Chapter 9: Hiring the right people – your most valuable investment
|"When you hire people that are smarter than you are, you prove you are smarter than they are. "
- R. H. Grant.
Most doctors take a very casual approach towards employing staff. Vacancies are filled as and when they arise, and employees are left to muddle their way through, till they either learn to do the job, or walk off. Most doctors can get away with this , because labour laws in India are still very primitive, and there are few safeguards for employees working in doctors clinics. However, not only is this very wasteful of the doctors time and energy, it is also very shortsighted. After all you need to remember that just like you spend a lot of time and money and energy before buying an ECG machine , you need to spend a lot of time before employing a new staff member. Remember that your employees are an investment in a successful practice and you need to build a high-quality staff to keep your practice running smoothly so you can spend your time practicing medicine
The basic rule is hire tough - a simple, yet powerful principle, because hiring the right employee will reduce staff turnover. Your formula for managing your staff should be: Hire tough - Manage easy. If you are a good manager, you should be able to go on a two-month vacation and come back to a clinic which is functioning as efficiently as when you left.
A good manager is one who has truly learned to manage: to get the work done through other people. You need to teach your employees a sense of responsibility for their tasks , and should not need to constantly monitor whether they are fulfilling their duties. The secret is to hire a person with the right attitude, and then teach them the skills they need to get the job done.
Each employee represents a major investment. Unfortunately, doctors only consider how much they actually pay each employee , and since this is usually a small amount, they tend not to devote much thought or energy to hiring the right candidate. However, remember that hiring the wrong employee can prove to be very expensive ! If you lose even one patient thanks to the inefficiency of your staff, this can be a major financial loss to you. Your employees are your public face – they represent you to your patients, so select them with care !
The quality of your clinic can never exceed the quality of the people who make it up. You need to have a systematic method towards employing staff, and you can learn a lot from the techniques employed by the HRD departments of large companies. Losing an employee can cause havoc in your practice, because training a new employee is a time consuming affair. To avoid costly staff turnover, hire the best personnel possible - and then make your medical practice a place they wont want to leave.
Prepare Job Descriptions
Start by writing a job description – what duties does this job entail ? You also need to write a person specification, which describes the type of person you want for the job, detailing skills required, qualifications needed and personal qualities necessary. Advertise appropriately, then screen resumes to find those applicants with all or most of the necessary skills, education and experience to meet that position. You can also ask your present staff to suggest people who they feel would make good employees.
Pre-screen Probable Candidates by Phone
Pre-screen those candidates by phone who look best on paper. A brief conversation can help judge the candidates telephone manner. If you dont get a positive feeling, neither will your patients. Just a few minutes on the phone can eliminate some candidates and save time that would be wasted in an interview.
Use an Application Form
Develop an application for your practice or use a commercially available one. Do not just accept the applicants resume. Having the applicant complete the form also allows you to judge his handwriting and spelling skills.
When interviewing, watch for clues that the candidate will mesh with your practice philosophy and culture.
To give you an idea of how the applicant will perform on the job, develop some basic skills tests or use commercially available, standardized tests for English, spelling, math and keyboarding.
When calling for references, provide the applicants name and dates of employment shown on the application and mention the position for which she has applied. Ask open-ended questions and encourage the person to keep talking. Suggested questions are: Was the candidate reliable? What were her strongest and weakest points? Why did she leave? Would you rehire her?
When you find that perfect candidate, hire her. Be sure your salary and benefits are in line with those in your area. A qualified candidate may have several job offers and you dont want to lose that individual for a few dollars. Hire qualified people and give competitive compensation. Many doctors take pride in paying the absolute minimum to their receptionist – and this explains why staff turnover is so high. Turnover generates hiring costs and undercuts efficiency, since it takes time for employees to get to know your patients, your idiosyncrasies and the system of patient flow. Consider offering a few thousand rupees more than the average salary for your area. If thats what it takes to have a first class person representing you at the front desk…its well worth it.
All new hires should be given a probation period during which time you can assess their on the job skills. As your interviewing skills are honed, this period should just be an affirmation that you selected the right person to fill the job. Once the probation period is over, its a good idea to sign a formal employee contract. This gives your employee the job security they need – and also helps to give you peace of mind that they are likely to stay with you for at least the period of the contract.
Just hiring a new person is not enough – to make the most of them, you need to train them as well, so they fit in well into your office ! Unfortunately, most doctors simply employ a new person, and then expect them to learn on the job itself. Training new personnel can be a source of frustration for medical practices. It is, after all, quite an undertaking to try to remember all the tasks related to a particular position and then to train the new employee to perform that mountain of tasks .Unfortunately, in many practices, new employees are forced to learn their duties on the job, often by trial and error. While this method has long been in use, it is less than optimal and can lead to poor performance, poor patient care, low job satisfaction and high employee turnover.
A simple way of having a formal training process is to have a checklist of the duties a new employee is supposed to master, and then to provide training in each. When new employees know what is expected of them, they can take a more active role in their training and feel they are truly succeeding. In turn, this can boost job satisfaction for all employees in the practice, increase efficiency, improve patient care, reduce the rate of employee turnover and decrease long-term practice expenses.
A four-step training approach is recommended when you are breaking in a new employee.
1. Demonstrate the skill as you want it performed. As you demonstrate, point out the important aspects so that your employee understands why each part is important.
2. Role play with the employee. Always give the employee an opportunity to practice with you first. Dont force your staff to experiment a new skill on a patient.
3. Give the employee feedback on what was done correctly. Too often managers only correct mistakes. Positive feedback is much more important in training new skills. Once you have explained what was done appropriately, give feedback on what needs to be improved.
4. Supervise the skill in a real-life setting. This last step gives the employee an opportunity to ask questions if necessary. After you watch the skill, give feedback. Be sure to point out the strengths before you point out areas that need improvement.
A procedure manual is a useful tool for training. It simply sets the standards that the entire clinic lives by in writing. Since procedures are formalized, they guide the performance of everyone in the clinic and help to keep things uniform and consistent. Every clinic should have a procedure manual, but sitting down to write the manual can be dull, dry work, so ask your staff to pitch in. Each can write down how they perform their own duties, and you can then correct this.
Some of the details a procedure manual should contain include:
1. Telephone procedures—answering techniques, calling missed appointments, scheduling new patients, handling problems.
2. Regular patient procedure—sign in, filling treatment rooms, scheduling next appointment.
3. Collecting money—what to say, handling unusual problems, sending statements, phone call collections.
Since writing procedure manuals is a new experience for most people, there is one important technique that makes it easier. Each step should be an action step – it should describe a specific action. If you start each sentence with a verb, you will have an action step. Here is a simple example of the procedure which needs to be followed when opening the clinic in the morning. Writing all this down might seem like a lot of trouble, but if you set up systems , you will find they save you time, energy and money.
OPENING THE CLINIC
1. Unlock doors
2. Turn on lights
3. Turn on air conditioner
4. Check messages on answering machine
5. Put on computer
6. Check for cleanliness
7. Check bathrooms for toilet paper, towels
8. Check appointment schedule
9. Pull out patient charts
Remember that working in a doctors clinic is a stressful job, with constant distractions, and the need to handle multiple jobs at a time – greeting patients, collecting money, answering phones, putting patients on hold, and ensuring the doctors workflow is running smoothly. However, most doctors still treat their staff as ordinary clerks , as a result of which they still overwork and underpay their front desk employees. The time, money and energy you invest in hiring the right person will pay off hundred-fold ! .