Your Staff Is Key To Your Success
Getting and Keeping the Right Staff
Job Descriptions, Salary Ranges and Fringe Benefits
Training
Evaluations
Office Communications
Terminations
Personnel Policies and Procedures
Human Resources Overview

Your Staff Is Key To Your Success 

One of the most valuable assets in your practice is your staff. From medical procedures and financial operations to day-to-day practice management issues, you need to be able to trust and count on your staff members so you can devote your attention to the care of your patients.

First opinions about your practice matter a great deal, and your patients' first views about your practice are formed in the initial minutes that are spent in the waiting room. During this time, a warm and pleasant atmosphere plays a very important role in shaping your patients' opinions of the general character of your practice. Visitors welcome staff members who demonstrate that they care about their patients' medical issues and concerns.

It is, therefore, crucial for you to recognize the important role that your staff plays in the success of your practice. Staff members deserve a great deal of respect for their daily tasks which are often performed against a backdrop of intense pressure. Practice staff who are enthusiastic and motivated about their jobs will do their best to support the success of the practice. Therefore, they must be properly trained for their specific roles in the management of the practice.

It is also important to note that your practice may be subject to a variety of personnel and employment laws such as The Equal Employment Act, The Equal Pay Act, The Fair Labor Standards Act, The Consolidated Omnibus Budget Reconciliation Act, and the Employee Retirement Income Security Act - just to name a few. If in doubt, it is important that you get correct information or good legal advice about which laws apply to your practice.

This guide is designed to give you an overview of basic human resources management. In the coming months, ExpertPractice.com will develop an application to provide you with improved human resources performance through a comprehensive product that will help you with the hiring process, salary setting, evaluations and performance reviews, time keeping, terminations, policies and procedures manuals, and safety issues.

Getting and Keeping the Right Staff 

A basic rule of thumb that applies to all professional practices is to have reliable employees of the highest caliber. Staff and morale problems can be very disruptive to the practice's operations. Therefore, you need to determine the personal and skill requirements for your practice staff, and then seek the best people to satisfy those requirements. In addition to their technical ability, some of the qualities you want to look for in an applicant include:

• Stability and loyalty from previous positions
• Enthusiasm for the work
• Organization of thinking
• Judgment in dealing with people and task issues
• Ability to get along with others

Once you identify the staffing needs of your practice, you should develop job descriptions for each position needed.

You have many options for finding your staff members. The following list highlights some of the most popular methods:

• Word of mouth is an effective method of letting others know that your practice needs a good employee. This also includes letting your existing staff know about openings, as one of them might be interested in taking another position.
• Tell your colleagues about your needs. Often, the best candidates for your practice are those who are familiar with the requirements of working in a medical environment. Other physicians might know of individuals who are looking for a change.
• Newspaper advertisements with a request to interested candidates to fax or send resumes to your office will allow you to pre-screen the applicants before you go through the time-intensive interviewing process.
• Employment agencies are another source of applicants. However, be aware that employment fees are usually associated with using an agency.

Once you have selected a few candidates, it is time to interview and select the single best qualified applicant. Each should complete a standard employment application (which can usually be purchased from a stationary supply firm). Your office manager should conduct the initial interviews and then select the top one or two candidates for a second interview with you.

In general, you should hire employees who are very capable of performing the requirements of the open position, and ideally, have the potential to grow within the practice. You can test for skills (data entry, etc.) as long as you use reasonable tests and apply them uniformly to all applicants. Though your practice will provide the staff with training, hiring individuals who are self-starters and who can learn quickly will greatly improve the effectiveness of your practice. Prepare a list of question you want to ask during the interviewing process. Some of the questions you may want to ask include:

• Why do you want to change jobs?
• Why does this position appeal to you?
• What do you like best about your current position? Like least?
• What prior experiences have you had which you feel uniquely qualifies you for this position?
• Do you have time constraints (i.e., childcare, etc.) which would limit your ability to work overtime occasionally?
• From a career standpoint, what type of a job would you like to have five years from now?

Deciding whom to hire is your choice. Naturally, federal and state employment laws must be observed. However, as a general rule, if you are looking for a person who fits best with the needs of your practice and if you do not discriminate based on arbitrary factors such as race, age, sex, or sexual preferences, you'll be fine by selecting the person you feel is the most appropriate applicant for the job. Before you make a job offer, be sure to check applicant references. Once hired, you will need for your new employee to complete a variety of employment-related forms (to include Federal forms I-9 and W-4) as well as applicable state forms and insurance applications.

One of the most important hires you will make will be your office manager. The office manager needs to be able to deal with many issues, such as overseeing billing, coding, marketing, financial analysis, practice planning, resolving patient complaints and overall management of your staff.

New employees, as well as existing ones, should always be aware of issues that impact their ability to perform their tasks. Thus, it is important for your practice to conduct both new hire and periodic on-the-job training to enhance employee skills. Training materials or human resource experts may cost you a bit of money right now, but they will payoff. Your practice will always have a flow of new ideas and properly trained staff to back you up.

Job Descriptions, Salary Ranges and Fringe Benefits 

As mentioned above, having written job descriptions is important in several ways. First, a written job description helps you identify exactly the job that needs to be done and aids in determining the set of skills for which you are looking. Second, it helps in training employees in their areas of responsibilities. Third, it allows you to counsel employees about their performance. Ideally, your office manager should write job descriptions for each position and submit them to you for final approval.

You will also need to set a salary range for each job. Talking to you colleagues or looking in the classified section of your local newspaper may be good ways to determine what other practices are paying for employees in a specific job classification. Establishing competitive salary ranges and communicating them to your employees is a good way to avoid future personnel problems. Employees may be placed anywhere within a salary range based on their background and qualifications. Beware that placing a new employee at a salary above an existing employee may lay the seeds of discontent. Nonetheless, if you feel it is justified, you have every right to pay a better-qualified applicant more compensation. It is important to note that both federal and state laws limit the number of hours that an employee can work without receiving overtime pay. Be sure that you are current on such laws. Having each employee complete a time sheet is a good way to help protect your practice against suits filed as violation of such laws.

Benefits will vary between practices. In general, small practices, like other small business do not usually offer a rich fringe benefit package. However, many good employees may leave one practice for another if there is a significant difference in the benefits offered. Common fringe benefits to consider include:

• Health insurance
• Life and disability insurance
• Pension plans

Training 

If your new hire is experienced, you may not need to spend too much time in skill-based training except on the unique policies and procedures of your particular practice. If they are inexperienced, however, you will need to ensure that they are well trained by developing a training program. In most practices, training is on-the-job. That is to say, the employee learns by performing the job.

Developing a training program is not difficult. It starts by creating an outline of what needs to be covered. Typical items include:

• An orientation to the office and introduction to the staff
• A copy of the practice's policy and procedure manual
• A copy of the practice's personnel manual
• A copy of the employee's job description
• Orientation to the employees workspace and immediate resources (copy machines, computers, etc.)
• A person they can go to for any questions they may have

It is important for you, the practice manager or the employee's immediate supervisor to review each item carefully with the employee and be available to answer any questions. In terms of the job itself, the policy and procedure manual and the employee's job description are the most important training tools. While not difficult, good training techniques are important to ensure that your employee is working to their full potential. Some common training rules include:

• Explain to the employee what needs to be done
• Show the employee what needs to be done by having an experienced person perform the tasks
• Have the employee perform the tasks while an experienced person is watching
• Critique the employee's performance through positive and negative feedback. Be sure you compliment the employee for the things done correctly as well as show them what aspects of their performance needs to be changed
• Watch the employee perform the tasks and provide feedback until all the tasks are done correctly
• Follow-up with the employee on a regular basis to until you are sure that they are performing the tasks properly on an on-going basis

Training is not a one time event. Rather, you should be continually looking for opportunities to improve the performance of your staff through training. New laws and regulations, for example, are constantly being passed which affect your practice. Your staff needs to understand how they impact their job. Perhaps you have observed that various staff assignments could be performed more effectively. Staff meetings provide a great opportunity to both identify training needs and provide training. Remember that a well-trained staff will result in a more effective and well-run practice.

Evaluations 

You should never be too busy to provide your employees with feedback about their performance. Tell them that you're happy with their performance. Talk to them about ideas that you have for improvements and get their input. Your staff wants to know how they are performing and want to hear you say good things about them if they are performing well.

Your regular feedback, especially positive feedback, will build morale among your staff. Soon, you may notice that your devoted employees will take initiative and additional responsibilities in your practice. Staff members who like what they're doing and who know that their work is being appreciated will go beyond their basic job requirements to make your life easier.

You should develop a formal evaluation procedure where you meet regularly with each individual member of your staff to discuss their strengths and weaknesses such as attitude, appearance, work product, ability to accept responsibility, and need for supervision. This formal evaluation can also be used for giving your staff raises. You should seriously consider raising your employees' salaries on an annual basis. Explain to them that at the end of the year, their individual job performance and overall the performance of the practice will determine the amount of their raise. While this is not a formalized incentive plan, it will give your employees a financial reason for contributing to the success of your practice.

Office Communications 

It is often said that good office communications provide the lubricant for a well run practice. Often times, staff meetings are seen as unnecessary and an intrusion into the hectic practice schedule. Yet, regularly scheduled staff meetings provide you with an excellent opportunity to commend your employees on what they are doing right, and offer suggestions on what needs to be improved. Having staff meetings more frequently usually means that you don't need to have several longer meetings during the year. Discussion issues can focus on how the practice operates, issues raised by patients, or specific training opportunities for such topics as billing and collection, coding, etc.

Terminations 

Every now and then, you will experience an employee who does not meet your expectations - even after numerous counseling sessions and efforts aimed at helping that employee. You may be left with the reality that you need to terminate that employee. This is never an easy job. However, when handled quickly and respectfully, a termination will help your practice by eliminating disruptions encountered by you and your staff in your daily management of the practice. Inadequate staff member performance can do nothing but hurt your practice's performance in many different ways. Wrongful terminations, however, can bring lawsuits or other labor actions. Before you terminate an employee you should counsel the employee and document your actions and performance improvement recommendations to the employee. This documentation should be placed in the employee's personnel folders. Some experts recommend that both you and the employee initial the documentation before it is placed in the personnel folder. If you suspect legal problems with an employee you plan to terminate, you are advised to seek the advice of a qualified attorney prior to taking action.

Personnel Policies and Procedures 

Someone a long time ago must have decided that a policies and procedures manual should be a thick and heavy document. While your employees may never read such a manual it is important that your practice have a set of personnel policies which provide guidance on what your employees can expect and what is expected of them. Thus, you need to develop a viable manual that is easy to understand and is periodically updated. This manual should be tailored for the needs of your practice, explain employee requirements and benefits, and provide descriptions of patient relations and general internal policies. Standards items addressed in many personnel manuals include:

• Organization and management of the practice
• Office hours
• Lunch and other breaks
• Personal appearance
• Attitude
• Proper telephone techniques
• Office security
• Confidentiality
• Payroll
• Fringe benefits (see above)
• Sick leave
• Vacations
• Holidays
• Maternity leave
• Workers compensation insurance
• Jury duty
• Family emergencies
• Funerals
• Absenteeism
• Performance and salary reviews
• Disciplinary actions
• Termination

You should instruct your employees to read the policies and procedures manual. Allow them to ask any questions they may have. In many firms employees are then required to sign a simple statement that they have read and understand the manual. Every so often, your practice should give an in-service training class on the policies and procedures manual. This class should remind employees of key practice policies, especially those that have changed since they were hired.

Human Resources Overview 

Your employees are essential to your practice's smooth operation and financial success. Don't ignore them or take them for granted. Always appreciate the good work that they are doing on a regular basis. Keeping in mind that they are the strength behind your practice use the following as a guide to ensuring that you get and maintain a top grade practice staff.

• Know what your practice needs and hire the right number of employees for your specialty and size who have the correct background, experience and temperament
• Conduct in-depth interviews to fill job openings
• Hire the best people and pay them well
• Train your employees well and keep them up-to-date
• Talk with your staff members and give them formal performance evaluations
• Reward performance by giving raises and bonuses
• Develop and use a policies and procedures manual