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. 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 unacceptable questions to ask, etc. You’ll find some of those articles in this issue of Hot Tip.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 paperwork. This would include signing whatever employment contract you use as well as having them read all of the 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 the 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 until the time they leave, for whatever reason.

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Workable Collection Examples and Tips

Workable Collection Examples and Tips

This article is a continuation of The Truth About Collections. If you haven’t done so yet, we recommend reading the first article to get the full picture.

Let me explain. If at the end of your fiscal year you have enough money to pay for everything, i.e., all of your overhead is covered, such as your staff salaries, your mortgage/lease, equipment payments, taxes, etc., any lost income then becomes your own lost personal net income. For example, if you were collecting an average of 93% (5% lower than what should be your standard) with an annual gross income of $650,000.00 ($55k per month), this would equate to a loss of $32,500.00 per year. Over ten years this amounts to a staggering $325,000.00! And that is essentially straight out of your own pocket. This is the equivalent of you working one year or more out of every ten years for free. Many doctors we survey think that “a few percent here or there isn’t that significant.” I hope the above numbers disabuse you of that idea.

With the above in mind, is it now worth it for you to spend the time to train your receptionist and/or collection/finance person on collecting properly?

Here are some tips on things that you can do to increase your collection percentages.

First Contact

When a new patient/client initially calls to make an appointment, the receptionist should keep it as simple as possible for the patient to arrive. So, you want to schedule them in as soon as possible. You want their first impression to be that they feel well serviced. The new patient/client should be informed to arrive early enough to fill out paperwork, so the appointment can happen on time. Payment terms and conditions should not be discussed on the phone with them. You want to make it as easy as possible for the new patient/client to come into the office and not be put off by anything during the initial contact. When they get into the office, you can then go over your financial policies. You should ask them to bring any insurance information that they have should insurance be relevant to the potential treatment. This should include the name of the company, their policy number, what is covered, what their deductible is, etc. Do not worry about having to get into the details of this over the phone and don’t make the patient feel harassed by this. You don’t want to turn the patient off before they even arrive, or they may not arrive. You want the patient to feel friendly and comfortable about coming into the office, but at the same time, you want them to bring any relevant data that they can.

When They Arrive

As soon as the new patient/client comes through the door, they need to be greeted warmly by the receptionist. The receptionist should then supply the new arrival with the necessary forms to fill out. Included should be a form covering your specific payment requirements indicating that payment is due at the time of treatment and/or your insurance agreements and arrangements. If insurance is involved, the form should include a place to provide what insurance they have, how much is covered, what the deductible is and, most importantly, that they will be expected to pay the copay, deductible or anything not covered by insurance at the time of treatment. They should also be told that, unless otherwise agreed upon, you don’t offer billing but will gladly accept cash and most major credit cards. Let them know if you offer financing through companies such as Care Credit, and if they feel that they will require such financial assistance, make sure they meet right away with the person in your office who handles these matters. If you don’t take care of it on the spot, you are likely to be left with a collection problem on this account. Make sure that you require their signature on this form that signifies that they have read, understood and will comply with the financial policy of your office

Once They Have Received Treatment

Validate your patient/client for the good decision that they made to confront and handle the problem that they came to you with. Let them know that they did the right thing and that the investment they made was a good one. Follow up the first treatment with a quality control call, ideally from the doctor, to make sure all went well.

As treatment continues, make sure that everyone in the office continues to reinforce the good decision the patient/client made, and make the patient/client feel welcome in the office.

If you do these things, you will see a turnaround in your collection percentages, and you will see your net income go up.

Questions? Ask the Editor

If you have any questions or suggestions about this article, please feel free to submit them below. Our editors speak with professional Dr’s like yourself every day. They would be delighted to hear from you.

Real Office Policy Examples and Checklist

Below is a list of items that should be included in any basic office policy or policies:

  • Patient Relations
  • Sexual Harassment
  • Orientation and Training
  • Work Hours
  • Fringe Benefits
  • Solicitation
  • Equal Opportunity Statement
  • Terms of At-Will Employment
  • Definitions of Full Time and Part Time
  • Pay Periods
  • Vacations
  • Sick Leave
  • Maternity Leave
  • Tardiness
  • Personal Time Off
  • Absenteeism
  • Staff Meetings
  • Breaks and Lunchtime
  • Unemployment Insurance
  • Problem Resolution
  • Wage and Salary Guidelines
  • Retirement Plans (if any)
  • Holidays
  • Funeral Leave
  • Leave of Absence
  • Jury Duty
  • Disciplinary Measures
  • Continuing Education
  • Workers’ Compensation Insurance
  • Health and Safety Rules
  • Appearance
  • Office Security
  • Telephone Use
  • Where to Park
  • Voting
  • Job Performance Reviews
  • Uniforms
  • Dating of Patients
  • Confidentiality of Records and Information
  • Cleanliness and Maintenance
  • Reimbursement of Expenses
  • Outside Employment


Policy is very important to establish so that the entire group understands the rules and agreements upon which the office operates. When you have good policies known and understood by all staff, you get an effective and efficient team that coordinates and cooperates at a high level.

Below are some sample policies about the subjects suggested previously. Always consult with a good employment attorney before implementing your policies to make sure that they conform with the laws of your area.

Example General Policy Introduction

Welcome to our practice. The following policies are designed to provide working guidelines for all of us. Written office policies help to:

prevent misunderstanding and lack of communication;
eliminate hasty, unrefined decisions in personnel matters;
ensure uniformity and fairness throughout the practice; and
establish the basic agreements that everyone in the office operates on.

Our practice is open to change. Changes happen as a result of internal growth, legal requirements, competitive forces or general economic conditions that affect our profession. To meet these challenges the practice reserves the right, with or without notice, to change, amend or delete any of the policies, terms, conditions and language presented in this manual. Changes in personnel policies are made after considering the mutual advantages and responsibilities of both the owner and staff. All of us need to stay aware of current policy and, as revisions are made, new pages will be given to the personnel to place in staff manuals.

Remember, your suggestions are welcome. Just notify the office manager whenever problems are encountered and wherever you think improvements can be made.

Example Harassment Policy

This practice is committed to providing a work environment free of discrimination. This policy prohibits harassment in any form, including verbal, physical, religious and sexual harassment. Any employee who believes he or she has been harassed by a co-worker, manager or agent of the practice is to immediately report any such incident to the office manager or next highest authority. We will investigate and take appropriate action.

[As harassment is a big legal issue in today’s world, we also suggest to all practice owners that a more extensive policy be written that further defines the types of harassment and the exact steps to follow should it occur. We also suggest that you check with your attorney on proper policy in this area.]

Below is a sample policy on employee classification. These classifications are important for any employer to know because they affect the type of working hours, pay, benefits and bonuses that various employees are eligible for. Some of these classifications and their accompanying benefits or restrictions can vary from state to state. Therefore, it is important that you consult with an attorney who is familiar with the employment laws in your state before implementing this type of information.

Example Employee Classification Policy

  • New Employees: this category would include those employed for less than a specified number of days, during which they are on probation.
  • Regular Full-Time Employees: this could include staff who work a minimum of 32 hours a week.
  • Regular Part-Time Employees: this would include staff who work less than the minimum required.
  • Temporary Full-Time Employees: this would cover staff who work full time but are hired for a limited specific duration.
  • Temporary Part-Time Employees: this would include staff who are hired for a limited duration and work part-time.
  • Exempt Employees: this covers staff who qualify under the Fair labor Standards Act as being exempt from overtime because they qualify as executive or professional employees. Make sure you know the exact rules and regulations on this before you exempt anyone from overtime.
  • Non-Exempt Employees: such employees are required to be paid at least minimum wage and overtime.

Example Overtime Pay Policy

Overtime pay is paid according to the Federal Fair Labor Standards Act and our state’s wage, hours and labor laws.

Exempt Employees: employees exempt from the minimum wage, overtime and time card overtime provision of the Fair Labor Standards Act do not receive overtime pay.

Non-Exempt Employees: employees not exempt from minimum wage, overtime and time card provisions of the Fair Labor Standards Act do receive overtime pay.

Overtime hours must be authorized by the office manager or owner in advance of extra hours worked or as soon as possible thereafter. Time not worked but paid for, such as vacation, holidays and sick leave will not rate or count for overtime calculation purposes.

Example Time Tracking Policy

Each staff member is individually responsible for recording work time on the attendance sheet and/or time card when reporting for work, leaving for lunch, returning from lunch and leaving at the end of the day.

The attendance sheet and/or time card is a legal document and must not be destroyed, defaced or removed from the premises. Never allow another employee to enter your time for you and vice versa.

Overtime must be authorized in advance of extra time worked or as soon as possible thereafter. Overtime, changes or omissions on the attendance card must be authorized by the office manager and initialed.

When you leave the premises, let us know. If you have to go out of the office or the building on personal business during your scheduled work hours, first, get permission from your supervisor. Then, check in and out on your attendance sheet or time card.

Whether you use the above examples or not, having written office policy is vital to the smooth operation of any practice. It is the foundation of education, training and correction in your office and can make the difference between a well oiled machine and a machine that is constantly having problems and is in need of repairs.


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Forming Office Policy

Forming Office Policy

All doctors are extremely well trained in their profession. Unfortunately, very few doctors are trained in business or employee handbook policy creation and their appropriate implementation.

Every healthcare practice is a business that provides a beneficial service to its patients and clients. The less the practice owner knows about business management, the less service he or she will be able to deliver. The more he or she knows about practice management, the more successful their practice will be.

Forming office policy is one of the most basic and important practice management tools that any owner can implement to make a more successful practice.

Why is policy so important? Why do we consider it a fundamental practice management tool? The answer is simple but important.

Policy is important because it sets up the group agreements, the rules of the game, the procedures to follow. It is usually based on what has worked and what legal guidelines are important to know and follow. Without good office policy, you get a chaotic environment because people end up making up their own policies. This results in inefficiencies and lack of teamwork.

Policy that is understood, agreed upon and adhered to will strengthen the office and provide the best means to achieve practice goals. Even those policies that are unspoken and assumed to be known should be put in writing. By putting all policies in writing, problems and confusions that could otherwise surface will be curtailed and even eliminated. Additionally, in this litigious world, having written office policies that are attested to as read and understood provides a layer of protection from potential disgruntled employees who have violated the policies.

Policy is vital to achieving teamwork, cooperation and efficient coordination in any group activity. If everyone knows the rules of the game, the game is much more easily played. These rules and procedures are outlined in office policies.

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Generating New Patients by Using Surveys

How do you market for new patients in a cost efficient and effective manner? Internal marketing is always the best avenue to begin with as it produces the most cost effective return, which is of utmost importance in managing a practice. Surveys are one method of internal marketing. But how do you go about generating new patients by using surveys?

Here’s an initial tip that you can use to more effectively market. You can do a simple survey with all new patients that come in to find out what brought them to your practice. This can be done as part of their new patient intake forms or verbally done by the receptionist or any other designated staff member.

We have a variety of prepared surveys for our clients to use. Here are some question types you can use to make your own survey:

  • If you were referred, who referred you and what did they say that interested you in our office?
  • If you responded to an ad, which one did you see? What about it attracted you?
  • If you responded to our website, how did you locate it and what about it interested you?

A second tip is the use of surveys on your existing patient base. Start by going through your existing patient records and find about 50 of your “A List” patients/clients. Do a demographic study of where your best patients/clients are from. Then write a survey for those patients/clients and find out:

  • What attracted them to your practice?
  • What keeps them coming back to your practice?
  • What do they like the most about your practice?
  • Are there any services they would like to receive from you that you don’t currently offer?

You can then use this information to target the greatest demographic area of your “A List” patients/clients and use their survey answers as “hot buttons” in a marketing campaign targeted to generate more patients/clients that are similar to these “A List” patients/clients.

This is called targeted marketing. It’s all about generating quality patients and clients, not just people walking through the door. Quality patients keep their appointments, follow your treatment programs, pay their bills, spend more than their insurance allotment etc. These are the kinds of patients/clients you want to generate for your practice.

If you can determine what area your best patients/clients are from and what brought them to you in the first place, you can then design a marketing campaign to generate more of those type of patients and clients.

Don’t just guess at what you think will bring new patients/clients in the door. Find out what got your best patients/clients there and use that information to your advantage. “Know before you go” is the motto of all good marketing. You find out the “know” by surveying.

Ken DeRouchie

The practice Solution Magazine is published by www.silkinmanagementgroup.com

The Benefits of Regular Practice Newsletters

Marketing is a vital part of the management of any business, whether a health care practice or any business in general. Implementing successful marketing actions that help increase the number of new patients/clients as well as help facilitate the retention of existing clients and patients is important to the success of any practice. Are you taking advantage of the benefits of regular practice newsletters as part of your marketing activities?

One of the best and least expensive tools in your marketing “tool box” is the newsletter. A newsletter is a tool that can be used to reach not only existing patients/clients, but potential patients/clients as well. As an internal device, it is an excellent way to stay in touch with your patients/clients and keep your name, your practice and your brand in their mind on a regular basis.

A practice newsletter provides advantages for the practice that other promotional and marketing methods don’t always offer. It provides a simple and compact way to communicate a longer message and can easily be put onto your website as well. It also creates a perfect forum for continuing education.

In years past, creating a newsletter involved costly printing and postage. In today’s computer driven society, most of us have a home computer allowing for email newsletters to be used. Email newsletters have a much higher likelihood of being seen and read by your intended audience as it shows up right in front of them when they open their email program. It’s simple math: they more of them that are seen, the more of them that will be read.

Here are two other major advantages of regular newsletters:

  •  The more contact you have with your current patients/clients, the more likely they are to respond to recall reminders and schedule appointments. Familiarity breeds response.
  • Email newsletters give you the opportunity to market for referrals and generate new patients/clients.

Here are a couple of inexpensive but feature rich services we recommend for email newsletters.

Constant Contact: www.constantcontact.com

Campaigner: www.campaigner.com

Neither of these services requires any kind of programming knowledge. They are very simple to use. You simply create a user account and then log into it. You can then pick from hundreds of pre-made newsletter templates which also allow for customization with your own graphics. You can cut and paste your own content into the template and save.

The maintenance of the database is simple and automated. You can upload your email data base list as a Microsoft Excel spreadsheet or as a comma delimited text file. Once the newsletter is sent, the people on your list have the ability to remove themselves from the list with just one click if they don’t want any future emails. If there are any bad email addresses on the list, they will show up in the statistics as “bounced” emails and you can remove them.

Both of these services offer good statistical tracking of the emails you send – i.e. how many were opened, what links people clicked on, etc. so you can see what people find of greatest interest. This is useful in tailoring future newsletters.

The cost for these services is extremely low. They both work on a sliding scale, depending on how many email addresses you have in your database. The starting range for up to 500 email addresses is only about $15-20 per month! That’s a far cry from only 10 years ago when putting a hard copy newsletter together and mailing it to your patient/client data base could easily cost more than $1000.

If you aren’t now sending out regular (monthly or quarterly) newsletters, we highly recommend that you begin doing so. If you do so you’ll find greater patient retention and more referrals walking through your front door.

Ken DeRouchie

The practice Solution Magazine is published by www.silkinmanagementgroup.com