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

Help Stop This Deadly Disease

BATAVIA, Ill.-(Business Wire)-April 2, 2009 – According to a recent study conducted by The American Heartworm Society (AHS), heartworm disease continues to be a major health concern throughout the United States. The study indicates the need to continue to raise awareness among the more than 82 million pet owners about this potentially deadly disease and correct some of the misconceptions about its transmission, prevention and treatment.

The results of the study show that heartworm incidence in dogs is on the rise in the US and there is a continued increase in the geographical spread of the disease. The extended occurrences were found particularly in the northwest region and around the Rocky Mountain States. The Delta, South-central and Southeast regions also saw an increase in reported cases, with prevalence being the highest in the Delta region.

Heartworm disease is found in all 50 states. All dogs, regardless of breed, size, general health – and whether they are considered indoor or outdoor pets – are vulnerable to it. Once a dog tests positive for heartworms, treatment for the disease is complicated. It’s lengthy, traumatic to the pet and its owner, expensive, and can be risky. Cats can get infected too, and while heartworms are easy to prevent, there is no approved treatment if they get infected.

Heartworms are transmitted by an infected mosquito biting your dog and depositing tiny larvae on the skin which migrate through the tissues and mature until they reach the heart and lungs. There, they cause debilitating damage that can rob the animal of its energy, its quality of life and, eventually, of life itself.

“Fortunately, there is an easy, reliable way to prevent pets from contracting heartworm disease in the first place,” said Dr. Sheldon Rubin, president of AHS. “Heartworm Preventives are highly effective, convenient to administer, and available at a small fraction of the cost of treatment,” he added. They must be dispensed by a licensed veterinarian.

Pet owners are urged to consult their veterinarians about heartworm disease, and to follow his or her recommendations carefully in order to protect their pets. “The American Heartworm Society (AHS) hopes to raise pet-owner awareness of heartworm disease and has designated “April is Heartworm Awareness Month,” said Dr. Sheldon Rubin, president of AHS.

About the American Heartworm Society

The American Heartworm Society, headquartered in Batavia, Illinois, is the global resource for the prevention, diagnosis and treatment of heartworm disease and was formed during the Heartworm Symposium of 1974. The American Heartworm Society stimulates and financially supports research, which furthers knowledge and understanding of the disease.

“Should I Lease or Should I Buy, That is The Question”?

by Brad Beck

Vice President, Banc of American Practice Solutions

Are you still writing rent checks? Have you ever asked yourself; “would I be better off purchasing a location instead of leasing?” In order to answer these questions you need to carefully review the advantages and disadvantages of leasing or purchasing property for your practice.

Buying real estate certainly has its rewards. Developing equity in real estate can be a sensible way to grow your business and personal wealth portfolio. What are the advantages and disadvantages of leasing property though?

One of the advantages of leasing is that your credit rating is not as crucial and normally requires little or no down payment. Another benefit is that you don’t have to worry about selling the building when you want to move to a new location. And, of course, your monthly rent may be considered a tax deduction that you can deduct as a business expense.

The disadvantage of leasing is fairly obvious – you never build any equity in the property and your rental rates could increase based on market conditions.

What are the advantages and disadvantages of purchasing? Crunching the numbers is important when doing any comparison. One advantage is when you own the property you eliminate dealing with a landlord. Additionally your interest on the mortgage loan should be tax deductible. Also, by making improvements to your property you could increase its value and, by holding the property long term, you should gain equity that can be used for retirement. With a fixed mortgage, you never have to worry about your payments going up annually like a rent payment, unless your interest rate is variable. Also, there is normally a depreciation tax write off available to the owners of a property and this could save you significant tax dollars. In fact many accountants recommend that a property be bought in the doctor’s name and then leased back to the doctor’s corporation (if he has one) to get the maximum tax benefit for the doctor.

One should also be aware that there could be some downside to owning real estate. Owning real estate could require you to invest time and energy in tasks that are not related to the day to day running of your office. Costs such as unexpected repairs, routine maintenance, trash pick-up, landscaping, and possibly snow removal should be considered in your cash flow analysis. Being a property owner could require you to be subject to legal and regulatory laws not associated with leasing property as well. Also, selling the property to get your money back out of it can take time and be subject to the economic whims of the real estate market.

Have you taken a look at your business plan? Have you asked yourself; “how much space will I need ten years from now? Will I be able to grow my practice and expand with the possible restrictions of the size of property I buy and/or will I be able to expand my rental space, as needed, in a leased property?”

All of these matters should be looked at when making the decision to purchase or lease. Answering all of these questions will help you make the decision as to whether leasing or purchasing is really best for your business future.

For a new practice, Banc of America Practice Solutions offers a Conventional Commercial Real Estate loan product that can provide you with an option of up to twelve months of interest-only payments that will give you lower payments at the beginning of the loan while you are building your client base. Banc of America Practice Solutions also offers fixed rate Conventional Commercial Real Estate loans of up to 25 years. Most banks usually don’t offer a long term commercial real estate loan, which is important to keep your payments low and affordable. Along with the longer term, Banc of America can lock in your rate in for 12 months, so you know today what your rate will be tomorrow.

Whether you are an established doctor buying the building where you are currently located, relocating your clinic to an existing building or condo unit, refinancing the existing debt on the building, or even starting an additional practice, contact Brad Beck Vice President Banc of America Practice Solutions @ 800-214-6087 and he will be glad to help you with your Conventional Real Estate needs.*

* Banc of America Practice Solutions is a wholly owned subsidiary of Bank of America, NA. Banc of America Practice Solutions and Bank of America, NA are registered trademarks of Bank of America Corporation. The suggestions set forth above are not intended to express, imply or infer any guaranty of success or promised result, and are intended as guidelines only.