By Dr. Steve M. Cohen
Once upon a time, medical offices could count on such a solid, even lucrative income stream that some minor problems, even considerable costs, could be accepted.
That’s not been true for a long time.
Increasingly complex and intrusive regulation, rising insurance costs, and an increasingly litigious environment are now accompanied by reduced and delayed payments. Starting or managing a medical operation is not for the faint of heart.
This blog isn’t going to help with everything. You won’t find answers for medical issues. This isn’t where to look to for help understanding all the nuances of ICD-10. But the nuances of ICD-10 are only half the challenge. The other half is getting your staff to tackle this and other issues effectively.
This may sound backwards, but one of the first things you need to consider is keeping your staff around. Assuming you don’t have any truly bad apples (more on that in a minute), you should spend considerable attention and effort in retaining the staff you have.
Certainly, there are probably some days where you feel like doing away with the entire group. But most managers realize that staff turnover, retraining, and related issues are a major drain on office revenue and other resources. In some cases, losing the wrong person can lead to other losses as the remaining staff tries to pick up the slack and morale suffers.
One study estimates that finding a replacement for a given employee requires approximately 20 percent of the employee’s salary. A better plan is to do everything possible to keep your staff intact. Especially with your top performers, they’re worth the effort.
The good news is that employee retention is not a problem solved solely by throwing money. Certainly, competitive pay and benefits are important, but many studies and a great deal of experience indicate that some “free” investments make a big difference. Consider a few examples:
• Talk to your staff. Talking, and listening to your team is one of the most worthwhile investments you can make. First, you’ll both benefit from a two-way conversation but showing staff that you value them with your time and attention can pay major dividends. Clearly, your time is valuable and not easy to come by, but budgeting a few moments regularly will benefit you and the organization.
Consider this: when you spend a few minutes with a staff member, you’re not only talking about the subject at hand, you’re communicating that you consider that person valuable. That can be invaluable in terms of morale and motivation.
Additionally, staff members are indeed the ones who know the most about many areas in which they work. If you want to gain some ideas about improving office efficiency, individual staff members may not know everything, but they’re often a good place to start. Remember that when you’re trying to find a few minutes to talk with one.
• Keep the office atmosphere positive. Sure, it’s work, not a vacation, but ensuring that the office environment is positive and free of chronic tension is important. This can be a difficult, complex issue, but eliminating things like bullying and harassment are good for morale and efficiency, let alone reducing lawsuits and fines.
I’m occasionally confronted with clichéd responses when I question the atmosphere around some organizations. “Boys will be boys.” “It’s always been that way.” You get the idea. The truth is, if one person is uneasy because of off-color, racist or other juvenile behavior, odds are many more feel the same way, but fear speaking out. The problem for a manager is that unease affects work. Instead of feeling like they are part of a team, people go to work dreading confrontation, even when they are not the target. Don’t let that persist.
• Finally, consider releasing employees who don’t pull their weight. This may sound like a contradiction, but the best way to keep your good employees is often to reduce or eliminate those who aren’t producing effectively and supporting the organization.
There are almost unlimited variables on this topic, but one thing to remember is that if at all possible you don’t want to fire someone. Whether the individual is actively antagonistic to the office mission, or it’s someone who just doesn’t produce well enough, pursue a negotiated separation if at all possible. It’s easier for you, better for the organization, and much better for the employee.
A negotiated separation offers a win-win advantage for both employers and employees. A flat-out termination is a win-lose situation that the employee can turn against the employer by filing wrongful discharge for up to two years after the termination.
There are more potential tips, but all relate to a bit of creative thinking that can help the bottom line of most medical offices. To balance the budget, sometimes you must look past the dollars and cents.
Dr. Steve M. Cohen is Principal and Lead HR Consultant at HR Solutions: On Call, an advisory service for medical practices and other small businesses.