A Satisfied Staff Pays Off

For just over $200, office manager Tracy Hacker surprised her staff, boosted morale, and gave employees another reason to continue working for Allergy and Asthma Associates in Birmingham, Ala.

"I called a special meeting and they thought someone was in trouble. Then I took them outside where there was a limousine waiting and told them what the meeting really was," laughs Hacker. "We had a great time. We rode around and watched a movie in the limo while we ate lunch. I really wanted to give them a break and let them know they're a classy staff." The cost? For a two-hour limo ride, including tip, $115; plus $90 for seven box lunches.

The lifeblood of your practice is not only patient satisfaction, but also staff satisfaction. Perks like limo rides are just one way physicians are showing staff they're appreciated. Part of the challenge, in addition to stretching dollars, is knowing the answers to these questions:

• What is it about your practice that makes employees want to work hard every day - and do it with a positive attitude?

• How do you retain those employees at your practice in the years to come?

Employee retention efforts merit consideration in these days of budget-consciousness. "Practices are in an economic position in which they have to look very carefully at costs," says David Gans, director, practice management resources, Medical Group Management Association (MGMA). "Physicians are being paid less for what they do, but everything else costs more."

Experts say the tried-and-true combination of a good salary, health benefits, and retirement plan are not enough to keep employees anymore. So ask your staff to suggest the perks and benefits that will satisfy them, and then determine an affordable way to provide the reasonable ones, with help from your human resources or office manager. If you plan wisely, you'll end up with top-notch, loyal workers and avoid frequent (and costly) hiring and training of new staff.

'Thanks' means a lot

Robyn Levy, an Atlanta allergist, says recognizing employees' contributions doesn't have to be expensive. "We all think they must want a lot of money, but what they want is to be appreciated," she says. One of the keys to Levy's success as a solo practitioner is thanking her staff of 15 every day. "It takes no money for me to say, 'Thanks for your hard work,' or 'I couldn't have done it without you today,' but I do really mean it," she says, also adding that when a patient compliments the staff, she's sure to pass it on.

Other perks from Levy to her staff include: birthdays off with pay, an inexpensive gift and a handwritten note for their date-of-hire anniversary, and a facial or massage to celebrate the practice's opening date.

Another key to keeping employees energized is giving quarterly reviews rather than annual ones, says Levy. Specific job descriptions are reviewed and she offers new and interesting tasks whenever possible. "There was a [clinical] employee interested in doing skin tests, so she went and got some training and now she can do that. It makes her happy and it makes us happy," she says.

Allowing staff to hold their own meetings helps maintain employee satisfaction, too. "They like it when I don't attend - it gives them a sense of autonomy," Levy says, noting that she receives minutes from the meetings.

So how does all this attention to staff benefit the physician? "They don't leave me, they don't call in sick a lot, and sometimes they will even work when they're sick," she says. "Plus, they take good care of me and make life easier when I'm going in many directions."

Sometimes, staff benefits can also directly add dollars to the practice - and to employees' pockets. For instance, Levy's administrative assistant concentrates on collecting past-due accounts; in return, the assistant receives 10 percent of what she collects. "She can make about $1,000 more a year," Levy says.

So if thanking people, buying small gifts, and providing regular employee feedback isn't expensive or time-consuming, why aren't more physicians "investing" in their staff?

"A lot of physicians don't stop during their busy days. Without meaning to be rude, they can be egocentric because the work revolves around them. But they need to stop and say things like, 'I really appreciate your filing all those charts. You did a great job.' It takes two seconds to say it," says Levy.

Nancy Merry, executive director of Medical Employment Directory of Springfield Inc., a healthcare recruiting firm, based in Springfield, Mo., adds, "As the medical community realizes quality staff is becoming more scarce, their efforts are starting to be acknowledged. If physicians don't acknowledge them, they are going to lose people and those practices are going to be floundering."

Satisfying the masses

While the limo and massage concepts may be affordable for smaller staffs, how can you keep a larger group happy? Start by listening better.

For instance, employees at the Hedges Clinic, in Frankfort, Ill., no longer receive the long-standing office Christmas gift of dinner and a show. No, there wasn't a budget cutback - administrator Frank Schibli simply paid attention to his staff's wishes. The 45 employees at the clinic requested an office lunch and a gift certificate rather than the night out. Now, employees are a little happier with their holiday gift and the practice saves about $1,000 a year.

One new item that's sure to make an impression with staff are the two round-trip plane tickets Schibli plans to award to a selected employee this year. The cost to the practice was virtually nothing. The tickets are the result of accumulated frequent flier miles from the practice's credit card, earned as a result of normal business transactions.

Another example of a low-cost, high-impact employee perk is advertising your practice on the radio, for example, and including the name of the Employee of the Month at the end of the spot, says Merry. This is a common way to recognize a hard worker and doesn't cost additional money if your practice is already buying radio airtime.

Ensure equal treatment

Schibli notes that whatever you decide to offer staff, it's important to include everyone. His employee perks are given to nonclinical employees too - a group often overlooked. Remember, your front-desk employees are the main contact with your office - the people your patients call and see first. Schibli occasionally sends flowers to those employees to recognize their contributions. And when pharmaceutical representatives offer to buy lunch for physicians and nurses, Schibli allows it, as long as the administrative staff is included.

An even larger practice than Schibli's - Quincy Medical Group - makes sure to acknowledge everyone, which is not an easy task with its 700 employees and 88 physicians. The physicians and executive management spend about $20,000 on an employee appreciation week, buy occasional lunches, sponsor nights at sporting events, write personal thank-you notes, and give employees small gifts like Quincy Medical Group T-shirts. "These may sound expensive, but given the size of the practice, it's all relative," says Diane Weber, associate administrator and chief financial officer of the practice, which is based in Quincy, Ill.

Weber notes the difference between practices that appreciate employees and those that do not: "If you work in an organization [that doesn't recognize employees], when you need people to go the extra mile, they aren't necessarily willing to do so," says Weber, a 23-year veteran of the practice, which has had minimal turnover for years. "If staff have to kick it up a notch and squeeze in an extra patient, what is their incentive?"

The practice also offers a generous retirement plan. "Employees are vested after one year. Even in a cost-savings mode, the doctors never want to touch it," says Weber. And the practice offers a much-appreciated short-term disability plan that employees can use for themselves or to care for their families. "It doesn't cost us much because the need for it doesn't happen often," she says.

"We believe these are some of the reasons our retention rate is as high as it is. It costs a lot of money to have turnover," says Weber. "Happy employees are your best referral source - these employees promote the physicians' office. So we think doing these things is money well spent."

Karen Gatzke can be reached at editor@physicianspractice.com.

This article originally appeared in the July/August 2002 issue of Physicians Practice.