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Recruiting, Supervising, and Motivating Office Staff Daniel G. Wallace, MD, MPH, FACP Kaiser Permanente, Rancho San Diego La Mesa, CA.

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Presentation on theme: "Recruiting, Supervising, and Motivating Office Staff Daniel G. Wallace, MD, MPH, FACP Kaiser Permanente, Rancho San Diego La Mesa, CA."— Presentation transcript:

1 Recruiting, Supervising, and Motivating Office Staff Daniel G. Wallace, MD, MPH, FACP Kaiser Permanente, Rancho San Diego La Mesa, CA

2 Managing the Office

3 The Best  Choose your two best employees. Write down their two best attributes. Write down two reasons that make them the best employees.  Choose your two worst employees. Write down their two worst attributes. Write down two reasons that make them the worst employees.

4 Choosing a Winner  Picking the perfect tree for your yard  Picking the perfect vase for your house  Picking the perfect car for the family

5 Choosing a Winner  Picking the best players for a soccer team  Picking the best bridesmaid  Picking the best secretary for non-profit organization

6 Attributes  Basic Characteristics  Inherent Aptitude The Human Factor: the potential or inherent quality

7 The Human Factor

8 Expectation  Best Tree: shade versus evergreen, large versus small  Best Vase: colorful versus blend with theme, holds water versus fits into space, holds roses versus sunflowers  Best car: fits the family versus fits the mood

9 Importance of Staff  Patient Satisfaction 70% of patients who leave a physician practice indicate “staff issues” as a basis of their decision to transfer care.  Risk Management There has been a 450% increase in malpractice claims related to failed office procedures from 1999 to 2004.

10 The Risky Employee

11 Who are “Office Staff”?  Physician Staff  Physician Extenders  Ancillary Staff

12 Ancillary Staff  Front Office  Back Office  Other  Define by skill set  Define by location within the office  Define by task

13 Ancillary Staff  Is best defined by the tasks and responsibilities the employee performs because that will be the basis for their job description.  Do you know the tasks and responsibilities each of your employees is charged with performing each day?

14 Recruiting Ancillary Staff  Know the position requirements.  Know the minimum training/skills required.  Know the aptitude required.

15 Recruiting: Aptitude  Athletes perform as stars when placed in the right positions.  Plants thrive if the climate is right.  Parties hum with the right mix of people.

16 What Aptitude will be required for the position  Outgoing verses quiet  Detail oriented verses thinks outside the box  Quick thinker verses slow and methodical  Controller verses follower

17 Recruiting  Define the position and aptitude required  Define the skill set required  Define the schedule required

18 The Interview  Prior to the interview ascertain that the potential employee has the minimum skill set required. If not, do not interview.  During the interview ascertain the potential employees skill set, aptitudes and personal goals.

19 Interviewing Techniques  Direct Questions: Ascertain level of competence.  Ask Questions that help ascertain the applicants basic characteristics and inherent aptitude: Determine implied work ethic Evaluate appropriate decision making skills Assess ability to work independently or conjointly as determined appropriate for the position.

20 The References  Use the references to insure the potential employee is: Consistent Dependable Skill set has been appropriately represented Reaffirm your impressions regarding the candidates aptitude

21 Hiring  Define the new employees role in context with the other employees in the office.  Define the expectations of the position both short-term and long-term.  Provide the new employee with written/internet resources to reference regarding office structure, processes, and policies/practices.

22 Retention  Acknowledge performance  Acknowledge commitment  Acknowledge special effort

23 Performance  Use quantitative data Highest score on patient satisfaction survey or office annual review. Highest score on chart review. Highest score on interoffice reliability evaluations.

24 Commitment  Sometimes the best employees are the employees who consistently perform their job at a high standard. Not always the best, not big on innovations, but do their jobs well. Reward years on the job Reward consistent good overall performance Reward no missed work days

25 Special Effort  Acknowledge and recognize efforts by an individual that goes beyond expectation.  Acknowledge and recognize efforts by team/office that goes beyond expectations.

26 Conflict Resolution  Staff retention depends on the ability to effectively resolve conflicts Do not make assumptions Understand the conflict Identify root causes for conflict Look for process improvements to reduce conflict

27 Document Performance Issues  Initial concerns and issues  Concerns and issues identified in during the employee meeting  Expectations and action items identified for the employee  Expectations and action items for yourself  Specify a timeline.

28 Follow-up on Action Items  One action item for yourself should always be follow-up. Were changes implemented? Were changes effective? Did changes have unexpected consequences? Is the employee meeting defined goals? Be specific. Specific Time Line to meet expectations.

29 Final Step  If the employee is still not meeting goals and/or there are unexpected consequences of changes to meet again.  Define specific goals that must be met.  Specify Time Line.  If the employee is doing better, let the employee know.

30 Termination  Let the employee know how they did not meet the specified goals.  Do not give life advice.  Explain in detail the process of being fired, the employee’s rights and expectations.

31 Look back to your description of the “Good” Employee  Basic skills/training  Aptitude  Expectations of the position  Does the employee know you feel they are performing well?

32 Now look at your description of the “Bad” Employee  Is your “bad employee”: “The misplaced employee” - expectations of position don’t match the employees basic characteristics or inherent aptitude. “The victim of poor processes” - expectations can’t be met with processes in place. Is the “bad employee” aware they are not meeting expectation?

33 Set the tone in the office  Be positive  Encourage the staff to be positive  Do not allow negativity in the office.

34 Summary  “Happy employees understand their duties, are properly compensated, and are recognized for their achievements.”  Happy employees perform well and stay.  Be consistent.

35 Scenario One  You are responsible for hiring a clinical nurse for the back office. The job description includes being the sole clinical nurse in the office responsible for IV hydration, wound care, etc. You are about to interview the first applicant. Three references confirm he is an excellent employee, who on his own established a nurse triage program which has become invaluable to the group. He also spearheaded the creation of a community nurse clinic that has been a boon to the groups success and an excellent marketing tool. However, he has not had any clinical experience in ten years. He is no longer IV insertion, BLS or ACLS certified.

36  The applicant is great. He is personable, professional, and personal goals match the mission statement of the group Scenario One (cont’d)

37 The Conflict  You now have someone you want to hire that is not qualified for the position you need to fill. It’s possible that the applicant transitioned into administrative work because that was his what he enjoyed and was better at. Even with recertification and training he may not have the clinical skills you are looking for.

38 The Lesson  Confirm the applicant meets the basic skill set before the interview. Do not interview anyone that does not meet the basic skill set.

39 Scenario Two  You have reviewed references, interviewed, and hired a woman to manage patient accounts, billing, and insurance issues. She is doing well with most of her duties and getting along well with the staff.

40 The Conflict  The new employee is responsible for arriving to the office early each day (7:30am) to prepare for opening the office at 8:00am. The start time was mentioned during the interview but not included specifically in the job description. The new employee has been late frequently causing turmoil among the other staff.

41 The Lesson  Make sure expectations and responsibilities are clearly defined for prospective employees.

42 Scenario Three  You have a long time employee who has been an excellent medical assistant. He is conscious, knowledgeable and great with patients. To reward him for his years of good service you promote him to “back office supervisor.”

43 The Conflict  He has no experience (basic characteristics) or inherent aptitude for managing other people. He has been promoted to a position in which he cannot perform well.

44 The Lesson  Whether hiring from outside or promoting within, make sure the person is right for the position.

45 Scenario Four  You have a long-term “irreplaceable” employee who performs well but constantly makes negative remarks regarding the performance of other employees. Retention among other staff is difficult and morale is low.

46 The Conflict  An attempt to discuss the issue with the employee went poorly. The employee senses you feel she is “irreplaceable” and is not motivated to change.

47 The Lesson  A positive attitude and mutual respect among all employees is the most important factor in an office. Set the standard and consistently enforce it.


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