Improving Employee Retention

Employee turnover adversely affects patient care and practice profits, but there are steps you can take to hold on to top performers.

Improving Employee Retention

How much will you pay for your next new hire? According to Jay Shorr, managing partner of practice management consulting firm The Best Medical Business Solutions, “it costs 25% of an employee’s annual salary to properly train and indoctrinate him into your organization, and it takes approximately three months before you can turn a new hire loose and feel comfortable he is ready to work on his own, fully comprehending your organization’s operations.”
Susan Vasko, MD, co-founder of Columbus Aesthetic and Plastic Surgery in Columbus, Ohio, recognizes the critical role a long-term employee plays in a business, especially a cosmetic practice. “We have a very sophisticated clientele and they have many choices in seeking a plastic surgeon,” she says. “We have a very large variety of procedures that we offer—both surgical and nonsurgical—so the person answering the phone must be well trained and knowledgeable.” For Dr. Vasko, the advantage of an experienced employee is that he can be “skilled in converting an inquiry into an appointment.” This is something a revolving door of new hires cannot readily accomplish.
There are many reasons why an employee leaves an organization, some of which you have no control over. Family emergencies or obligations may take staff members away on a short-term or long-term basis. Spouses take jobs in other states, or an employee may wish to stay home for the first few years of a new baby’s life. These are unavoidable circumstances. But for those areas that you can control, it is critical that you maintain solid managerial practices.

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Get Rid of Underperformers

It may seem incongruous to talk about employee retention while also suggesting that practice owners cut certain employees. But retention truly is about hanging on to the best associates. If you have individuals on your team who are holding you back, adversely impacting your patient care or slowing down organizational operations, it’s time to show them the door. According to Shorr, “a great doctor should have a great team that is always one step ahead of his next move.” Does this describe every member of your organization? If not, you may want to re-evaluate your team. If you are aware of shortcomings, it is likely that other team members are experiencing frustration as they deal with work that needs to be corrected, regular absences or difficult personalities. Don’t let an underperformer drive valuable team members to seek out other opportunities.

Talk to Your Employees

One of the best steps you can take in letting staff members know that you value their work is to keep your finger on the pulse of your organization. Engage regularly with every member of your team. Take employees to lunch. Schedule a few minutes to sit with associates and understand their jobs, challenges and goals. It is very easy to get wrapped up in daily appointments, surgeries and pressing practice management concerns, from the moment you set foot in your office to the second you leave for the day. But, if you can take just a little time each week to talk to your team members and express your appreciation for their time and contributions, it will pay off in less turnover, better patient care and more conversions. “Employee retention will always be a problem as long as the employee is underappreciated, undercompensated, and does not have any future direction, goals and chances for advancement,” says Shorr.
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Avoid Restrictive Policies

Just as it is important to talk with your associates, it’s also imperative to not have too many rules in the rulebook. Some practices put in place an oppressive set of policies that cause employees to become bogged down in attempting to comply with every rule rather than focusing on the essence of their jobs. Some policies are absolutely necessary, such as attendance and dress codes. But is it absolutely necessary that every employee be required to wear scrubs—even the receptionist? Do you need a policy spelling out how much time associates can spend on personal phone calls or checking their Facebook statuses? In a small office, are signed time cards crucial to the operation of the practice, or can your one or two employees simply work on the honor system? After all, you will know when they are not present.
Offer Competitive Compensation
It can be quite frustrating for practice owners when an employee leaves for more money. But consider this tip from Shorr: “Many medical practices do not pay their staff competitively. To lose an employee over $.25 to $.50 an hour is one of the most deficient business decisions a medical practice can make, since it costs so much to hire and train a new employee.” Look at your pay structure. Are you still paying the same wages you were five years ago? Do you institute across-the-board pay increases, or do you provide merit increases for those who go above and beyond? The problem with giving every employee the exact same pay increase is that your star performers will
begin to realize that no matter how hard they work, the lazy individual next to them will get the same raise, and they will begin to look at other opportunities. “Many times, a practice is willing to pay the next employee more than it was paying the employee it just allowed to resign,” says Shorr.
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Incorporate Valuable (and Fun) Perks

Beyond basic compensation, there are other perks you can offer to retain top employees. Keeping your benefits package up to date and attractive will help you hold on to associates. “Perks are extremely important, as they make the employee feel appreciated,” says Shorr. “Allow your staff to participate in some type of bonus program, personal time off, compensated external training, and individual retirement accounts, such as a simple IRA or 401(k). These long-term benefits encourage employees to remain with you, because they are more vested in their personal portfolio.”
The very nature of your work is in itself a benefit. “There are several benefits to working in a plastic surgeon’s office,” says Dr. Vasko. “The field is very exciting in terms of new procedures and products. Our practice offers excellent benefits, such as health care, training opportunities and discounts on products and aesthetic procedures, so employees have the opportunity to have procedures that they are interested in performed.”

Recruiting with Retention in Mind

You can improve employee retention even at the moment of hire by seeking individuals who have long-term potential. Perhaps you are seeking a receptionist—a critical position in your practice. “Potential patients often have general questions about procedures,” says Dr. Vasko, “such as cost, down time and so forth, and the staff must be able to provide accurate information on the phone.” Rather than look for just another warm body to answer phones and greet customers, look for a candidate who can do more for you down the road. Maybe a nursing school student would greatly enjoy the opportunity to learn the business from the inside while getting the necessary training to do something more with the practice once she has attained the proper credentials. Conversely, seek candidates who will take an entrepreneurial approach to their front desk role and turn that pivotal position into a dynamo of customer service, efficiency and even sales.
The second step you can take is to approach your recruiting just as you do marketing. Consider posting job opportunities on your website and placing ads in your local community magazine. Let the chamber of commerce know you’re hiring. And, if you encounter an incredibly great person at another type of business—restaurant, retail store, bank, salon—ask if she would consider joining your team.
You’re recruiting and hiring not only for today, but for the next several years as well. Keeping an eye on employee retention gives your practice stability and continuity, something your patients will appreciate. “Patients do not like it when they continually see new employees,” says Shorr. “They become accustomed to your staff members and feel they play a personal part in their medical care. In fact, many patients will ask to be treated only by certain staff members.” Working diligently to retain these top employees will help your practice operate more smoothly, more efficiently and more profitably.

Steven Austin Stovall, PhD, is professor of management and chair of the entrepreneurship program at Wilmington College in Wilmington, Ohio. Contact him at steven_stovall@wilmington.edu.

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