harder. Given the higher profile of podiatric medicine in recent years, patients are constantly filling waiting rooms. Having a qualified staff that knows the ins and outs of your office is essential for keeping and maintaining a successful practice. With this in mind, a few podiatric physicians and practice management consultants shared their secrets for retaining top employees. 1. Why Simple Gestures Of Appreciation Go A Long Way It may seem simple enough but in a frantic day in the doctor’s office, it is easy to forget to say “thank you” to a staff member. The real key is to make your staff feel appreciated. “Like showering, if you want to stay clean, you have to do it every day,” says Dr. Ornstein. He says doctors should show their admiration to their personnel, whether it is a “thank you” when they are handed something by the staff or just leaving them encouraging notes. John Guiliana, DPM, agrees, adding that rewards and incentives are nice but giving positive feedback is very important. “In fact, most staff that I speak to feel that the most important aspect of their job satisfaction has to do with self-fulfillment and a feeling of being appreciated,” says Dr. Guiliana, who has a New Jersey practice. 2. Pertinent Tips About Bonuses And Incentives Of course, everyone likes a pat on the back but people do enjoy material recognition. Nicholas Romansky, DPM, will give a hard-working employee an extra $50 to $100, or even an extra paycheck if they work especially hard on a project or even around the office. Dr. Ornstein concurs with Dr. Romansky about bonuses but he also did something unusual for one of his new staff members who is a single mother. She was concerned about being away from her children so he gave her a cell phone to keep in contact with them. “That is the one thing that she talks (to people) about,” says Dr. Ornstein, who has a 16-year-old practice in New Jersey. An additional perk that he suggests is to have a pharmaceutical company’s sales representative wine-and-dine a staff member instead of you. Dr. Ornstein says this will make the staffer feel important. Another bonus for Dr. Romansky’s team of 17 is that he works with Philadelphia sports teams. A nice reward for hard-working staff may be tickets to games or even concerts. Some employees not only want to be challenged in the office, they want to be credited for it as well. “Since the staff is a practice’s biggest asset, I am often shocked how reluctant physicians are to invest in them,” states Dr. Guiliana. “Projects with clear and concise goals and objectives lend themselves well to a bonus structure. An example might be a business development plan or a plan to reduce accounts receivable aging.” 3. Be Flexible With Employee Time Another great benefit for harried workers is giving them the freedom to come and go in the office as long as there are firm rules in place, note Drs. Romansky and Ornstein. For example, if someone has a family event he or she wants to attend, the employee can go and make up the time later that day or during the week. However, it is important for staff to know that unless there is a critical reason why they cannot come in later or leave early or take a day off, they are free to do so as long as they give you advanced notice and make up the time. 4. Have An Open Door Policy That Is Wide Open Communication is the key to any business. Allowing your staff to know what you expect from them and letting them know they can come to you is vital not only for the day-to-day operations but the future of your practice as well. With two offices in Pennsylvania, Dr. Romansky says it is a little tricky having an open door policy but he does manage. However, no matter where he is, he says it is important to him that his staff knows they are always welcome to talk to him about office issues. Dr. Romansky says it is also important to treat staff as you would want to be treated yourself. “You are only as good as the people around you,” he replies. 5. How Meetings And Discussions Can Increase Communication Another effective method of increasing communication is to hold monthly meetings, which can involve more than planning patient visits and operations. The meetings can allow office workers, managers and doctors a chance to develop more of a comfort level with each other, points out Dr. Ornstein, who has conducted roundtable discussions and lectures about retaining staff for the last five years. In addition, having unorthodox meetings can be very beneficial for everyone. In Dr. Romansky’s office, people have a “rage debate.” He says this gives each person on the team a chance to get things off his or her chest and talk about office issues. “It fixes problems and everyone feels better,” notes Dr. Romansky. However, he says one-on-one discussions with staff members may be needed when disagreements occur. “If I have an issue with someone, I pull the employee aside and talk to him or her. I don’t let anyone (co-workers/patients) know about it,” emphasizes Dr. Romansky. While confrontations between staff and patients are rare, they do happen occasionally. Dr. Ornstein says it is important that you back up your staff in front of patients. Once it is over, he suggests speaking to the staff member in private. However, one should never yell or correct staff in front of patients, counsels Dr. Ornstein, who is the President of the American Academy of Podiatric Practice Management. 6. Be Thorough In Hiring And Emphasize Cross-Training Mature. Cross-trained. Hard worker. Responsible. Someone who can accept criticism. These are the attributes that Dr. Romansky looks for when hiring a new staff member. While these qualities should be universal when looking for a new member to join your team, they can be overlooked. If you do a thorough interview, you can find the right fit to make a staffer want to stay with your practice for a long time. Another element to the interviewing process that goes unnoticed is checking references and doing background checks. Dr. Ornstein is a big believer in this as he notes that hiring the wrong individual with an unproductive work past can break up the stress-free harmony in the office. Once you have hired the new person, it is important to provide appropriate training. Dr. Ornstein says retraining is valuable for veteran employees as well. “You are strong, not weak, and this will make your muscles stronger,” is what Dr. Ornstein says to his staff when he sends them to local seminars that are job related. David Marcinko, MBA, CMP, CFP, believes it is important to cross-train employees as well. “As an example, we have seen practices where the front-office and back-office staff are cross-trained to fill in for each other as needed,” points out Dr. Marcinko, the CEO and Academic Provost for Medical Business Advisors (www.MedicalBusinessAdvisors.com). One of the benefits of having personnel who are efficiently trained is that the office become more valuable economically and it makes for an easy transition if the practice is sold to a new doctor owner or undergoes a related change due to a merger or acquisition, explains Dr. Marcinko. “This efficient, smooth-running staff is related to the office economic concept of goodwill, which is a real but intangible asset,” maintains Dr. Marcinko. 7. Making The Commitment To Detailed Reviews As part of good communication, reviews allow you to communicate to the employee just how important he or she is to your practice. Reviews also let employees know how far they have progressed and how they can improve their work. Dr. Romansky has his work cut out for him because his staff usually tells him if a new employee is a good fit to his 17-year-old practice. This also reflects the advantages of having an open-door policy with staff and making sure they feel comfortable enough to be candid with you. Facilitating this type of respect and honesty can provide unexpected benefits for you as well. While many three-month reviews are about the employee’s performance, Dr. Ornstein goes beyond that to make the office worker feel appreciated and to retain staff a bit more easily. He gives staff a sheet that breaks down the costs of keeping them, providing them with insurance and how much it costs the office to give them a day off. He believes this will show them how much they are valued in his office. 8. Secrets To Balancing Job Satisfaction With Job Frustration As with any job, there is a yin and yang to it. There are parts of the job that a person truly enjoys. There are other aspects that employees find frustrating and they wonder why they bothered to apply for the position in the first place. However, there are ways to counter this. “Investing in the staff also means investing in their growth,” states Dr. Guiliana. “A great deal of personal growth and job satisfaction is often gained by having them attend seminars and other learning venues.” Another solution that Dr. Romansky offers is to shift the restless worker to a new department. For example, if there is an open position in his office, he usually hires in-house. If he knows there is someone who has grown tired of the front office, he will move him or her to the back of the office, such as to the billing department. Not only does this save time in hiring someone new but the newly positioned employee is already familiar with the flow of the practice. In addition to growing bored with a task, there are other things that can make an employee grow frustrated with the job. Dr. Marcinko says other employees can be the cause of this aggravation. His consultancy performed an on-site office profit augmentation review at one practice when there was front office strife among five employees. It turns out the problematic employee was the doctor’s spouse. “Once the spouse was removed from the scene, peace and efficiency returned. This occurred because the spouse was really only a defacto employee, and acted more of a condescending busybody than a real worker bee,” notes Dr. Marcinko. It is important to curtail any disruptive confrontations before they become too big to control and you find yourself minus an exceptional co-worker. 9. How To Handle The Star Employee Who Is A Reluctant Teacher One of the problems of rewarding an excellent employee is that it may create feelings of isolation or a feeling among other staff of not being needed or wanted. Ideally, no one in the office should be the “all-star” but it does happen, according to Dr. Marcinko. Mostly, this occurs when the person has an extra ability, such as speaking a second language or knows how to work a certain computer program. One of the ways to combat the feelings of uselessness in other employees is to find “the exact trigger point for these feelings.” For example, he warns about the dangers of the “knowledge hoarder,” someone who wants to stay the top dog by not teaching others what he or she knows. People like this can cause problems with the rest of your team. On the other side of the spectrum, having a “golden child” may not only create resentment with other staff members but the person may start to slack off, feeling almost invulnerable because of his or her “importance” to the practice. Dr. Marcinko says one must determine if this person is worth the trouble of having around if he or she does not do the job to the best of his or her ability and is causing unrest among co-workers. However, if you hire someone else who has the same qualifications as the star pupil, Dr. Marcinko notes this may lead to the worker with the special talent feeling like he or she no longer has a valuable role in the practice. He cites an example of one practice that only had one employee who could speak Spanish despite being located in a Hispanic neighborhood. “Over time, the problem was reduced as natural workforce attrition took place and the doctor slowly hired employees who spoke both languages,” says Dr. Marcinko. “Of course, in the long-term, the star employee felt unappreciated as her uniqueness dissipated. Yet her eventual absence was not felt by the practice as much as if she had remained the only bilingual employee.” It may be tricky to make everyone feel appreciated but Dr. Guiliana says one must strive to do so in order to retain good employees. “Again, all employees should be made to feel valuable,” insists Dr. Guiliana. “While it takes some energy and a change of habit, it is rather easy to find things throughout the day to praise each and every staffer for doing. If you cannot (easily find these things to praise employees for doing), they should not be part of the organization.” 10. Understand The Value Of Exit Interviews That said, if an employee does leave, it does not mean you cannot use that to your advantage. Find out why he or she is leaving and what changes the employee would have liked in order stay at your practice. “Learn from the experience. Conduct an exit interview to determine what changes the organization may need. If possible, have the valued employee mentor his or her replacement,” suggests Dr. Guiliana. Dr. Ornstein agrees about finding out why an employee is thinking about leaving because “the cost of losing a key employee is $50,000.” The New Jersey podiatrist says it costs time and money to interview someone and provide appropriate training, let alone the time it takes for an employee to get used to the rest of the staff, patients and the flow of the office. In Conclusion Also keep in mind that a long-time key employee can “sell” your practice, mentions Dr. Ornstein. Many times, patients call in asking if the doctor can perform a certain procedure. A veteran nurse or receptionist can say the doctor has done dozens of these procedures with very good results while a trainee may not know the answer, leaving the patient to wonder just how good the doctor is at the given procedure. Indeed, the ability to retain valuable employees is one of the hallmarks of a successful practice.

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