February 1, 2023
If you consider hiring staff a daunting task, you are hardly alone. America’s post-pandemic workforce is a tumultuous place, and many medical practices are feeling the impact directly.
This year began with six in ten people working from home—most by choice—in a dramatic escalation of remote work that is changing the nature of jobs and hiring. Last year, more than 47 million people left their job, increasing a trend underway for the last decade, and the turnover is unlikely to abate anytime soon. Polling shows that almost half of U.S. healthcare workers plan to leave their job by 2025.
The result is that attracting top talent, a job that was difficult in the best of times, can be even more challenging. In a private practice, where the skill sets you are hiring for may vary from reception, office management and billing to nursing and medical care, it may be harder still. Despite recession fears and high-profile layoffs, employment numbers show it is still very much a seller’s market.
“We’re in the tightest labor market on record,” Julia Pollak, chief economist at ZipRecruiter, told CNBC.
For physicians looking to fill positions, that means hiring must become a real priority. The staff you hire impacts everything from costs—personnel is often the single largest expense for any business—to patient care, and it will certainly affect how much time and energy you spend managing people. It pays to get good at this.
Employment experts say that embracing more sophisticated strategies, developing a recruiting pipeline and creating a culture that employees want to join can transform the hiring experience. Practices that are willing to do so can make finding candidates easier, eliminate crisis hiring and ensure the best chance of finding high-quality office staff.
“So much of what happens in hiring is reactive, and not proactive, tactical and strategic,” said Thad Price, CEO of Talroo, a job advertising platform that powers more than a billion job searches each month. “But at the end of the day, hiring is strategic.”
The best place to start, Price and other experts say, is with a question: what type of culture do you want in your office?
“You have to think about what culture you're looking to achieve, your company’s North Star,” Price said. “As a doctor's office, you're caring for people, you're helping save or transform lives, you're providing happiness. I think the first thing you need to do is really focus on your brand. There are a lot of doctors' offices, so why would a job seeker work in your office?”
There’s a lot that goes into the culture of a medical practice, from values and core beliefs to everyday expectations and workflow. It can be defined by big things, like your company’s mission, and small things, like what people are allowed to wear. It can be impacted by personalities, policies and experiences. The important thing, experts say, is that it should be created deliberately.
“The biggest mistake organizations make is letting their workplace culture form naturally without first defining what they want it to be,” wrote ERC, an Ohio-based HR resources company in business for more than 100 years.
Employment experts say that there are many ways to evaluate, define and shape culture, ranging from professional solutions to interviews and group conversations. Policies, routines, expectations, the office environment, reporting relationships, communication and management styles can all be adjusted to bring about the culture that works best for your practice.
“Make culture as important as your business strategy,” ERC wrote. “It’s too significant to ignore, and shaping it is one of your most important responsibilities.”
Dr. Robyn Siperstein, who heads Siperstein Dermatology Group, a practice with more than 100 employees in Florida, might agree. She is so serious about culture that she once eliminated a capable employee who did not fit into the culture she created, which is patient-focused, compassionate and enthusiastic.
“I literally got sick to my stomach the day I had to do it, but it was the best decision I made,” she said in a Q&A with Nitra. “It was one of the first steps toward a truly culture-generated practice.”
After a dozen years, Siperstein’s 11-doctor practice now adds as many as 1,000 new patients every month, many of whom hear about her through word of mouth. Her referral base is centered on patients, rather than doctors. When asked what resources helped her scale, she said, “honestly, it was getting the culture right.”
One of the best ways to shape culture is to hire people who fit smoothly into your vision. Unfortunately, much of the hiring that takes place in medical offices is reactive, which makes finding these candidates much more difficult.
See if this scenario sounds familiar: a staffer gives notice, starting the clock on a two-week rush to find a replacement. A job description is created quickly and sent out over digital platforms. Resumes come in and interviews take place, often 30-minute Zoom calls filled with standard questions. You find candidates who are serviceable, but not exciting. Because the opening will place a heavy burden on remaining staff if it goes unfilled, pressure builds to get someone in the door in time to train them. A “best of the bunch” candidate is selected to solve the immediate problem.
While there are certainly times when a practice legitimately needs to fill a job quickly, this type of crisis hiring can cause many problems. It can lead you to lower standards, hiring candidates without the right skills and the right amount of experience. Equally dangerous, it can lead you to hire a candidate who does not fit well in the office culture. This can sour other staffers, create new management headaches and perpetuate the problem, increasing turnover that leads to more emergency hiring. To stop crisis hiring, you need to break the cycle.
The way to stop emergency hiring is to get serious about recruiting, adopting a more sophisticated approach that surfaces candidates with the right mix of skills, experience and personality to become long-term members of your team.
Good recruiting is based on networking, meaning your practice is always meeting new candidates—even if you don’t have immediate openings—and then staying in touch with those who have potential. The goal is to develop relationships over time with a pool of people who look promising and could fit well in your organization. When openings do arise, you will have a ready list. Like professional baseball clubs, which use minor-league teams to fill their rosters, you will have a farm team to turn to when you need to fill positions. You will have an “always on” recruiting program.
“Recruiting is a sales process, and we should look at recruiting like sales,” Price said. “You're selling the company. Just like any sales process, you need a pipeline in a recruiting process—you need a pipeline of candidates.”
While the system will be different at every practice, here are steps you can take to do basic recruiting:
Of course, there are many things that can get in the way of always-on recruiting. One of the primary barriers is time. Faced with a busy schedule, some will argue that spending time on hiring without any openings is wasteful. But consider the waste involved in hasty hiring and frequent turnover. Building the right culture and finding the right people is always time well spent.
Unlike decades past, when meeting good candidates required some serendipity, hiring today can be a highly targeted endeavor. Modern hiring platforms allow you to search on many different variables to find the type of candidates you need in your area, whether that is people with a certain level of experience or those who hold a specific credential or license.
Platforms like Indeed and Talroo, and sites like Nurse.com or DirectShifts, can help in a number of ways. Most obviously, they can provide a steady stream of candidates. They can also help you fine-tune your job search quickly, by gauging the amount of response. Hiring platforms also facilitate recruiting by allowing you to communicate with candidates, implement a screening process, conduct virtual interviews, make notes and manage relationships, all in one place.
They also have extremely useful data. For example, many platforms have salary information, allowing you to benchmark your compensation and ensure you are competitive. For example, Indeed can tell you that the average pay for a medical receptionist in Maryland with 10 years of experience is $47,654 a year. In neighboring Washington DC, however, it is $52,903. Talroo can show which zip codes have the most job applicants, identify the job titles that attract the most candidates and even reveal which of your competitors are hiring.
Whatever you choose, a modern practice needs modern hiring tools designed to communicate with candidates where they choose to search for work, and that means digital platforms.
While salary is still a prime motivator when people choose a job, many offices are finding it is useful to provide other incentives in a tight labor market.
Dr. Johnny Franco, owner of Austin Plastic Surgeon in Texas, is a great example. His practice, which currently has 15 employees, is moving into a massive new building and opening a second location in San Antonio at the same time. Within a year, he expects to almost triple his current staff. He and his managers already recruit on a full-time basis, but they have also created benefits that are designed to attract the type of people they want.
That includes a 401(k) plan with a 3% contribution, regardless of whether employees contribute; profit sharing that yields a year-end bonus; and solid health insurance. Some positions also have incentive programs that allow employees to make more money as they hit certain goals.
“We try to make this a system where, when they come, even if their base pay isn't crazy, they feel like they're well taken care of,” he said.
Employment experts say there are several things in addition to compensation and benefits that medical practices can do to attract employees and increase retention.
Of course, finding staff that fit into your office culture often goes beyond the ability to do a job.
“When I’m hiring in my medical practice, I always pay close attention to the soft skills candidates offer,” said Dr. Jae Pak, a hair restoration specialist and owner of Jae Pak Medical in Los Angeles. “We can train people to complete tasks, but things like emotional intelligence, a team-player attitude and great listening skills are harder to teach. More than anything, it’s about having the right personality mix and finding people who complement the strengths of other team members.”
Franco echoes that sentiment: “Attitude is the number-one thing we look for,” he said. “It's got to be a good personality fit.” And Siperstein has it boiled down to a slogan: “screen for aptitude and hire for attitude.”
Finding that fit starts with an extraordinary job description for use on digital platforms. As Price put it, “the job ad is all powerful.” The description you use will impact both the number of applicants you attract and the quality of those applicants. It is worth taking the time to create a document that will work hard for your practice. Here are three important guidelines:
To find exceptional candidates requires an exceptional job description, one that goes beyond qualifications and a boilerplate description of your business. “It is the most important piece,” Price said. “If you're not writing a good job ad, not being transparent, not writing to interest the reader, how will you ever get good applicants to apply?”
The 30-40 minute interview, filled with questions about strengths, weaknesses, recent successes and five-year goals, is a tired artifice. It does little to reveal what kind of person you will actually be hiring, how hard they will work, how well they will interface with others and whether they will fit into your office culture. Thankfully, doctors have found several better ways to evaluate candidates. Here are some ideas:
The goal behind all of these strategies is to get a more thorough look at candidates, and to give them a deeper insight into your practice, including its mission, culture and values. “Be honest with them,” Franco said. “The good, bad and ugly of everything. No job is perfect. It doesn't do them a service, and it doesn't do us a service, if they come here and two weeks later, they leave.”
As he put it, “We’re trying to make sure that everybody is in a system where they can be successful.”