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Assessing the effectiveness of your staff hiring and management practices
A 10-item self-assessment can help you determine which areas need improvement.
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“When I’m hiring a cook for one of my restaurants, and I want to see what they can do, I usually ask them to make me an omelet.”
– Bobby Flay
The average general ophthalmology practice in America spends 30 cents or more out of every dollar in collections on lay staff. Some eye surgeons work until noon every day to cover their payroll.
As a practice owner or manager, it is impossible to place too much importance on selecting, hiring, training and curating your support staff. To that end, this month we present a simple self-assessment you can perform alone or in a group meeting with your management team.
Here are 10 favorable staff hiring and management habits Score these items on a 0-5 point range, based on the following scale:
5 = We do a superior job in this area.
4 = We do a sufficient job in this area but could stand to improve.
3 = We are probably about average in this area compared with other practices.
2 = We do less well than we need to and really should improve.
1 = We are very weak in this area; doing better is a priority.
0 = We have a profound lack of this in our practice, and it is urgent that we improve.
1. We use all available promotional outlets to secure a large pool of candidates. We post every job internally. We provide a financial reward for current staff who bring new job applicants to our attention. As a matter of policy, we do not hire the first person we interview, even if they are very strong. We have the discipline to interview other strong applicants. Score ______
2. Before a new staff member is hired, we make sure they have a chance to shadow a person who is currently doing their potential job. Depending on the seniority of the position, this shadowing may be for just an hour or last all day. In addition, we ask final candidates to demonstrate their skills. For example, we have experienced technician applicants work up a member of our staff, and importantly, we look closely at the results. Score ______
3. When we are down to the final candidates for a position, everyone in the practice who is a stakeholder for the new hire meets the finalists and is urged to provide feedback. Is the candidate appropriate and job-ready? Will they fit in with the personalities present in the practice? Can they work at the pace and intensity our office requires? By engaging many interviewers for each hire, we dampen the selection bias of a single manager. Score ______
4. “Onboarding” includes a host of activities to orient a new staff member to the organization and help them master their job responsibilities and succeed in their new job. In large, well-organized practices, there may be a formal human resources department that is responsible for this. In the average practice, the relevant department head or the administrator/office manager will be responsible for onboarding. So when you score your practice in this area, think about the job you do onboarding new hires in the context of the scale of your organization. Score ______
5. Every job supporting an ophthalmology clinic needs different tools. Receptionists in a modest practice need furniture, a phone and a computer. Billers need ongoing coding education and on-call technical assistance. Technicians need a growing array of equipment in proper working order. Surgical counselors need patient educational material and a comfortable room to see their patients. If some of these tools are missing, out of date or in need of repair, both the worker and the practice suffer. Score ______
6. It is hard to provide consistent, superior patient care when the service standards only live in people’s heads instead of being written down. Good practices can become great when they get around to committing their informal protocols to writing. Such protocols form the basis for training, operational monitoring, gap analysis and process improvement. Score ______
7. Some staff departures are inevitable. Workers retire, depart to follow their spouse to another market, go back to school and start families. But in the best practices, each preventable staff loss triggers a formal assessment. Did we miss an adverse behavior in the hiring process? Did we “settle” instead of continuing to look for stronger candidates? Did we undertrain, setting up our new worker for failure? They may lose the staffer, but they do not lose the lesson that can prevent staff departures in the future. Score ______
8. Staff morale is improved through hundreds of actions that the best practices (and surgeons) pursue almost unconsciously. Fair, market-based wages. The brisk mediation of conflicts with co-workers or providers. Flexible hours. Abundant, specific praise. No favoritism. An appropriately fun, playful workplace. Score ______
9. “Turnover rate” is the percentage of your total support staff who leave the practice in a given year. For example, if a practice employed 10 lay staff (non-providers) and in the last 12 months two of them left (for any reason — a spouse’s relocation, termination, etc), the turnover rate would be 20%. The typical turnover in general business is around 35%. In a typical ophthalmology practice, the figure is 25% or less. Give your practice higher marks if your turnover rate is under 20% and lower marks if your practice’s lay staff turnover rate in the last 12 months exceeds 30%. Score ______
10. Having a very low turnover rate may actually be an adverse sign. Owners and administrators who are resistant to terminating low-performing staff create a low-performing practice. So ask yourself, “Do we consistently strike an appropriate balance between high performance standards and leniency?” “Do we readily terminate a staffer who continues to fail to live up to our standards and expectations?” Score ______
Now add up your score (and the average score if you are doing this as a group exercise). With 10 favorable habits, and with up to 5 points each, there is a maximum score of 50. There is no comparative scale (yet) that compares your practice to others, but this summary score can be a valuable internal reference of the practice’s fitness in this critical area.
Finally, pick one or more of your lowest-scoring items and hold a group discussion on how these can be improved. Use this to write down a commitment such as, “Our turnover rate in 2019 is on track to hit 35%. In 2020, we commit to a 25% or lower turnover rate by writing down key protocols, undertaking a reset of our training program, conducting a local salary survey and increasing wages where warranted.”
- For more information:
- John B. Pinto is president of J. Pinto & Associates Inc., an ophthalmic practice management consulting firm established in 1979. John is the country’s most-published author on ophthalmology management topics. He is the author of John Pinto’s Little Green Book of Ophthalmology, Turnaround: 21 Weeks to Ophthalmic Practice Survival and Permanent Improvement, Cashflow: The Practical Art of Earning More From Your Ophthalmology Practice, The Efficient Ophthalmologist, The Women of Ophthalmology, Legal Issues in Ophthalmology, Ophthalmic Leadership: A Practical Guide for Physicians, Administrators and Teams, Simple: The Inner Game of Ophthalmic Practice Success and a new book, UP: Taking Ophthalmic Administrators and Management Teams to the Next Level of Skill, Performance and Career Satisfaction. He can be reached at 619-223-2233; email: pintoinc@aol.com; website: www.pintoinc.com.