Reed Tinsley, CPA

Retaining Key Employees in Your Medical Practice

Many medical practices are you tired of losing good employees to the competition? They are looking for ways to stop the revolving door of hiring one good employee only to have two others resign? As health care organizations strive to deliver quality health care, retaining key employees is an ongoing concern. Employers can begin to address the growing concern of how to retain good employees by asking employees, “What makes for a good place to work?”

A study conducted by the Gallop Corporation found the top responses to be:

 Having the opportunity to do what I do best.
 Having the sense that someone cares about me.
 Knowing what’s expected of me.
 Getting recognition for what I do.
 Having opportunities to learn and grow.
 Being productive.

A common thread runs through these responses — effective performance management. Physician practice managers do not intentionally ignore employees’ needs for recognition and professional development. Usually absent are both a system and accountability for ensuring employees understand expectations, receive feedback about their performance, receive recognition for good performance, and have a plan for professional growth and development.

10 requirements of the perfect (physician practice) manager

Jamie over at (e)merge (http://emergewithus.com/) turned me on to this list at TechRepublic - review it - how many of these traits do you or your practice admininstrator possess?

1. Be a “people person”

2. Be visionary

3. Be a good communicator

4. Be technically proficient

5. Put your employees’ needs first

6. Encourage teamwork

7. Lead by example

8. Treat your staff like professionals

9. Encourage professional growth

10. Do something special

Satisfying all the above criteria is not enough. You are also required to do something special for your employees that:

Will be remembered fondly decades from now.
Can be shared by the entire group.
Won’t break the budget.

To read commentary to each of these traits, go to

http://m.techrepublic.com/blog/10things/10-requirements-of-the-perfect-manager/3157

Turnover is Costly

I have heard that there is a study by the United States Department of Labor that confirmed that costs to replace an employee could equal 200% of salary. Regardless of survey, we all know the actual and hidden costs to replace an employee. Some costs of unplanned turnover include:

• Departing employees costs (vacation pay and other benefits);
• Advertising for the new position;
• Management interviewing time for the new employee;
• Conducting background checks (driving, criminal, etc.);
• The time it takes to train the new employee;
• The new employee's initial low productivity;
• Unbudgeted overtime for staff covering the empty position while it is being replaced;
• Possible low morale of remaining staff and its related impact on productivity – staff becomes overworked and stressed during this time.

So my question for you is: How is the turnover in your physician practice? If high, what is the problem and how are you going to fix it?

Stopping Workplace Drama in the Healthcare Practice

Whether it’s the backstabbing, power struggles, dealing with the queen bee, or the “untouchable” employee, or even just navigating through change, drama manifests itself in many ways in a medical practice. You KNOW it goes on in your practice - gossip, poor coordination of the team, disruptive physician or disruptive employee behavior - and you KNOW it is a huge distraction away from good patient care, efficiencies and profits in a practice. Drama is a drain on a medical practice - a drain on physician and physician executive time, a drain on time that could be spent on patient care and driving referrals, a drain on administrator and office manager energies.

Finally there is an audio-conference that actually discusses and addresses these issues. Presented by Greenbranch Publishing on Wednesday, February 29th, author Marlene Chism, award-winning author of “Stop Workplace Drama,” gives practical ways to identify and eliminate drama before the drama translates into turnover, absenteeism, poor morale, and a financial impact to the practice. In addition, learn how to cut through your own personal drama - whether it is a difficult family issue, a business problem, a health challenge or a financial struggle…you don’t need to create further issues at work! The material presented in this webinar translates from business to personal. Take control today and start learning how to halt the drama in the healthcare workplace, right here, right now.

For more information, go to:

http://greenbranch.com/article_940_Stop-Workplace-Drama-in-the-Healthcare-Practice.cfm

As I've said many times - my experience and external data has proven that the physician practices that do the best at human resources are the ones that are the most profitable!!

Where to find medical practice billers (or any employee for that matter)

Smart organizations know that hiring the wrong employee is costly – so costly, in fact, that it is well worth the extra effort to hire the right employee the first time around – every time. Productivity, morale and, even, the organization’s revenue are at stake in the hiring process. Here are important steps – both in hiring and keeping – the best medical biller. So where can you find a good biller (or any employee for that matter)?

Remember that staff can help recruit, so ask them for suggestions. A current staff member may have a friend who would fit in well with your operation. More employers are offering small incentives – for example, a $200 gas card – to employees who suggest a job candidate who turns into a hire. Managers and employees alike can network with colleagues at local medical billers’ associations. Many of these groups can also circulate the job posting. Turn to local training programs and community colleges when posting a position, as well as using advertisements in the local newspaper. Local community colleges and technical schools that train billing and office staff may be able to place interns. Internships can give you a view of how a potential candidate would fit with your team well before you ever need a replacement.

Online job listings like monster.com and careerbuilder.com can be expensive, but they will get the word out to a lot of people. Post the opening on your organization’s website and don’t forget about social networking. If your organization uses Facebook or Twitter, use them to spread the word about an opening. Staff might mention the opening to their online “friends” and “followers”, too.

Regulary evaluate your new doctor associate

Any expectations you have for a new Associate only works if you follow through with frequent valuations. However, I am often struck by how little attention senior doctors give to basic personnel management of newly employed physicians.

Groups commonly schedule regular evaluation ses­sions for newly hired lay employees, yet overlook them at the physician level. You've invested too much in your new hire — especially if you're promising fu­ture partnership — to adopt a sink or swim attitude.

New hires need attention

Today's young doctors in particular often feel over­whelmed when confronted with the reality of seeing patients day to day. I've recommended mentoring in the past, so the new doctor will have one physician s/he feels comfortable talking with about these feel­ings. Don't assume an established physician doesn't need a mentor as well. Maybe s/he came to your pri­vate practice from an academic setting. At the least, support his or her developing referral contacts and medical community relationships for a while.

Set up informal evaluations, or "checking in" ses­sions, on a regular basis at least every three months for the first year. If you see problems or patterns oc­curring, increase the frequency. Assign the mentor or one or two senior physicians to the task of conducting these informal sessions. Assuming everyone in your group is taking care of it usually means no one ends up doing it.

Formalize a routine

Make it clear in your employment agreements that new hires will have sit-down performance review ses­sions every six months. Make the job description and resulting evaluations deal with all aspects of the new associate's work — both clinical and interpersonal. Dis­cuss strengths and weaknesses, and be sure to explore personality factors.

It's difficult to confront and correct difficult behav­ioral traits at any stage, but it's best to handle them early on. And although these sessions may feel awk­ward, many associates actually welcome the eedback. Besides, the more regular the evaluations become, the less awkward they'll feel for the employee physician and for the senior doctor doing the evaluating.

Follow through

Too many groups fail to follow through - You may have the best intentions and start off on the right foot. The associate appears to be perform­ing fine and everyone seems too busy to hold evaluation sessions. Soon, small problems begin to appear. Senior doctors pull out the file and realize they missed the last evaluation.

Such a scenario lets a potential problem magnify, and backing off evaluations gives your potential part­ner the wrong signal. What's more, it deprives you of the chance to mold the new doctor into the kind of partner you really want.

Actually, good group governance demands evaluat­ing all physician-members' performance — even that of the most senior member. At least, though, you can establish the feedback process with your new doctor hires from Day One, even if it seems nearly impossible to install it at the senior level.

Physician practice employee recognition idea - a good one or a bad one?

I recently ran across the following website:

http://www.baudville.com/?home=trifectanew

They sell sets of pre-printed sticky notes for the busy practice administrator to use to give positive feedback to employees. You just sign and deliver according to the ad on the website. Let's face it. What employee doesn't get a boost out of getting a pre-printed sticky note from the boss saying "You Nailed it" or "You Rock"?

What makes these even more of a value is that they come in sets of four in a binder that has inside the cover several  reasons why you might "reward" someone with a sticky. If you are a negative person, it is probably good to have the handy reminders that you might award a sticky for "keeping focused" or "being persistent." But I hope this comes with a warning label to keep it hidden within the desk. If the boss is out, seeing the locked and loaded stickies combined with the reminder list of why a subordinate might deserve such a reward open on the desk of the boss might generate many Facebook postings, if not outright laughter.

There is a point here, which I hope is obvious. if you are so bad about giving your employees feedback that buying pre-printed stickies to give out kudos is tempting to you, that siutation probably merits some more time and consideration. Medical practices are busy places and competency is just assumed every day. But people like to hear when they are doing a good job, even if a pre-printed sticky note doesn't seem like the right tool for most physician offices.

But if you want to try passing out a few notes to employees for positive feedback, I do have an idea for you. Always include a GIFT CARD with them!!

Are your medical practice employees put in a position to succeed?

 Employees, who don't feel connected to their work, engaged by their management or loyal to their organization are approximately 53% less productive than their engaged counterparts. Employee engagement is hugely important in the healthcare industry. With loads of paperwork, EMR transitions, industry overhauls, an endless stream of patients, new emphasis on customer service and a daily influence on matters of life or death, it is vital that healthcare workers be passionately plugged into their work.

Research published in a 1999 Harvard Business Review demonstrated that people excel at jobs that interest them deeply, more than at jobs that their education, skills or experience might suggest are perfect fits for them.

Employees who are highly engaged are excited, enthusiastic, focused on their work, emotionally and mentally involved with their company, highly productive, not easily distracted. That energy and momentum is critical for optimum business success. This is why you should review your organizational chart to make sure your employees are in the right job role.  If an employee is not engaged, it may not be that they are a bad employee, they're just not a fit for that particular job position. If they are put in a position where they can be passionate about their work, it will benefit them and you as their employer.

Regularly Evaluate Your New Doctor Associate

Any expectations you have for a new Associate only works if you follow through with frequent evaluations. However, I am often struck by how little attention senior doctors give to basic personnel management of newly employed physicians. 

Groups commonly schedule regular evaluation ses­sions for newly hired lay employees, yet overlook them at the physician level. You've invested too much in your new hire — especially if you're promising fu­ture partnership — to adopt a sink or swim attitude. 

New hires need attention 

Today's young doctors in particular often feel over­whelmed when confronted with the reality of seeing patients day to day. I've recommended mentoring in the past, so the new doctor will have one physician s/he feels comfortable talking with about these feel­ings. Don't assume an established physician doesn't need a mentor as well. Maybe s/he came to your pri­vate practice from an academic setting. At the least, support his or her developing referral contacts and medical community relationships for a while. 

Set up informal evaluations, or "checking in" ses­sions, on a regular basis at least every three months for the first year. If you see problems or patterns oc­curring, increase the frequency. Assign the mentor or one or two senior physicians to the task of conducting these informal sessions. Assuming everyone in your group is taking care of it usually means no one ends up doing it. 

Formalize a routine 

Make it clear in your employment agreements that new hires will have sit-down performance review ses­sions every six months. Make the job description and resulting evaluations deal with all aspects of the new associate's work — both clinical and interpersonal. Dis­cuss strengths and weaknesses, and be sure to explore personality factors. 

It's difficult to confront and correct difficult behav­ioral traits at any stage, but it's best to handle them early on. And although these sessions may feel awk­ward, many associates actually welcome the feedback. Besides, the more regular the evaluations become, the less awkward they'll feel for the employee physician and for the senior doctor doing the evaluating. 

Follow through 

Too many groups fail to follow through - You may have the best intentions and start off on the right foot. The associate appears to be perform­ing fine and everyone seems too busy to hold evaluation sessions. Soon, small problems begin to appear. Senior doctors pull out the file and realize they missed the last evaluation. 

Such a scenario lets a potential problem magnify, and backing off evaluations gives your potential part­ner the wrong signal. What's more, it deprives you of the chance to mold the new doctor into the kind of partner you really want. 

Actually, good group governance demands evaluat­ing all physician-members' performance — even that of the most senior member. At least, though, you can establish the feedback process with your new doctor hires from Day One, even if it seems nearly impossible to install it at the senior level.

Managing behavior vs performance

Think about how you manage employee group – is it easier for you to address performance issues than it is to address behavior issues? Here are some typical examples of behavior issues: 

“She does her job really well, it’s just that her attitude towards the patients is rude.” 

“Great worker, but she never helps the other team members out.” 

“My best employee, but I’ve noticed sometimes she is inappropriate on the phone.” 

Do you tend to ignore poor behaviors of good workers? If yes, how is it affecting the other team members? How does that reflect on you as a manager? It’s important to realize your superstar employees are watching closely how you are managing the other employees in your physician practice.