Building a Successful Practice Through Efficient Hiring

To build the most productive and profitable practice, having stable staff who work together to accomplish the mission of the practice is vital. Knowing how and whom to hire is a key skill. To lose employees who may have seemed appropriate for your team when you hired them, yet were not actually a good fit once on the job, is an enormous hidden expense in a practice.

In fact, based on the typical costs of finding, interviewing, testing, training and getting a new employee fully functioning on the job, turnover costs can equal six to nine months of the position salary. If a job pays $3000 per month, your costs could be anywhere from $18,000 to $27,000 each time the position turns over. Therefore, it’s vital to know how to screen applicants properly in order to hire the best possible individuals for your practice and to avoid the stress and high cost of frequent turnover.

Checking References

Checking the references that a job applicant provides is an important—but often neglected—step in the hiring process. The quality of staff can make or break a practice; so, investigate carefully and hire only those whose backgrounds indicate competence and imply that they would be good employees.

Checking references is not always an easy process. In order to protect themselves from legal or privacy issues, many employers have become reluctant to voice opinions about a former employee. However, you should still do reference checks on any candidate whom you consider hiring, to gather any data available.

It’s best to check references prior to a one-on-one interview with the applicant, since you might uncover information that will eliminate that candidate beforehand and save you the interview time. If that’s not possible, check references after the interview, but before hiring.

Here are some questions you might ask references:

  • How long was _______ employed by you or your company?
  • Can you tell me his/her ending wage/salary?
  • 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?

Again, a past employer may not be willing to answer some of those questions. The key question is the last one, “Would you rehire this person?” This question is important to ask if the person providing the reference is very guarded or hesitant in giving answers.

Keep in mind that checking references is just one of several vital steps in the hiring process. Another important part is to determine the attributes your ideal applicant would possess.

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How Do You Hold Employees Accountable for Their Positions?

Surveys show that workers are happiest when they are productive and are contributing to the success of the group in which they work. To boost morale, efficiency and longevity of workers, one must:

  1. understand the importance of one’s production,
  2. know exactly what one is supposed to produce and have a clearly defined final product,
  3. be properly trained to get that product, and
  4. be specific. Generalized statements leave too much room for interpretations and argument.

Whether you have a staff of 2 or 30, each position in the practice needs to have a clearly defined final product. Both the manager and the employee need to know exactly what the person on the post is expected to produce. For instance, a receptionist’s product is “communications handled swiftly, accurately and in a friendly manner.” A receptionist who consistently obtains this final product will keep the flow lines and the communication lines of the practice functioning and will be a valuable group member. How many new patients have been lost because a receptionist has failed to answer a phone call swiftly, answer questions correctly and/or set an appointment?

Determining the final product for each position is a starting point. A statistic needs to be developed, so the final product can be monitored accurately. For example, one of an office manager’s final products is “staff members who are fully trained for their positions.” Using a statistic such as “percentage of employees fully trained for their jobs” would show the OM’s performance.

How do you hold employees accountable? The answer is:

  1. name a final product for each position,
  2. figure out a way to quantify that product as a statistic,
  3. monitor the statistic,
  4. evaluate statistical trends, and

apply the correct formula to remedy any downward statistic or improve an upward statistic.

If you are a practice owner and would like free help with a particular employment concern or any other management topic, fill out the form to your right, and we will be more than happy to assist you. Scroll to top

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Generating New Patients by Using Surveys

How do you market for new patients in a cost efficient and effective manner? Starting with internal marketing is always the best approach­, 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 the first tip that you can use to more effectively market: do a simple survey with all new patients who come in, in order to find out what brought them to your practice. This can be done as part of their new-patient intake forms, or the receptionist or any other designated staff member can ask the questions verbally.

We have a variety of prepared surveys for our clients to use. Here are examples of some questions you can use to create your own survey:

  • If you were referred, who referred you and what did that person say to interest 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 to use 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 search of where your best patients/clients are from. Then write a survey for those patients/clients to find out:

  • what attracted them to your practice,
  • what keeps them coming back to your practice,
  • what they like the most about your practice and
  • which services, if any, 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 who are similar to those A-list patients/clients.

This is called targeted marketing. It’s all about generating quality patients and clients, not just getting people to walk 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 in which area your best patients/clients reside and what brought them to you in the first place, you can then design a marketing campaign to generate more of those types 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.

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12 Steps to Collect Past Due Accounts

Collecting on past due accounts is a function that the Accounts Manager will find herself/himself having to do. Any contact with a patient/client, even under these circumstances, should be kept on a friendly, professional and dignified basis. This will promote respect for the office and its business practices.

Always remember the following points with regard to your patients/clients:

  • Most people have good intentions and want to cooperate with agreements that they have made.
  • Although a person’s account may be overdue, most people still have a good intention to take care of it.
  • Most people prioritize their bills and will first pay those that they feel are most pressing.
  • Most people with past due accounts will pay those bills where someone is actively requesting them to pay.

Bearing in mind the above, your role is to arrange to be one of the creditors that your patients/clients will not delay paying. The following points may be helpful in this regard:

  1. Bill promptly every month.
  2. Ensure that your bills are accurate.
  3. Ensure that you have the original signed financial agreement from your patient/client.
  4. Contact the patient/client as soon as you realize the account has become delinquent.
  5. When you speak with the patient/client, let them know that you believe that they are able to make payment.
  6. Let the patient/client know that you expect to be paid, and refresh their memory on the signed agreement.
  7. Allow the patient/client their self-respect; never back them into a corner, insult or badger the patient/client.
  8. Explain to the patient/client that you want to help him/her work it out so that they can maintain the agreement that they made with your office.
  9. Be prepared to offer some options to the patient/client that they may not have considered.
  10. Be willing to really communicate with the patient/client so that a true understanding and agreement can be reached.
  11. If absolutely necessary, utilize the credit reporting associations. Let the patient/client know that you are planning to do so and that this will go on their credit rating.
  12. As a last resort, utilize the services of a collection agency, and let the patient/client know that you plan to do so.

If you are an owner and would like free help on collecting past due accounts or any other management topic, fill out the form to your right, and we will be more than happy to assist you. Scroll to top

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Your Responsibility to Your Staff

Just as your staff has responsibilities to you and your practice, you likewise have several responsibilities to your practice and staff.

The complexity of active leadership can be best understood by breaking it down into its essential and integral parts:

1. Communication: It is vital for the owner of a practice to maintain excellent communication with his/her staff and to provide active and visible leadership. The following are key elements involving communication that you, as an executive, should implement:

a. Communication of Goals.
Determine the purpose of your practice (most often presented in the form of a mission statement) and communicate that to your staff. Impart the goals of the practice to the staff and keep them informed of the projects that you intend to implement to achieve those goals. The better informed your staff is and the greater understanding they have of such matters, the more likely they will be working in tandem with you.
b. Communication Tools.
There are some fundamental communication tools to implement in the practice; see to it that your staff uses them. These tools can be established and maintained by your office manager; but, as the senior executive and leader of the practice, you must reinforce them. Examples of those tools are: written requests or proposals, written office communications, written office policies and the use of an effective communication relay system.
c. Responding to Communication.
It is vital that you and your staff respond swiftly to written communication. When people do not receive a reply to their memos or emails within an appropriate and reasonable period of time, thereafter they become less willing to communicate. As a result, the business can have more problems on its hands. (Keep that in mind when reading the second part of this article.

2. Staff Meetings: It is also vital that you ensure that the practice holds staff meetings once per week. This is one of the most valuable opportunities available to you for educating staff, setting goals and targets, and handling problem areas that should be addressed by the staff as a whole. The communication lines within the business will strengthen considerably too.

You, as the owner and leader, in addition to your office manager, should continually strive to establish strong coordination and leadership for your staff. Any problems or disagreements between the owner and office manager should always be sorted out OUTSIDE of the staff meeting and should never be addressed in the presence of any staff.

Staff meetings run most effectively if the owner and office manager meet prior to the staff meeting to plan and coordinate those matters to be addressed with the staff.

Fill out the form on this page to read the rest of this article and find out why writing and implementing Policy in your practice, as well as setting Goals and Targets successfully, is so vital to achieving expansion. (highly recommended). Click to scroll to the top of the page.

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Turn a 40 Hour Week Into 30 and Stay Profitable

Do you ever get to the end of the day and realize that you didn’t get half of the things done that you intended to get done?

Do you find yourself giving endless streams of orders and then having to spend time following up to make sure everything was really done?

Do you often have to redo work because it was not done correctly the first time by someone else?
Is scheduling a problem?

Managing time in a healthcare practice is an art. Unique problems arise because, as the doctor, your main priority is treating patients. But, how are you supposed to keep your full attention on patients and at the same time stay on top of the crucial administrative work that is paramount to maintaining a thriving practice? The essence of successful time management is the attainment of a level of organization which facilitates the goal of a healthcare practice, a high quantity of well and happy patients.

Simply stated, how well you organize determines how many hours you work and how productive you are during those hours.

If you are having difficulty managing your time, the first action you should take is to keep a time log during a typical work week. While this may be arduous at first glance, you will find it well worth the time and energy you put into it. Carry a small notebook with you throughout the day and log everything you do along with the amount of time you spent doing each. This is best done by logging the events as they happen and avoid trying to reconstruct the information at a later point in time.

At the end of the week, you will be able to look over the information and tabulate how much time was spent on the various activities you engaged in. This exact record will help you isolate areas of the practice that are not being competently handled by your employees and/or are problematic to the point of requiring much of your attention.

The next action you should take is to have each one of your employees keep their own time log, just as you did yours. At the end of the week, you can gather the logs and review the activity of each staff member.

Read part II of this article and find out the key questions you should be asking yourself when you have completed your log. Request “Turn A 40 Hour Week Into 30 and Stay Profitable – Part II” (highly recommended). Scroll to top

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Where is Your Net Profit?

You’ve worked hard all week; the office atmosphere is rife with discipline and brisk efficiency. The staff have been getting along with one another and you are proud of the team spirit they’ve both individually and collectively demonstrated. In fact, your staff has almost read your mind and anticipated your every need. All of the patients have arrived on time for their appointments, and the majority of them have even heeded your advice and accepted your treatment plans!

Now it’s Friday afternoon; the staff has received their paychecks, which reflect production bonuses that you’ve doled out in appreciation of their contribution to the overall increase in production. But then you look at your bank balance and you’re surprised and sorely disappointed at the lack of funds left over for you. What happened?

Where is your net profit? Did you work hard all week just to earn less money? The bank balance should be going up, not down!

You wonder if it’s worth all the effort. All of that increased production might just have landed you into a “higher office-overhead/higher tax-bracket” situation. It’s that frustrating income vortex — the place where, despite producing and collecting more, you take home the same amount or less. And following a few of these “successful” weeks, you shake your head and realize that if you endure much more of that kind of success, you’ll go broke! So, what should you do?

Let’s start by taking a look at the myriad of possibilities of what might have occurred that resulted in your not having any profit for yourself:

Management Issues:

  • Could you consolidate loans for equipment and/or your practice into just one loan, in order to reduce your monthly loan payment and possibly the interest amount?
  • Can you reduce the amount of inventory the practice maintains?
  • Are you collecting your Accounts Receivables with minimal aging? Do you collect at least 97% of the amounts billed?
  • Do you have any sort of monitoring system that helps you to know at a glance, statistically, who is productive and who isn’t?
  • Do you have written office policies that are known and enforced?
  • Does each position in the office have a fully delineated job description?

To learn the 8 staff-related issues that can plague you and adversely affect your net income read the final half of this article by filling out this form (Highly Recommended).

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Looking Toward the Future: How to Make Your Practice Salable

If you are a practice owner, you should know that, in most cases, getting in is easier than getting out. That is, exiting a practice is often more difficult than building it. Exiting is a process, not an event, that should be planned far in advance of the day you turn the keys over to someone else.

The factors that make your practice salable include a good management team, steady profits, patient/client loyalty, a solid reputation, predictable transferability and much more.

With these factors in mind, let’s look closely at ten vital actions that you should take NOW, so that when the time arrives, you will have developed a truly marketable and valuable practice.

  1. MAINTAIN STRONG REFERRAL SOURCES

Professional relationships add tremendous value to a practice. Do professionals in your community routinely refer their patients/clients to you? If so, are those relationships so strong that you can bridge them over to a new owner?

For example, if you have several professionals who reliably refer a significant number of patients/clients to you, you would want to ensure that those referral sources will continue to send patients/clients to the new owner. Otherwise, your prospective buyer might want to factor in a sale price reduction that takes into account the loss of the projected income represented by those referral sources.

Most professionals will continue to refer to the practice after your departure, as long as they are assured that the clients/patients they refer will receive the same good care that you currently provide them. It is also important for your referral sources to know that the new owner will reciprocate with referrals to them (if that is the type of relationship you currently have).

Maintaining your referral relationships and then transferring them to a new owner during transition will help your patients/clients too. By doing so, you maintain both continuity and quality of care for them, and that fosters tremendous goodwill.

  1. MAINTAIN FACILITIES AND EQUIPMENT

Generally speaking, people are inclined to pay more for something if it looks attractive. The same principle applies when buying a practice. If your facilities are pleasing to the eye, you might be able to command a higher price. While a clean carpet is only just that, it might demonstrate to the buyer that every aspect of your facility and practice is probably well maintained.

Well-maintained, state-of-the-art equipment also speaks well of you. It says that you have a growing practice that is keeping in step with technology.

  1. INCREASE YOUR GROSS SALES

The best indicator of the value of a practice is its cash flow. Your successor will want assurance that he is acquiring a reliable income stream. Now is the time to concentrate on reactivation of old patients/clients, increasing your marketing budget to attract new patients/clients, setting goals for the staff and moving the practice toward maximum productivity.

  1. IMPROVE YOUR BOOKKEEPING RECORDS

Part of selling a practice requires that you develop and present an accurate picture of what you have accomplished. In order to command the best possible price, you must be able to prove that the practice is highly profitable.

Plan to have at least five years’ worth of strong financials as the buyer wants predictability. Have an accountant prepare “compiled statements.” That lends credibility. The practice buyer will want well-maintained, accurate accounting records to help with future planning. Additionally, thorough records can even help you explain a slump period.

  1. DECREASE OVERHEAD EXPENSES

Analyze your payroll, department by department, function by function, employee by employee. If personnel are underutilized, eliminate a job position and reassign its duties to other employees.

Improve your bookkeeping procedures so that you can readily and accurately track your expenses and potentially cut them. Eliminate nonessential monthly expenses, taking care not to hinder expansion activities. Keep a close eye on your discretionary expenditures, such as advertising, travel, new equipment, seminars, utilities, telephone, etc. By decreasing the overhead of the practice, you will consequently improve cash flow and thus be likely to sell your practice for a higher price. You gain a tremendous amount of control by just knowing where your money is coming from and where it is going.

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Leadership Attributes and Management Qualities

As a practice owner, you should be asking yourself the following questions objectively:

  • Am I a good leader?
  • Do I run from conflict?
  • Am I able to motivate my staff?
  • Is my office harmonious or is it filled with conflict?
  • Does my staff “own” their jobs, or do they just punch in and out?
  • Do I ever feel that my staff is “holding me hostage”?
  • Am I running my practice? …or is my practice running me?

Did you answer any of those questions favorably? If you’re like the average practice owner, the answer is no. That’s because, like most doctors, you were not trained in leadership and executive skills. Consequently, you will often find yourself in management situations in which you lack certainty about what to do. Insufficient leadership could easily result in poor staff performance, unhappy patients, needless stress and lost income.

Maxim: The Morale of the Staff Is Based Upon Their Individual and Office Production.

Believe it or not, most staff members want to do a good job. They want to improve and they like being acknowledged for a job well done. When one produces a good product, it’s a reflection of his competence. Demonstration of competence raises anyone’s morale. As a leader, you have the opportunity to foster an environment that can bring about ever-increasing competence and morale.

So, how does one become a good leader? Is leadership a personality trait with which only a few are blessed? No! Leadership skills are taught and, with practice, can be put successfully into daily use.

The first quality a good leader has to have is the ability to confront situations, i.e., to face up to them. If you are the type of owner who runs and hides from conflict and staff problems, then you need some improvement in this area. First, decide that you are going to face up to the problem. Simply take a moment and make the decision; this is very helpful.

Next, grab someone — a friend, your spouse or a colleague — and roleplay the problem. Have that person play the part of the troublesome individual, hitting you hard with backtalk, new problems, can’t-be-dones, etc. Be sure to do the drill until you find that you are more confident and even feel somewhat excited to try out your new skills and presentation. You will be surprised at how easily the situation will resolve once you do this. Keep in mind that your staff can’t and won’t follow if you don’t lead.

It is very important for you to maintain excellent communication with your staff and to provide demonstrable leadership.

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How to Properly Correct Employees

It would be wonderful if employees never make mistakes and always do a perfect job. But we’re all human; on-the-job errors are part and parcel of working in a practice. That begs this question: What do you do when a staff member messes up and how do you correct him?

Here are some suggestions on how to properly correct your staff:

As part of this overall process, you must have written job descriptions and office policies that clearly delineate which tasks a person is responsible for on his/her job and the overall working guidelines for the office, respectively. The reason that proper, written job descriptions and office policies are so important is that you should use them as part of your correction procedure. Unfortunately, very few practice owners have them in place.

For starters, if you need to correct a staff member, make sure you review any specific disciplinary policies that you have issued, so that your actions are consistent with them. For example, if your policy states that proven theft results in an automatic discharge, you would not utilize a gradient approach to termination by merely reprimanding someone guilty of stealing.

Typically, the first step in correcting a staff member is to direct his attention to the specific item he violated, as delineated in his job description or in your written policies, indicating the appropriate action that he failed to take or the inappropriate action that he did take. Direct the staff member to reread the policy and/or job description. Ensure that he understands it and clear up any confusions or misunderstandings. This corrective action is usually sufficient to handle the first offense.

If the staff member commits a second offense involving the same issue, the office manager or practice owner should review the situation with the staff member and have him sign a copy of the policy or procedure that covers what was violated, as an attestation that he understands it and agrees to abide by it. We then recommend that you put a copy of the signed document in the staff member’s personnel file and give him a copy to put in his staff binder. One may consider that this constitutes a warning.

To learn how to apply these policies in specific situations, such as;  How many warnings should be issued? What if the employee is an excellent producer? Read the final half of this article by filling out this form.

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