Nailing Down Hiring and Retaining Staff at Your Practice

In most medical practices, staffing is the single largest expense item. This is not only on a per visit basis, but also related to retention and replacement. Estimated costs for replacement of an employee start at 70 percent of an annual salary, e.g., full time $10.00 an hour equals ~$20,000 yielding a replacement cost of $14,000. No check written but significant resources utilized in the process. Turnover is expensive and retention is difficult!

That's why practices should consider this concept when hiring an employee in hopes of retention down the line: KSA, knowledge, skills, and attitude. Let's look at each one.

Knowledge relates to the background and understanding that an employee brings to the organization. This speaks not only to their role or position, but a more global understanding of the issues faced by the practice. This knowledge can be gained via education or experience. This can be evaluated in the hiring process by adding a few questions to your interview process: What is a healthcare exchange? What constitutes a treatment (care) plan?

Skills relates to their ability to do the job they are applying for or currently occupy. These skills again are formally taught or gained from experience. Here a working interview or some other testing options are available during the interview process.

Attitude is difficult to change, but it's the real key to adding an employee to your team. What are the employee's goals, how do they answer questions around providing and/or improving patient care? In communication it is noted that 55 percent of the message relates to body language, 38 percent to tone of voice, and only 7 percent to the words used. The key then in the interview process is to observe how the questions asked are answered. If doing a team interview, the applicant and the team should sit in the same position, those NOT asking questions should observe. Of course, you can always get a "feeling" as to how the applicant will fit in.

Let's go further in the thought process. Do you have a "learning organization" culture? What effort is extended for onboarding a new employee? Beyond that, what programs do you offer related to the development of the individual's (and overall organization) knowledge? Do you offer or support formal training, meetings, tuition reimbursement, seminar funding? In skill development do you have a "coaching" program - one that helps directly in enhancing or learning new skills? Do you have a mentoring program, which means shadowing an employee who assumes responsibility for their "mentee"?

As we look to the future, by 2020, it is estimated that 50 percent of the workforce will be millennial. The "general" mindset of these employees is built around learning, involvement, and participation in the organization AND their own development. This is not to ignore others simply to make a point that there is a clear need to review the hiring and retention process.

I started with a discussion on cost. Let's end with a note that a knowledgeable, highly-skilled employee with an "engaged" approach to their daily work will lead to improving the patient experience and outcomes, after all isn't that what the practice of medicine is all about.