Business Management

Well, we’ve talked about the importance of getting staff into a practice who complement the practice –are aligned with the practice’s values. Now let’s examine the actual effects of staff turnover on the practice.
Staff turnover affects the practice in four main areas: Productivity, Financial Returns, Long Term Viability, and Satisfaction to the Physician. Let’s look at them.
EFFECTS ON PRODUCTIVITY Increasing work for the remaining staff. This is rather obvious, but think about the work that’s left undone. If a clinical staffer has to cover the phones because the receptionist is gone, some work is going to be omitted. It might be her regular clinical work or the phone answering, depending on which she feels is more important. But other staff get involved too, and she will likely make her choice based on the amount of flak she gets from other staff members and even her sense of duty to the practice. But one of those jobs will not be done well, and staff and customers know it’s not being done well.
Lower morale for ‘good’ staff. Staff who work hard – those with a sense of duty and industry, tend to be much more negatively affected by the increased work generated by high staff turnover. Most of the time they like to get things done completely and done well, which is almost impossible when a vacant position’s work is being covered. Consequently, and this is a killer, it’s the best staff who tend to be most depressed or angry about vacancies, and are more likely to walk if the situation remains unresolved. Increased errors and omissions in paperwork. This is another problem whose cause is rooted in the distraction and gloominess of covering multiple jobs and knowing it’s not being done well. Even a conscientious employee will make errors if the distraction is great enough; and if it’s constant over the course of weeks (waiting for a replacement) the problem is compounded.
EFFECTS ON FINANCIAL RETURNS Decreased income due to reduced productivity. Whether it’s because they’re physically missing or that they can’t do as much when they’re filling in for others, missing staff mean you’re just not going to bill the dollars. With vacancies, the physician can’t work as fast, technical work is delayed, information may not be collected, mailings are delayed – all result in a combination of lower billed amounts and delays in billing.
Increased liability to the practice. Sadly, in our litigious society people have become conditioned to look for a place to fix blame, and of course physicians are considered a prime target. Consider, then, the extra risk a practice with high staff turnover is incurring when staff are covering for vacancies. They are distracted by unhappy patients and fellow staff members, are working in areas outside their training or skill areas, or are just plain mentally blunted from the extra work. Errors are easy to make, and the situation is such that it offers trial attorneys a field day when they get the case before a judge or jury. “How long had this situation been going on, Doctor?”, or “What did you do to be sure errors were found and corrected?” go a long way toward making a physician wonder why he or she didn’t go into a gentler field, like brick laying or alligator wrestling. Dollars will go out the door at worst in settlements, at best as increased insurance costs.
TIPS AND TRICKS FIRST, to prevent turnover, have regular meetings with your staff to discuss how to run things better. Keep the agenda very short – What are the top two things you’d like to see improved? or How do YOU think we can do this better?. And then be quiet and take notes. When you do this kind of meeting, be SURE to follow up and address the ideas that come up. Be honest, if you don’t think an idea is workable tell them so, but look for ways to implement as many of the ideas as possible. When employees know that you are listening and that something will be done, they are much more likely to stick around. Not only that, but they’ll work harder and enjoy the job more.
SECOND, write up a set of interview questions for each position in the practice, and have a plan for immediate action when a staff member leaves. Fast replacement will keep staff happier, maintain productivity, reduce rework and liability, and improve your patient satisfaction. It’s worth it!