Doctors don't offer help and healing to patients all on their own. A medical practice is a team. That's why choosing the best medical and administrative staffers is so critical. Here are 13 tips to help you find and retain the right people.
Doctors don't offer help and healing to patients all on their own. A medical practice is a team. That's why choosing the best medical and administrative staffers is so critical. Here are 13 tips to help you find and retain the right people.
Lee Wan, MD, an ophthalmologist at Oxnard-based Coastal Eye Specialists Medical Group, knows a thing or two about hiring good people. The median tenure of the staffers in his employ is--and this may seem like a misprint to many doctors--a whopping 10 years. What makes someone stick by you for a decade or more? And how do you spot the person with the commitment, compassion and drive to do so? Well, to have good people on staff, Dr. Wan says, you simply need to hire good people.
That, he and other physicians emphasize, not only hasn't changed as healthcare continues to transform, it's actually truer than ever. Computer skills have been required for decades, for example, but now office staffers must be able to use sophisticated practice management systems integrated with clinical decision-making support programs and electronic medical records. How do you spot the job applicant who can handle the types of cutting-edge technology in your office? You're probably better off looking for a good overall employee who you can teach the technology details to on the job.
"Computer literacy now goes beyond simply knowing how to use word processing and the mouse," Dr. Wan explains. "It includes not only e-mail, but also text messaging, multimedia presentation and organization, search engine use, and safe and efficient Internet browsing. Indeed, every new piece of equipment is computer-based, so staffers need to be comfortable learning various types of programs and recognizing the common software interfaces that they use." Specifically, he adds, "security and privacy issues are also more important, so employees must be constantly vigilant for virus attacks, spam and security breaches. Being able to troubleshoot simple hardware and software problems without having to call tech support for every little glitch helps, too."
However, the increasing sophistication of medical office technology notwithstanding, "the basics, still, are someone who is kind, eager to please, happy, sociable, energetic, compassionate, thoughtful, smart and interested in medical practice," Dr. Wan says. "You can't teach someone to be compassionate, motivated or a good team player. But if someone is, it becomes much easier for that person to learn about insurance and office operations and to develop clinical knowledge and skills."
Finding that someone is the key, of course, and it requires careful attention to the questions you ask, the job you describe and the benefits you offer. Here are 13 tips from experts who've suffered the proverbial trials and tribulations of finding excellent office staff.
1 Make sure new hires know the importance of customer
service. "First and foremost," says Nabil Razzouk, PhD, CEO at
Arrowhead Orthopaedics in
2 Make sure new hires can embrace changes in the way
health benefits are designed and administered. As consumer-directed plans grow,
for example, front-office employees may need to be able to explain the
subtleties of, say, procedure pricing and plan reimbursement to patients.
"A person in the insurance department should have the responsibility for
explaining some of the differences to patients and serve as the patient
insurance advocate, but also a lot of that responsibility belongs to the
benefits departments of patients' employers," says Judy Capko, of Capko
and Co., a medical practice management and market research company based in
3 Customize your approach to ensuring an understanding of patient benefits in your practice. Everyone in Dr. Wan's office is familiar with various benefits structures because that familiarity is "absolutely essential in an ophthalmology practice where we have a mix of medical insurance, vision plans and self-pay patients," he explains.
The general rule is front-office staff tries to make the initial coverage determination, but Dr. Wan ensures that every person who comes in contact with a patient during a visit or afterward understands. "Everyone-front, back and in between-needs to be able to discuss coverage, treatment options and cost information with the patient, and to be able to present that information in a medically appropriate, medico-legally safe, regulatory-compliant and customer-friendly way." That should be made clear to applicants early in the hiring process, he says.
4 Make sure you take
Plus, given the area's heavy patient volumes, the abilities to multitask smoothly and efficiently and to deal with constant interruptions and conflicting demands-without letting the stress become visible to patients-are also "more essential now than ever," he says. Asking questions about the ways applicants have handled tough situations in prior jobs can give you a window on how they would tackle difficulties in your practice.
5 Know what you're looking for in a new hire. "Decide what's most important," Razzouk says. "Are you looking for a more assertive collector? A more efficient biller? A more customer-oriented, front-office person? A medical assistant who is more attentive to details?" Setting out a list of criteria will help you focus on the attributes you seek.
6 Measure all candidates against a written job description during the interview process. "Use that instrument as an objective tool to compare to the skills, experience and attitude of the applicants," Capko says. "An important part of it is a description of the personality traits required for the position. For example, if it involves working directly with seniors, the job requirements would include being patient and flexible with a desire to please."
Capko says job descriptions help you be analytical about comparing various candidates' job histories and skills and can guide your questions of candidates' references. Tell past employers the goals and needs of the position and pointedly ask if they think the candidate can meet them.
7 Make sure potential new members know the kind of team they might be joining. "Our practice is highly mission-driven, and every staff member must understand that, so he or she will know what our response should be in almost every situation," Dr. Wan explains. Practices that are more finance-driven are often successful and high-performing-but staff members have to embrace that philosophy. "Having a finance-driven employee in a mission-driven practice, or vice versa, doesn't work well," he says.
8 Do your homework before the interviews begin. Applicants at Arrowhead submit a resume and complete an employment application form. "Both should be reviewed diligently for consistency and to identify missing information and discern the applicant's communication skills as well as the general fit of the applicant for the position," Razzouk says. The human resources director conducts that first-level screen. If the applicant appears to have the basic skills necessary for the position, he or she is then invited for a preliminary interview.
9 Take your time. Razzouk's practice conducts specific second and third steps as well. An applicant who's invited for a second interview meets with the appropriate department supervisor to help the practice assess the candidate's "fitness to operate in a specific job micro-environment," he explains. "A very reserved person who may do an excellent job in medical records may feel over-exposed in an open nurse station with a number of people around."
Interviewers listen for deficiencies in communication skills and assess the experience applicants have that actually relates to the available position. They also try to gauge the type and level of training that might be required should a given candidate be hired.
If there's a third interview with Razzouk himself, the focus is on "the applicant's character, attitude, initiative, customer service potential and overall fit in the culture of the practice," he says. Subject to a reference check, a successful applicant receives an offer call and, if accepted, a letter of employment-at-will "to establish sort of a psychological contract," Razzouk says. "We state the job assignment, any specific responsibilities, the line of supervision and the hourly rate."
10 Don't get too bogged down in whether a candidate has very specific experience. This is especially true for specialty practices who may be seeking--but not finding--people with skills specific to their particular patient population.
A focus on a good overall employee is still most important. "It's difficult to find someone with highly specific skills at the interview level," Dr. Wan says. "Applicants who have similar experiences are good candidates, however." People with experience in, for example, an optical shop, dentist's office or senior center may be great candidates, especially if they blossomed in their previous settings. "The applicant's personality and interest are the biggest factors," he says. "We have to plan on providing training on the more specific skills."
11 Remember that a good hire is really a two-person
dance. Dr. Phillips, who has offices in
"Unhappy employees are toxic to a practice," Dr. Wan states. "If someone isn't happy to have a job here, we encourage that person to go, with our blessing, regardless of skill sets or cost-benefit ratios."
12 Admit your own hiring weaknesses. If you don't have the time to conduct a thorough search--or you don't trust your own "sense of smell" when interviewing prospective staff, don't hesitate to use the services of a staffing company or involve another colleague, such as a fellow member of your local chamber of commerce or medical association, Razzouk suggests.
Plus, you can improve your skills as well. Several top-rated books are available to coach you on the latest technique, called behavioral interviewing. The method relies on learning what an applicant actually did in a given situation, as opposed to having him respond to a hypothetical case. Start your questions with "Tell me about a time when..."
13 To retain who you've hired, focus on one basic principle. The bottom line, according to Capko, is this: "You must recognize that you need smart people working for you, and you need to value their contributions." Sounds simple, but many practices fail to do that.
After going through the rigorous hiring process, don't leave employee success to chance, Capko says. Doctors need to respect their employees and treat them right. That includes investing in a business approach to provide a formal orientation and training program, setting performance standards and complying with them, and paying employees who perform well what they are worth. She concludes: "Quit throwing them to the lions and setting new employees up to fail!"
WE INVITE Your Comments. Share your feedback on this article. E-mail Chris Womack, associate editor, at chrisw@socalphys.com or call 213/226-0325.
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FEATURE ARTICLE SIDEBAR
Health Benefits for Healthcare Workers
It's no surprise that the staff of a medical practice pretty much assumes it will enjoy decent health benefits. But that doesn't make those benefits any more affordable for doctors' offices than they are for other employers.
"Over the past five years, the list of benefits
physician offices typically offer has been shrinking, as fewer medical groups
are finding themselves able to pay for everything," says Nabil Razzouk,
PhD, CEO at Arrowhead Orthopaedics in
Employees are willing to share in the cost of health insurance, notes Judy Capko, from consulting firm Capko and Co. in Thousand Oakes, but they want to be part of a more-affordable group policy. Indeed, she says, offering competitive benefits is emerging as perhaps the best way to appeal to a broad base of skilled applicants.
Oxnard ophthalmologist Lee Wan, MD, offers "100 percent healthcare coverage for employees with a cafeteria plan that provides for dependent coverage, as well as other benefits," he reports. His office made a decision several years ago to offer only plans it contracts with and considers good payers, so despite the higher cost, it has declined all HMO plans and several PPOs. "At least I know if I or my employees need healthcare, we can be confident that the doctors we use will get paid and will, we hope, be happy to see us," he says.
This year, the practice is switching to a high-deductible health savings account plan. "It seems complicated, and there isn't much expertise available to help set it up," Dr. Wan comments. "But staffers gain more flexibility in how they allocate their healthcare dollars, and it's satisfying to think that if they don't get sick, the additional money goes to them, not an insurance company."
Sample Questions for Applicants
A short list of simple, specific questions can help you
assess whether candidates have the ability to attend to an available job, says
Nabil Razzouk, PhD, CEO of Arrowhead Orthopaedics in
Start the interview by asking the candidate to tell you a little about himself or herself. Then ask: What do you see yourself doing in a couple of years?
-What was your major accomplishment in the last job you had?
-What would you say is the most important job in a physician office? Tell me why you think that is so important.
-Can you give me an example of how you handled a customer service situation in a previous job?
-What would you say is the most important thing for the patients who come to see a physician?
-If you were seen upset on the job, what is likely to be the reason for that?
-If you were to submit your resignation to your supervisor two months from now, what would that be for?
-What do like most about working in a physician office?
-What do you like least about working in a physician office?
-What would you say is your main strength?
-What would you say is your main weakness?
-This is a [fill in your specialty] practice. Can you tell me what you know about [specialty]?
-What compensation do you expect for this position?
-What questions do you have for us today?
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FEATURE ARTICLE SIDEBAR
Hiring Case Studies
Not convinced it's smarter to hire a good person you can train than a skilled person you have to keep an eye on? Consider these two testimonials:
Lee Wan, MD
Dr. Wan, an ophthalmologist at Oxnard-based Coastal Eye
Specialists Medical Group, recalls: "My current administrator started here
almost 15 years ago as a temp without any real medical office experience. But
she was a quick learner and was interested in what we were doing."
She went back to college to take business classes at night, developed expertise in the billing and financial operations of the practice and "learned more about personnel and other management aspects, with the help of my outstanding, highly experienced previous administrator," Dr. Wan says.
Most importantly, she learned leadership skills as she moved up through the ranks. "Today, she's proven to be an excellent administrator," Dr. Wan says. "She's an advocate for our patients, the practice and our doctors, and a resource for many inside and outside our practice."
Dr. Wan says it "was a matter of getting the right person and providing the environment for her to develop."
Dr. Phillips, a partner at Inland Eye Specialists, has a
similar tale to tell. The head technician in his
Dr. Phillips contends that too often new hires are shunted off to the file room. But he saw--and now reaps the benefits of still employing--a "diamond in the rough."