I recently learned that this article I wrote for PracticeLink ("Timeline of a Physician Job Search") took silver in a national awards competition! Quite a pleasant surprise (partly because I didn't even know the editor had submitted it). If you or someone you know is a job-seeking physician, check out this link (and if you have comments, I'd love to hear them). -
A practice we worked with recently was struggling to improve profitability. The practice’s new manager wanted to make an impact fast, so she decided to try replacing longer-term staff with less expensive newbies; since staffing was such a big practice expense, she reasoned that this was the best way to improve profitability. The physician owners were surprised not just that the strategy hadn’t worked, but that we questioned the decision. “Isn’t that the kind of thing you practice management consultants recommend?" they asked. But cutting experienced staff members who perform well just to save a few dollars isn’t something we’d recommend trying. Those exiting employees will take with them all the knowledge they’ve accumulated – knowledge that is easily taken for granted. While cuts might boost profits temporarily, it likely won't take long for patient service to deteriorate. Service will also be undermined by the panic felt by the rest of the staff. When employees see their most loyal colleagues being shown the door, they’ll wonder if – or when – the axe will swing their way. Once those doubts creep in, your most energetic and ambitious employees will begin job-hunting in earnest. Swapping out older workers for younger ones may draw a charge of age discrimination as well. Worst of all: the potential upside is probably small. Differences in pay for experienced versus new staff are typically large enough to cause a big swing in profitability. For example, a $5 per hour difference translates to $10,000 per year. The costs of recruiting and on-boarding a replacement could easily exceed these small savings. It’s natural to look critically at expenses when profitability is flagging. But insufficient revenue is often the main reason profits disappoint – and cutting your best people will severely impact your ability to fix that problem. Instead of cutting valued but ‘expensive’ employees, look for ways to refocus staff and make the practice more productive.
Do you find yourself reluctant to discipline difficult employees because they’ll be hard to replace if they quit? Is that same fear causing you to retain employees who’ve failed to improve, despite being counseled again and again?When the consequences of poor performance never materialize, underperforming employees will soon perceive they’ re exempt from the standards you’ve set for everyone else. Even worse, your better employees will have to pick up the slack and tolerate negative energy from complainers – increasing the risk you’ll lose the people you value most. Many practices feel squeezed for talent in their local markets. It’s understandable to be concerned about a key job staying unfilled for too long – but, still, keeping underperforming employees can harm your practice much more. Instead of going soft on performance problems, consider amending your hiring practices. For example, a little redundancy in your medical assistant ranks (e.g., maintaining one or two “extra” floaters) ensures coverage when someone’s out sick – or ends up leaving the practice. Those additional hands can also tackle valuable ad hoc tasks that might otherwise get skipped, such as recalls that serve patients better and generate additional revenues. A rolling system of recruiting can also ensure you don’t miss a chance to hire talented new grads. Establish recruitment relationships with local training colleges and med schools, and maintain key job postings for year round. (Be sure to use screening questions on recruitment sites and filters in your email software to help manage the applicant flow.) Even if you don’t need help immediately, being aware of available talent will allow you to hire opportunistically if someone exceptional becomes available. It will also provide a clearer picture of the current talent pool, so you don’t feel compelled to hold on to employees who aren’t measuring up.
Background checks in hiring are sometimes confused with reference checks. While both are important, the differences between the two are critical to understand. Reference checks involve conversing directly with a candidate’s former bosses and coworkers. It’s a subjective process that provides insight into a prospective employee’s strengths and weaknesses. Checking references helps you learn how well a candidate’s self-perception matches that of former bosses and colleagues. It can validate (or refute) key narratives shared by candidates, such as how and why they left their former job and what their work style is like. Background checks, on the other hand, deal with purely factual aspects of a candidate’s record. For example, did they earn the degree they claimed? Is the stated employment history accurate? And what about legal scrapes – is the candidate’s background free of convictions or sanctions that disqualify them from working in healthcare? There’s no escaping the time required to contact references directly, but technology has significantly streamlined background checking. With automated online fact-checking services, checks that once required numerous phone calls and faxes can now be done more quickly, completely, and reliably, at much lower cost. Background checks offer peace of mind in any hiring situation, but they’re even more essential in healthcare. For physicians and non-physician providers, verifying credentials and licenses is, of course, mandatory for patient safety and to avoid liability. HIPAA also requires care be taken to protect patient information; with medical identity theft on the rise, too, careful hiring is critical for every role in healthcare. Detailed background checks may even help protect against embezzlement – an all-too-common crime in medical practices. Technology can help you perform these crucial checks more quickly, thoroughly, and easily – usually for less than a few hundred dollars.
