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Practice Management

Best Human Resources Practices for Your Practice

by Sheila Grosdidier, BS, RVT, MCP
    Medical team

    What's going on?

    You hear all about unemployment, yet it’s difficult to find that perfect team member.

    There is a lot of activity in the practice, but sometimes there are too many team members scheduled and sometimes there are not enough. 

    While there has been a great deal of discussion in the clinic about how the economy has affected the practice, there is also a great deal of discussion about wages and why they aren’t improving.

    Most of your team members see themselves as being very skilled at their jobs and excellent employees. You, on the other hand, don’t usually agree with their assessment.

    So, really, what is going on? Trends in the labor market are having a significant effect on many businesses, particularly those that provide services. The July Society of Human Resource Management LINE Report found that in June 2011, with overall unemployment still a grave concern, hiring trends in the service sector showed an 8.7% increase in new hire compensation and a 17.4% increase in the difficulty of hiring new employees. The prediction? It will get harder to find solid, qualified team members, and you need to focus on retaining and developing your current team members.

    Do a quick audit of your practice. Here are four things you should be doing to ensure you are ahead of the human resources curve and not behind.

    Use Effective Hiring Practices

    While debate still rages about what information employers should be allowed to review prior to employment, there is little argument about one point: not taking the time to ensure that you do not hire a problem is akin to asking for problems. Employers have the right to evaluate candidates to ensure that they do not have a history of criminal or employment issues. Types of background checks include criminal, job, and wage histories; verification of college degrees and certifications; and Workers’ Compensation records, which are public record. You have the right to know information about a potential employee’s background that is pertinent to the job description.

    Background screening is not free. It requires a relationship with a background screening entity and takes time and money. However, the valuable information an accurate background check provides can help you cut down on turnover costs, reduce theft and fraud, avoid employee conduct problems, and, ultimately, increase your profitability. The cost of a bad hiring decision can be up to 150% of the annual wage of the position.1 BOX 1 lists 10 top reasons to perform background checks.  Read this real-life case to see how much a bad hiring decision cost one practice and for tips on how to set up internal checks and balances to safeguard your business:

    Case Report: How Did We Hire This Person?

    No other element will affect your team more than the careful selection of qualified, team-oriented individuals. This element is often overlooked and underestimated in its power to create and maintain strong teams. It is all too common for clinics to be overwhelmed and disappointed by a parade of mediocre applicants and to hire someone out of desperation instead of consideration. Regret followed by repentance is often the outcome. However, if you find yourself in this situation, make your repentance productive: use it to establish a plan to recruit and hire the right person for the team in the future. A solid hiring plan, as outlined below and in this flowchart, will help you avoid repeating your mistakes.

    Before beginning the hiring process:

    • Review the job description for the open position, and verify that it accurately captures the responsibilities of the position.
    • Make a list of the personal and professional qualities needed to perform the position well. As an example, consider a receptionist position. Obviously, you need someone who is customer oriented, able to multitask, and an orderly record keeper. However, this person must also be flexible, be able to work with a variety of different personalities, and use initiative. When candidates are interviewed, their personal and professional styles must be evaluated to establish whether they match the needs of the position.
    • Identify general behaviors you want to see in your team, and look for these traits in the interview as well.
    • Break your skill requirements into three primary categories: adaptive, functional, and technical. Adaptive skills include professionalism, punctuality, and a strong work ethic. Functional skills encompass managing information, recordkeeping, and bookkeeping. Technical skills include knowledge linked to the position, such as telephone skills and customer service. Breaking the skills into three categories improves your opportunity to ensure your interview is based on behaviorally focused questions that illustrate your priority list of skills and abilities.

    Okay, that all sounds good, but how can a job interview accurately capture this kind of information? To acquire top employees and to consistently hire the right person for the right job, you must be capable of implementing elegant interview techniques to reveal candidates’ strengths, weaknesses, and skills. It is time to move past the old interviewing questions and focus on the behavioral interviewing approach. (To learn more about behavioral interviewing, click here.) Use a job trial: ask the potential new team member to spend a day at the clinic, and evaluate his or her fit with the team. Be sure to ask for feedback from the other team members.

    Establish a Positive and Productive Workplace

    Selecting the right employees is an excellent step. Now make sure you have created an environment that nurtures and encourages your team. Treat your team as well as you want them to treat your clients.

    Know Where the Practice Is Going

    Develop a mission statement as a team, or review the one you currently have and determine if it needs updating. A goal of a mission statement is to establish a set of values that the team can follow and respect. It is essential that everyone participates in the process and is trained on how to apply the mission on a daily basis in the clinic. Have regular discussions at team meetings to identify how the practice is living and reinforcing the mission statement. It can also be helpful to craft a workplace commitment document (click here for an example).

    Communicate, Communicate, Communicate

    Without exception, employers who promote regular feedback, team meetings, and communication tools (e.g., a communication board, in-clinic e-mail) create a more positive work environment and greater employee job satisfaction. If the team feels that there are points where communication is lacking, discuss them with the team and set a solid structure for correction. A big mistake in many practices is that managers and owners discount the value of communicating with the team.

    Know That You Have the Power

    A positive work environment doesn’t just come from decisions and documents, it comes from people, including you. Evaluate your attitude: are you consistently positive in your interactions with team members? Think about what you can do to improve your positivism and promote it in others. Positivism has been defined as looking at life through positive lenses and looking for the good part of every situation. A list of suggestions for increasing positive attitudes in the workplace can be found in BOX 2.

    Box 2. Tips for a Positive Work Environment

    • Listen generously and speak honestly.
    • Keep your commitments; do what you say.
    • Work with your teammates. You will achieve more.
    • Ask for feedback and ensure you understand.
    • Give people the benefit of the doubt.
    • Attitudes are contagious. Is yours worth catching?
    • Smile! Work on demonstrating positivity to others.
    • Encourage others to share their concerns with you in a positive manner.
    • Minimize “bitch” sessions; move to constructive ideas.
    • Emphasize the benefits of what is done at the clinic. Instead of saying, “We are always just too busy,” consider, “I am glad we have clients who love us and make it possible for me to get a paycheck doing what I love.”
    • Remember that a positive environment affects your health in a positive way.
    • Make it a point to compliment someone every day.

    Catch People Doing It Right

    Meaningful feedback can come from peers as well as supervisors. Make it a point to let team members know that you appreciate their assistance and support, and when you see them doing something well, mention it. “Sarah, that was really great the way you helped Mrs. Jones calm down and understand the surgery her pet needs to have next week.” On average, employees hear fewer than two compliments on their job performance on a weekly basis, yet their employers rate them as exceptional employees. So let it start with you: make it a point to share your appreciation of a job well done with others. Compliments can be contagious.

    Read more: The Power of Positive Reinforcement


    Humor is essential! It promotes enthusiasm, energy, fun, and positivism in the workplace. A list of humor ideas for your practice can be found in BOX 3 .

    Empower Your Team

    No clinic can change unless the team members working there are involved in the process. Encouraging team members to do what needs to be done and allowing them to share and implement their ideas is the key to empowerment. Empowerment is about gaining the team’s input and sharing a vision together. Team members are pleased when they know they control their destiny. Focus on giving team members as much autonomy as available in their day-to-day actions.

    Have a Solid Management Structure

    Solid management is not just a good idea, it is paramount to the success of a practice. Team member retention, business development, and long-term achievement are directly aligned with not only talking about management but also having all the components that create a successful structure. These components include:

    • Job descriptions: Dynamic, evolving outlines of the positions within your practice. They are reviewed with potential employees and change with the needs of the practice. Job descriptions clearly outline expectations.
    • Evaluations: Written assessments of each team member’s performance that are reviewed with that person on a regular basis.
    • Phased training: A specific, outlined training process to follow for each position within the practice that ensures consistency and performance from team members as they begin with the clinic. The process also provides a way to verify, on a yearly basis, that individuals have “certified” for their position.
    • Employee manual: A clear, comprehensive document that outlines basic expectations, codes of conduct, and other policies and procedures for the practice. Ensure that all team members have either their own copy of the manual or easy access to one. 

    Read more: She Just Did What? Managerial Mistakes and Their Solutions

    Train and Coach

    It’s only natural for team members to have the ambition to learn new skills. As a result, they want to be offered opportunities to develop and have positive challenges in their position. This can sometimes produce conflict between an employee and the practice, such as when an employee seeks promotion and no positions are available or payroll issues preclude it. But it is unreasonable to expect a team member to do the same job year after year without growth and still maintain a strong, positive team environment. Studies have shown that team members can achieve professional growth even when they stay in the same position.2 The human resources challenge is to make work meaningful for your team members by providing new goals, projects, and rewards for a job well done.

    Achievement of new skills requires targeted, significant training. When considering training employees in new skill sets, take the following into account:

    • To maximize training, base it on specific goals of the team and practice as well as individual goals of the team member.
    • To keep training costs affordable and targeted to practice goals, it is essential to plan training experiences carefully and methodically.
    • Be sure that the team understands the value of the training to the practice and to themselves.
    • Ensure that what is planned does occur; avoid getting everyone motivated for training and then canceling the session.
    • Make training a team activity. Involve everyone and identify the desired outcomes.
    • Follow up with training to ensure implementation—you can’t expect what you don’t inspect.
    • Avoid training that will not be measured and implemented. Training is about enhancing skills and providing opportunities to amplify the individual’s expertise and value to the practice.
    • Reward team members for excelling in their positions and as team players.


    1. Omer E. It costs how much to replace an employee? http://ezinearticles.com/?It-Costs-How-Much-to-Replace-an-Employee?&id=2555834. Accessed August 2011.
    2. Buckingham M, Clifton DO. Now, Discover Your Strengths. New York: The Free Press; 2001.


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