Why Staff Turnover Is So High and What To Do About It

How many front desk employees or back office employees have you seen come and go from your practice? On average how long do they stay?

You interview potential employees and they seem like the perfect fit and then in no time you're wondering why they're doing certain tasks a certain way or why it is you didn't see those personality conflicts arising when you interviewed them. And even more frustrating is the fact you spent countless hours and resources training them - now you have to let them go and then spend more hours and money training a new person. 

This can be the most frustrating and draining thing for your office. On top of that, your patients notice when there is a revolving door of new people answering the phone or welcoming them when they walk in. Eventually your patients will start to wonder what the problem is with your management and why there is always someone new working in your office. 

The Top 3 Problems

1. Most of us as healthcare providers are hiring people based on work experience in a healthcare office:

• have they worked the front desk before?
• have they billed insurance before?
• do they have experience as an office manager, managing people?
• how long have they been an MA?
• how long have they been a nurse?
• what other practices have they worked in?

But what about who they are as people? This is often missed during an interview process. In my book, Unf*cking Private Healthcare, there is an entire chapter (Ch. 4: Rallying Your Team Behind Your Leadership) dedicated to answering this question. Here is the Cliff Notes version. 

Personality is important in who it is you hire. I would even argue its more important than their past experience working in a healthcare office. The main reason for this is because you can teach people how to complete tasks and learn new skills, but people for the most part are who they are.

Would you want a very quiet introverted type of person greeting and answering your phones? Most likely not - a person who is extraverted and has compassion would serve your patients much better. 

If you're hiring a new office manager would you want them to lack leadership qualities and be hands off? No! You would want them to be involved in the day to day support of your staff and make sure everyone is on board with what needs to be accomplished. 

2. This is for my cash pay folks and anyone selling ancillary products/services. How many sales minded individuals do you have in your office? And before you go crazy on me with the, "We're not in sales" or "I don't want to come across as salesy" - please understand that everything is sales. Sales equals customer service. 

The office manager in my last practice was a sales minded person. We ran a 7 figure cash based practice and there is no way we could have done that without having someone of her caliber in our office. We taught her about our services and how to use an EMR. Again, easy skills to learn versus teaching her how to be "sales and service minded."  

3. You haven't established a vision for your practice and thus lack a vision people can get behind and buy into. 

Think of it like this: why do you go to Chick Fil A versus a McDonalds? Other than the quality of food - their restaurants are always clean, the people are always friendly, and when there is a problem they do everything in their power to fix it.

This is NOT by accident, it's by design. Each one of their employees go through training on the "Chick Fil A way" and are encouraged to think differently about the service they provide. Do you have a "way" of doing things in your practice?

Better yet, have you established core values inside your business that you use as a filter for everything you hire from your front desk to your marketer?

The Solutions

1. Establish a vision for your practice. What are you all about? What are your values? How do you wish to stand out from everyone like you in your particular geographical area and niche? What is your "way?"

Teach these values and systems to your people! When you do this you will be able to see who on your team is bought in on those values and who can deliver upon them. 

No values or vision = no accountability. 

2. Hire a person with some sales experience that can up your customer service game and pay them a commission. Yes, I know this sounds weird, but sales people are motivated by money and can be your biggest problem solving asset when it comes to bringing more money into your practice.

I'm not talking about a marketing person. Marketing helps people find you, sales brings them in the door. 30 leads a month (as many marketing agencies advertise) makes no damn difference if you have nobody on your staff to close those leads and get those people on the schedule. 

This person is especially important if you are cash pay or you do have cash pay services in your practice. This person is motivated to sell the best solutions for your patient's unique problems. Remember it isn't "sales" when it's done correctly - its service.  

3. Start conducting group interviews. No more 1 on 1 interviews to start the process. Put 5 people in a room and talk to them about your vision and values for the practice. You will quickly be able to tell who is bought in and who isn't.

Then move to 1 on1 interviews where you dive deeper into your business and how they can be an asset to it. Show them your "way" so there is no doubt about your expectations or how things are to be done. 

Ask them questions that will pull out their personality:

• Are they proactive or reactive? Do they go get things done without being told or do they need someone to tell them what to do? Neither is good or bad - it just depends on the type of person you want for the role you're hiring. 
• Are they a toward or away from person? This means do they actively seek solutions or do they move away from problems. Sound strange? Think of it like this - most healthcare consumers are looking to move away from their pain or their illness. As the healthcare provider you're looking towards a solution to help them achieve this. So what happens to your staff when they're faced with a problem? Do they actively seek solutions or avoid dealing with it?
• Are they 'why' people or 'how' people? Some people are really good at coming up with new innovative ideas to fix a problem (why people) but they usually are not the ones to implement a plan for the idea. Implementers are your 'how' people - they will follow a plan to get a job done. So which role are you hiring for? Do you need a creative idea person or someone to follow an already set of tried and true set of procedures?

**Bonus Point** Know what you're hiring for and what you want those people to do! Get really clear on the position and what expectations you have for the person you are looking to hire. This will help you understand the type of person you need to hire and it also gives you clear questions to ask in the interview process. 

Ex: Right now, we average 45 new incoming calls each month and we are closing about 50% of those. We are hiring a new front desk individual responsible for handling those incoming calls and we would like to see that close rate increase to 70% in the next 6 months. 

This is a clear goal and potential expectation. You must know what success looks like for you new hire. Expectations without communication is automatic set up for disappointment.  

Conclusion

Just because your team has experience in years and they're good at what they do, doesn't mean they will be right for your practice. Their experience has zero to do with how much they believe in your vision or how well they will treat your patients. Experience only tells you they may posses skills necessary to do a job.

If you don't consider the answers to the solutions above, you could be hiring a team of completely different people, who operate and interpret information in completely different ways. This sets your practice up for communication issues and the continued marry-go-around of staff turnover. 

Good leaders don't have much to do if they don't have the ideal people to lead.