Checking References

What is the best way to go about checking references? checking-referencesIn our March 2013 issue of the “Hot Tips Newsletter” we presented some recommended hiring techniques and interview questions: (Read that article here).

As a follow up to that article I am going to touch base on the importance of checking references and some specific questions to ask when doing so.

Checking references is an important action in the hiring process and an often neglected part of investigating an applicant. This is not always an easy process as many employers have become “gun-shy” of giving out opinions about a past employee, especially if the opinion is not favorable. The proliferation of employment litigation has led to this reluctance. Even with that possible concern, one should still attempt to do reference checks on any candidate that you are considering.

The ideal scenario is to check references prior to any one-on-one interview you are going to do as you may uncover some information that will eliminate that candidate and save you interview time. If that’s not possible, then check references after the interview and before hiring.

Here are some questions you might ask:

• How long was “candidate’s name” employed by you or your company?
• Can you tell me his/her ending wage?
• Why is he/she no longer employed there?
• Was he/she a loyal employee?
• Was he/she dependable?
• Do you feel he/she is honest?
• Would you rehire this person?
• If you were to develop a self improvement program for this person, what areas would it cover?

Again, a past employer may not be willing to answer some of these questions. The key question which will give you an idea of the person’s worth is the answer to the question, “Would you rehire this person?” This question is important to ask if the reference person is very guarded or hesitant in giving answers. The question about a self improvement program will also sometimes work in a guarded situation.

This is just one example of a key step in the hiring process that will give one the best odds of hiring a top-notch employee. There are many other steps that we recommend that are covered in other articles in this issue and previous issues of The Practice Solution, as well as in some of our Hot Tips newsletters. If you diligently follow the recommended steps you will find those key, quality employees you’re looking for.

Ken DeRouchie-

Determining Your Ideal Applicant

In keeping with the hiring theme in this issue of The Practice Solution, here are some ideas on determining your ideal applicant. In our March 2013 issue of the “Hot Tips Newsletter” I wrote about some recommended hiring techniques and interview questions: (Read that article here). Also in this issue of The Practice Solution I wrote a follow-up article checking references. You can read that article HERE

In this article I will discuss things you can do to determine what your ideal applicant would look like. Once you’ve worked this out you can use as a type of checklist to compare against incoming applicants and/or applications. This will allow you to make better choices during the hiring process.

For starters we will begin with a basic assumption that you have a written job description for the position being filled. A written job description will tell you what type of person you are looking for and the basic duties and functions they will need to perform.

Using the job description and any other knowledge of the job that you have, write down in detail exactly what you are looking for. You will tend to attract what you are looking for if you are specific in naming it. This is similar to goal setting – if you do not specifically get a clear idea of and name the goal, you’ll never accomplish the goal. So look at exactly what you are looking for in filling this position.

When doing this, be real. For example, a front desk appointment setter type has to be nice and presentable, have good communications skills and be able to get patients to make their appointments. A collections person must be able to get patients, and/or insurance companies to pay and be good at the paper/computer work needed to track and collect.

So part of naming what you want is really looking for what is needed and what are the senior factors that must be present for a person filling that job.

The following is a beginning checklist you can use for listing out characteristics of your ideal scene applicant for the position you are hiring for. Most of these are applicable to any position you want to fill. You’ll then need to add other requirements that are more specific to the specific position you are trying to fill.

(Mark off whether your candidate matches or doesn’t match these traits)

• Wants to make a difference
• Enthusiastic
• Neat and appropriate appearance
• Friendly and personable
• Career oriented.
• Positive attitude
• Organized
• Self confident
• Non-smoker
• Ambitious
• Goal oriented
• Good eye contact
• Ability to work with others – team player
• Past work stability
• Past work performance
• Communicates well
• Application neat and complete
• Follows instructions
• Computer literate
• Wants to help others

Ken DeRouchie

Watching Out for Harassment in Your Practice

These days most business owners are aware of sexual harassment and the need for having policies and employee training on this type of conduct. But sexual harassment is only one form of workplace conduct that any practice must do everything possible to prevent. There are other forms of harassment that any business owner should know about and have appropriate policies on. You should always be watching out for harassment in your practice. Here are a few others you should be aware of:

• Visual harassment: This might include things like pictures, posters, screensavers of an offending or demeaning nature. Someone having a poster of the latest Playboy Bunny or some hot semi-dressed male model would not be smart as would an offensive screensaver that others in the office could see.

• Physical harassment: This could include threatening some sort of unwanted or harmful contact, blocking someone’s movement, unwanted touching of a person, etc.

• Verbal harassment (or written): This could include making unwanted statements about a person’s appearance, clothing, body, behavior, religion, sexual orientation and/or creating rumors about a person.

• Nonverbal harassment: Examples of this could be staring at a person and making them feel uncomfortable, looking up and down their body, nasty or derogatory gestures towards a person, following a person without their permission (i.e. stalking).

You should have office policy that covers these matters. The policy should explain what harassment is and the exact steps an employee should take if they experience any form of harassment. If you don’t have an office policy manual that covers these things, consult your attorney and get one done. A law office that is very good with these matters, one that we’ve referred many practice owners to and where this data comes from is:
The Law Offices of Timothy Bowles, P.C.
One South Fair Oaks Ave. Suite 301
Pasadena, CA 91105
626-583-6605 Fax

Ken DeRouchie

The Cost of Employee Turnover

All of the information we’ve written about on proper hiring and training procedures in this and past issues of The Practice Solution are based upon several key issues: a) to have the most productive office possible you have to have a team of good staff, working well together to accomplish the mission of the practice, and b) the cost of employee turnover can be very high, therefore hiring the right people who remain with you long-term can save a tremendous amount of money.

The facts are that employee turnover can be very costly. Studies indicate that such a cost can equal 6 to 9 months of the salary of the position. This is based on the costs involved in finding, interviewing, testing, selecting, training and getting a new employee fully functioning on the job. There is also the cost of lost income that can occur during the period of employee development, especially if the position is empty for a period of time.

If the position pays $3000 per month, your costs could be between $18,000 and $27,000 every time the position turns over. That may seem high, but because much of that is a “hidden” cost, you may not see it. But you will experience it in the long run. It’s therefore extremely important to test and screen applicants properly and carefully in order to hire the best possible individuals for your practice.

Your goal is to find employees who will work well within the procedural framework of your office and stay, contribute to and grow with your practice. In order to find those people you need successful hiring practices including tests, applications, reference checks, interview questions and more that can help with the hiring process. Only looking at a resume and conducting an interview is no way to determine the quality of an applicant. Hiring someone off of a resume/interview alone is a crap shoot and can be disastrous in the long run. If you are interested in learning more about successful hiring procedures, including what tests to use, what to look for in an application, what screening procedures are best to filter out the best applicants, who should you interview and how do you conduct a productive interview, contact me at: or call me at 800-695-0257.

Ken DeRouchie

Independent Contractors

Our readership, for the most part, is made up of privately owned health care practices in the dental, veterinary and optometric fields. It is not uncommon for them to occasionally hire outside vendors to do sporadic work here and there. Therefore we want to help you be aware of the various rules and regulations surrounding independent contractors.

For starters, what is an independent contractor?

There is no pat answer to that question as each state has its own rules regarding this. But there are some national (IRS) guidelines that any employer should be aware of when determining whether someone qualifies as an independent contractor or not.

The most basic concept to understand in this area is that individuals who are independent contractors have their own business, profession or trade. They are in business for themselves. They earn their money and receive their income from their own independent business. They do not depend upon one employer for their livelihood.

Some simple and more obvious examples would be: hiring a painter to paint your office; your attorney or accountant; hiring a bookkeeper to do your books who also does this for other businesses. None of these people depend upon you for their sole source of income, and you do not control their work hours, work location, etc.

Here are some specific points to look at when attempting to determine if a person you hired is an independent contractor (IC) or not. Review the following points in order to become familiar with what an IC is.

• Can the person earn a profit or loss from the work they are doing? If so, they could be an IC.

• Is the person told where to work, when to work, what he/she can or cannot do as part of the work? If so, they likely wouldn’t be an IC.

• Does the person offer their services to others in general? If so, they could be an IC.

• Does the person furnish their own materials, tools, etc. needed for them to do the work? If so, they could be an IC.

• Does the person work for more than one company or firm at one time? If so, they could qualify as an IC.

• Does the person invest in equipment and facilities? If so, they could be an IC.

• Does the person pay his/her own business and traveling expenses? If so, they could be an IC.

• Is the person told how to work, when to work, where to work by the hiring firm? If so, they would likely not be an IC.

• Does the person hire and pay his own assistants? If so, they could be ICs.

• Does the person set his or her own working hours? If so, they could be ICs.

• Does the person provide services that are an integral part of the hiring firm’s day-to-day operations? If so, they might not qualify as an IC.

• Does the person receive training from the hiring firm? If so, they might not qualify as an IC.

As mentioned above, the most basic thing to understand about whether a person is an independent contractor or not is: do they have their own business, profession or trade, and earn their income from their own independent business rather than one employer? If so, and most of the points we’ve gone over are present, they would likely qualify as an IC.

If you have any uncertainty on this subject, please consult your accountant or attorney before making any final decision regarding anyone’s qualifications as an independent contractor.

Ken DeRouchie

Hiring Techniques

The Application

One of the areas we are regularly asked about is how to best read and evaluate an employment application. Here are some things you can look for on an application that will give you an initial “feel” for the applicant.

• Neatness
• Completeness
• Does everything look accurate and honest? For example, are the dates of past employment consistent?
• Past work experience – what have they done that would qualify them to work for you – look for past responsibilities held and descriptions of what they did and the salary they earned.
• Past work stability – how long did they work at previous jobs or did they hop from one job to the next?
• Reasons why they left their past jobs – are their statements positive or negative about this?
• Gaps in time between jobs. What did they do?
• Comments they may write about themselves.
• Level of education achieved.
• Date available to start work.
• Yes or no questions – are they all filled out? Are there any questions raised from their answers?

The Applicant Interview

Once you have decided to schedule an interview with a potential employee, make sure you are fully prepared with the questions you want to ask. Since the purpose of the interview is to gather information to make an informed decision, it’s important that the questions you ask elicit as much information as possible.

There are basically two types of questions: open ended which allow a person to think and speak, and closed ended, which give basically “yes” or “no” answers. You want to ask open ended questions as they are more revealing. Here are some examples of open ended and close ended questions, each concerning the same subject. Look them over and you should easily be able to see how they will elicit different responses and how the open ended question will give you much more data for your hiring evaluation.

Close Ended: Are you highly motivated?
Open Ended: What career objectives have you set for yourself?

Close Ended: Are you qualified for this position?
Open ended: In what ways have your previous jobs prepared you for this position?

Close Ended: Can you accept criticism?
Open Ended: Give me some examples of times you’ve been criticized. How did you respond?

These are just a few examples of how to properly ask questions in a hiring interview. You can see that the open ended question will provide you with much more useful data to evaluate the applicant.

Applying the proper screening techniques when hiring, which would include proper use of the application, interviewing with information eliciting questions as well as testing can help you identify both the good and potentially dangerous applicant which will allow you to make a more informed decision.

Happy hunting!

Ken DeRouchie

Vacation Policy

One of the key areas that we’ve helped practice owners with is office policy. In this article we’ll present some ideas on what you can include in an office policy having to do with vacations.

The importance of having and using office policies that cover the rules, regulations and agreements for how a health care practice is to be run cannot be overstated. Without policy known and agreed upon, you end up with confusion, inefficiency and overwork in any practice. With proper policy in place that covers all aspects of a practice including such things as discrimination, paid holidays, vacations, retirement plans, etc., staff will know what to do and the result will be a smooth running office. Below is a sample vacation policy that can be adapted to any office.



Regular full-time staff and specified regular part-time staff get an annual paid vacation. The length of your vacation is based on the length of your continuous service with the office.


Length of Continuous Service

Less than 90 Days: 0 vacation days
After 1 year: 5 vacation days
After 2 years: 10 vacation days

Vacation pay for full and specified part-time staff members is at the regular pay rate.

Vacation benefits accrue on a monthly basis. However, since vacation time is earned in 12 month increments, staff members are not eligible to take vacation time off for time worked in less than a 12 month period.

New employees begin to earn vacation pay at the end of the orientation and training period. Upon completion of this phase, eligible new employees will receive vacation benefits retroactive to the date of employment. If employment is terminated for any reason after completing the orientation and training period, the employee is entitled to payment of prorated vacation benefits earned and accrued, retroactive to the date of employment.

Staff members may be required to take their vacation while the doctor is on vacation. If the entire staff goes on vacation when the doctors does, staff members not eligible for vacation benefits may be required to cover the office during the vacation period. All vacations will be approved at the convenience of the office so that continuous patient care is assured. Conflicting requests will be decided in favor of the person with the most seniority.

Any earned and unused vacation time must be taken prior to the beginning of a leave of absence. No vacation time is earned while on a leave of absence.

If a paid holiday falls during your scheduled vacation period, you will be given an additional day off with pay or paid for the day at regular wages. No allowance will be made for sickness or other types of absence occurring during the vacation unless the staff member is hospitalized.

Staff members are required to take their earned vacation time in the year after which it has been earned. If there are extenuating circumstances (for example when the absence may severely affect office operations during a critical period), you may be requested to carry all or part of your vacation forward to the next year.

Failure to return from vacation on the scheduled date is considered job abandonment and treated as a voluntary termination.

Regular full time staff members will receive holiday pay equivalent to the straight time pay received if the holiday falls on a regular working day. New employees do not receive holiday benefits until they complete the orientation and training period.

To be eligible for holiday pay the staff member must be at work, or on an excused absence, the day immediately before the holiday and the day immediately after unless approved, in writing, by management.

Holidays that occur during a leave of absence are unpaid.

If a holiday falls on a weekend, the office may close the day before or the day after the holiday and take this as a paid holiday day.

When a designated holiday occurs during an eligible staff member’s scheduled paid vacation period, the individual will receive an extra day off (the date to be approved and paid at the regular rate for the day).

Staff members who terminate employment will receive compensation for any past earned, but unused holidays such as one that occurs during a scheduled vacation period that hasn’t yet been used.

New Years Day
Memorial Day
Independence Day (July 4)

What Goes in a Job Description

I can’t stress enough the importance of implementing proper, well written job descriptions and office policies into your practices. As few doctors are trained in practice management or management and executive skills while in professional school, most doctors have to fly by the seat of their pants when it comes to running the business side of a practice. That’s why we often write about how and why to implement office policies and job descriptions in order to make the office run more smoothly.

This begs the question: what should be included in a job description?

Here are the key points that we include in a job description:

• The purpose of that position. For example, what is the purpose of the receptionist of a practice? It might be: “to keep the appointment book full, rescheduled appointments to a minimum and the patient flow smooth and efficient”.

• The product or outcome of that position – i.e. what are they suppose to produce? For a receptionist it could be, “A full appointment book with maximum productivity for the doctor and a correctly routed flow of patients and communication within the office”.

• Statistics for the position. You need some sort of metrics to accurately measure the productivity of any job. For a receptionist it might be “percent of patients kept to schedule” or “percent of schedule book filled”, etc.

• The various job duties the position is to perform. You can simply list them out, making sure you have the most important duties covered.

• Write-ups of how to do the various job duties you’ve listed. These write-ups should be written by people who have successfully performed the duties of the job and should be continually updated.

These are the key points that we find make a good job description that will help anyone put a new employee on the job and make any transition from one employee to another much easier. Here is a good article I read in the past on job descriptions. It will provide you with even more information on this subject: CLICK HERE TO READ

Ken DeRouchie

Putting New Employees On The Job

Practice owners bring on new employees for a variety of reasons. Often, when practices are undergoing expansion of production and income they require increased staffing. Or,due to poor past hiring procedures practice owners find that they have to replace some employees who are poor performers. And there is a natural attrition rate as well when a staff member moves out of town, gets a higher paying job, etc.

Many past Practice Solution articles have been written on numerous aspects of our successful hiring procedures including testing, how to conduct proper interviews, how to weed out non-qualified candidates, legally acceptable and non-acceptable questions to ask, etc. You’ll find some of those articles in this issue of The Practice Solution. This article will go over some of the best actions to implement when putting new employees on the job.

Once you’ve decided to hire a new staff member, the first thing to do is have them complete all appropriate paper-work. This would include signing whatever employment contract you use as well as reading all appropriate office policies and attesting to having read them.

Personnel File

A personnel file is vital for maintaining proper documentation on every employee. You can set yourself up for legal problems in the future if you don’t have this properly in place. Therefore creating a personnel file for the new employee is one of the first things you should do after hiring the person.

The office manager should create a personnel file for the new employee which contains:

• The full job application and any resume turned in during the hiring process.
• Any other forms used in the hiring process.
• Any tests taken.
• Any interview notes, write ups, etc.
• Employment contract.
• A copy of the policies the new employee read and signed.
• A checklist of everything the office manager will be doing with the new employee to bring them onto the job. Make sure the checklist is filled out as each item is done.

As the new employee becomes a regular employee, the personnel file should be constantly updated with job reviews, disciplinary warnings, commendations, etc. The personnel file is your key management tool for documenting everything having to do with that employee from the time they are hired to the time they leave, for whatever reason.

Office Policies and Job Descriptions

Every office should have an employee manual with all relevant office policies You should have basic office policies that cover hours of operation and work schedules, discrimination and harassment including resolution procedures, job reviews, employee classifications, vacation policy, etc.

When a new employee arrives, make sure you give them the appropriate policies in some type of “welcome pack”. Give them a deadline to have them read and have some form of written attestation that they were read and understood.

Having written job descriptions is also essential to smoothly putting a new employee on the job. If bringing on a new employee involves another employee leaving, see to it that the employee who is leaving updates any existing job description or, if none exists, writes up all of the duties and functions of the job to be performed. Needless to say, if you just fired an employee, or an employee quits under less than ideal replacement circumstances, it may be difficult, if not down right impossible, to have the departing employee do such a write-up. Therefore having existing job descriptions already in place is vital to any job/employee transition and a smooth running office in general.

Assuming you have a job description for this position, give the new employee a copy of it with a deadline on when it is to be read. Insure that the job description includes:

• The purpose/mission statement of the office as a whole.
• What an ideal staff member is.
• The purpose, product and statistics of that job.
• All the relevant procedures and write-ups relating to the job.

Whenever you are updating job descriptions, make sure the following points are included in the update:

• Any little things that are required of the position on a day to day basis which have proven to be successful.
• Special things that existing and/or previous employees do that they feel are beneficial and helpful to the doctor, other staff and patients.
• Anything that a new employee would need to know such as where things are kept, where things can be found, who handles various functions, specific policies relating to that position, etc.

The Doctor and Office Manager should review these updates and make any necessary additions, changes and modifications to insure that a full job description has been finalized.

If you are in a position where no job description exists and/or there is no one available to do them initially or write later updates, then the Office Manager should put the information together as best they can and add it to the office manual.

Familiarizing the New Employee With the Facility

Be sure to take some time to familiarize your new employee with the office, showing her/him where things are, what they are, who uses what, etc. Walk through the practice with your new employee and encourage them to ask questions and take notes. Familiarized the employee with how your patient flow lines work and why you have them set up that way.

Getting to Know Other Staff

Have the new employee sit down with each of your other employees and get to know them. Your new employee will now feel more comfortable and more able to assimilate into the office.

Ongoing Training

Insure that ongoing training is occurring in the following areas. This should be done consistently, not just on a “hit and miss” basis.

• The use of proper organizational requests.
• Statistics and graphs for the job.
• Proper written communication forms.
• How to ask for referrals.
• Office organization.
• Specifics on the technical aspects of the job.
• Any new office policies.

With the proper hiring and training techniques in place and the job descriptions and office policies to back it up, you can easily get new employees up and running with little hassle and great results.

Ken DeRouchie