Strategies For Staffing Success

Interview and Hire Effectively

Attracting, selecting and retaining the best employees are among the most critical predictors of success in any business. In a medical practice, failing to fill vacant positions with the right people impacts staff, patients and the bottom line. Practice managers have a tremendous responsibility to recruit, hire, train and mentor staff who will be effective in their positions on a long-term basis. With a typical vein practice employing 5 to 8 employees, turnover must be kept to a minimum, as staff need to be cross-trained to handle multiple tasks.

Despite corporate downsizing and layoffs, finding highly qualified staff that share your work ethic and practice culture has become more difficult. Changing demographics, an erratic economy and diminished employee work values, have brought new challenges to the recruitment game.

More than ever, considerations such as quality of life, commute time, and self-fulfillment figure into an applicant’s decision as to whether to accept a position, along with the opportunity to contribute their expertise, participate in decision making, advance professionally and share in an organization’s financial success. At the same time, employers are seeking employees with greater skills and more diverse expertise than just a few years ago.  Qualified job applicants are scarce and many medical practices find themselves struggling with the temptation to hire a warm body today and ignore the needs of their practice looking forward.

As a result of these trends, recruiting today is not what it was 10 years ago. Simply relying on classified ads or word-of-mouth referrals doesn’t necessarily net the best applicants as it may have in the past. Today, truly effective recruiting is much more strategic and targeted. That, coupled with the fact that bad hiring decisions can cost anywhere from $5,000 to $30,000 when an employee doesn’t work out, makes it critical for practice managers to implement new and innovative recruiting strategies.

Regardless of which recruitment method you use, keep track of the recruitment sources used so that you can identify the best sources for each job classification in your practice. Cut back on recruiting efforts that are not effective and spend time and money on the ones that produce results. Don’t forget to use your professional contacts, networking sources, and current staff as “mini” recruiters. Provide staff with a recruitment bonus for referring new hires. The bonus is payable after the new hire completes their 90 day probationary period.

Scan appealing recruitment postings from successful practices to get ideas on attracting the best candidates and learn what kinds of salary and benefits competitors are offering. Notice that effective recruitment messages usually include information about how the medical practice provides a good place to work. Not only do they advertise competitive benefits and pay, but also an atmosphere of excellence with growth opportunities.

A recruitment message should encourage the qualified applicant to take action. One of the best methods is to include an email address and ask candidates to contact the practice for more information. Other response methods include:

  • Ask applicants to send a resume and cover letter
  • Encourage applicants to schedule a time to tour the office

Here are some suggestions for creative recruiting

  • Hold an open house. Advertise the types of jobs available and encourage applicants to visit the practice;
  • Contact outplacement firms, give them a list of your open positions, and ask them to refer qualified applicants;
  • Design tailor-made recruitment brochures;
  • Start an employee referral program by soliciting staff referrals for open positions;

Selection Methods

The first step in developing an effective recruiting program is to determine your staffing needs and update relevant job descriptions. The basic aim of selection is to provide consistency in hiring practices. Employee selection methods include interviews, written tests, and reference checks, which can be used alone or in combination, with the latter being the best approach. At a minimum, you should interview applicants and conduct reference checks after narrowing down the candidates. Applicant selection requires a thorough analysis of both the person and the job. It necessitates making value judgments by appraising job-related qualities in candidates to determine who will be the most productive employees.

The selection process begins with reviewing completed application forms to identify individuals who meet the minimum qualifications for the position. Most medical practices choose to interview only the most highly qualified applicants. Less qualified applicants should be notified of this decision, preferably in writing. It is strongly recommended to use a standardized application form, even if the applicant submits a resume. A formal application form provides information about candidates that doesn’t appear on a resume. In addition, the application contains employment-at-will information and seeks the applicant’s permission to check references. You cannot rely on the accuracy of a resume. In fact, some experts say that approximately 35 to 40 percent of resumes are inflated and contain lies. That’s why it’s critical to conduct a reference check on those individuals to whom you intend to offer a job.

Regardless of the application procedure, every resume and application form should be thoroughly reviewed, which will save time during the interview process. In screening resumes and applications:

  • Look for breaks in employment;
  • Ask what the applicant did between jobs;
  • Verify that the applicant has the necessary work experience;
  • Check the applicant’s education to determine if he or she has completed the required course of study; and
  • Review the overall appearance of the completed application and resume for spelling, accuracy, neatness, etc.


The most commonly used employee selection technique is the in-person interview, which can be conducted using a variety of techniques. Many medical practices feel that the interview is the quickest, safest and fairest selection method. It can also be less costly and easier to validate than most written tests.

At the core of an effective interview is the development of appropriate interview questions. Designing appropriate questions begins with a review of the current job description and development of an interview guide (a list of questions that will be used for each candidate). Interview questions should be non-discriminatory and attempt to elicit specific, business-related information. A thorough analysis of job requirements prior to conducting the interview helps focus attention on relevant information.

Interviews can be conducted one-on-one or by a panel or group. Panel / group interviews tend to be more objective in evaluating applicants and are useful when consensus is needed for team-building purposes. Often, coworkers are in a better position to evaluate how an applicant’s technical and team-related skills will fit in with the group for efficient patient care. Team members will put a great deal of effort into the interview process if they believe their input counts.

Group interviews should be scheduled close together, enabling group members to evaluate applicants’ responses while those of previously interviewed applicants are still fresh in their minds. The group should receive instructions about appropriate and nondiscriminatory questions to be asked, including a list of questions and instructions on who will ask each question. At the conclusion of the interview, the applicant should be given the opportunity to ask questions of the group.

Some interviewers prefer unstructured, informal interviews that are conducted in a conversational style. If interview questions are not well structured or conceived, however, they may not be good predictors of job success. Research shows that structured interviews are approximately twice as reliable as unstructured ones.

To increase the odds of choosing the best applicant, many HR professionals recommend that no applicant should be hired unless given two separately scheduled interviews. An applicant may appear outstanding during the first interview but be a real disappointment the second time around. To make this process efficient, it’s a good idea for a Practice Administrator, Office Manager, or Team Leader to conduct an initial interview, followed by a second interview of the remaining applicants. The second interview should be conducted by those employees with whom the applicant will work closely with if hired. As a rule of thumb, applicants should talk about 80 percent of the time during the interview.

Past and present job behavior is the best indicator of future behavior and success in a new position. To hire a high achiever who is responsible, organized and effective, it is essential that you focus on critical job behaviors and consider the chemistry between the applicant and the practice. The applicant who shows the most evidence of past success is the one who should be hired. Ask about past behavior and achievements and then compare it with the behavior needed for success in the position the practice seeks to fill.

One way to separate excellent applicants from very good ones and get an idea of future job performance is to ask hypothetical, problem-solving questions that relate to specific job functions. For example, set up a scenario in which an irate patient approaches the applicant about a long wait time. Ask how the applicant would handle the patient and respond to the situation. Interview questions like these enable you to assess the applicant’s ability to work in and adjust to, the particular tensions and environment of the office.

The following are sample questions frequently asked during interviews.

To get to know you the applicant, ask the following general questions:

  • If you could have your choice of any job, what would it be and why?
  • Why do you want to work in health care?
  • What are your short- and long-range goals and how do you expect to achieve them?
  • What does success mean to you? How do you measure it?
  • What motivates you?
  • Do you plan to further your education? If so, to what extent?
  • What have you done to improve yourself during the past year?
  • If you could relive the past 3, 5 or 10 years, what changes would you make?
  • Tell me about your greatest achievement and greatest disappointment?
  • What are some of your weaknesses?
  • Tell me about the best and worst managers that you’ve ever had.
  • What constructive criticism have you received from past employers?
  • Everybody has pet peeves. What are yours?
  • What else do you think I should know about you?

To get to know about the applicant’s experience and reasons for seeking a new position, ask the following questions:

  • When did you leave your last job and why?
  • How long have you been out of work?
  • What have you been doing since you left your last job?
  • What did you like most and least about your last job?
  • At your last job, how much of the work did you perform independently?
  • At your last job, how much of the work was performed by a team?
  • Do you prefer working independently or as part of a team?
  • What are some of the problems you have encountered in your past jobs?
  • How did you solve the problems?
  • Have you ever offered suggestions to management? How did management respond?
  • What prevented you from advancing in your former positions?

To learn about the applicant’s plans for the future and motivation for applying for the job, ask the following questions:

  • If you feel you have any weaknesses with regard to this job, what would they be?
  • What do you expect to experience in this job that you did not experience in your past jobs?
  • Why should our practice hire you?
  • How do you feel about evening work? Saturday’s?
  • Are you considering other positions at this time?
  • How does this job compare with them?

Sometimes the interviewer will ask vague questions that, if unexpected, may be difficult for the applicant to answer. Be prepared to ask the following questions:

  • Tell me about yourself.
  • Are you switching careers?
  • You don’t have a college degree. Why did you decide not to further your education?
  • Why do you believe that you could handle this position?
  • Since you are overqualified for this position, what do you hope to gain from it?

Eventually, money will become an issue. Among the questions that may arise pertaining to compensation are the following:

  • What are your financial needs?
  • What is the minimum hourly wage you will accept?
  • What is your wage history?

Remember that an interview is a two-way conversation. For the applicant, the interview has two purposes:

  1. To sell themselves; and
  2. To evaluate the position


After asking questions, the interviewer usually invites the applicant to ask questions. The applicant may ask the interviewer the following questions to gain knowledge about the potential employer, and also to make a good impression:

  • Does the practice plan to expand?
  • Who are the physicians in the practice?
  • What is their personality like and how does it influence the practice?
  • What is the public image of the practice?
  • What are the greatest problems of this department / practice?
  • What are the greatest strengths of this department / practice?
  • What would you expect me to accomplish in this job?
  • How might these responsibilities and priorities change?
  • What qualifications are you looking for in the person who fills this job?
  • If this position is offered to me, why should I accept it?
  • Why isn’t this job being filled from within?
  • How many people have held this job in the last five years? Where are they now? Why did they leave the practice?
  • How soon do you expect to make a decision?
  • If I am offered the position, how soon will you need my response?

When the position involves management of other employees, these questions may be asked by the applicant:

  • How much authority will I have in running the department?
  • Are there any difficult personalities on the staff?
  • What will be the greatest challenge in the job?
  • Who would I supervise?
  • What are those employees’ backgrounds?
  • How do you feel about their performance?
  • How does their pay compare with what they could get elsewhere?
  • To whom would I report?
  • What is your management style?
  • What are the practice’s strengths and weaknesses?

Reference Checks

Reference checks involve verifying information provided by the applicant and obtaining additional information about previous job performance. This information is used in reviewing and evaluating a candidate’s background. Reference checks are especially important because, under certain circumstances, there maybe legal ramifications for an employer who does not exercise reasonable care in employee selection if an employee later harms another in the course of their employment.

Inform serious candidates up front that it is your group’s policy not to hire without receiving references from at least two of their most recent employers. Put the responsibility on them to bring you reference letters or arrange for a telephone interview. Candidates may state that they do not want their current employer to know about their job hunting.

Before checking references, obtain a written release from the applicant authorizing the practice to contact his or her prior employers. If such a statement appears on the application form and the candidate signs the application, the employer has already received such permission. Don’t offer an applicant a position pending a last-minute reference check. If the reference turns out to be unfavorable, a no-hire decision will appear to be made because of the reference.

Recruitment and Hiring Checklist

Step 1: Review job description. Does it need to be updated or revised?

Step 2: Create a recruitment plan for each position.

Step 3: Prepare job posting and/or advertisements.

Step 4: Require all applicants to complete and sign an employment application.

Step 5: Establish a spreadsheet to track applications.

Step 6: Create a file on each applicant, to be maintained for one year.

Step7: Screen application forms. Look for a time lapse in employment, omissions on the application or troublesome information.

Step 8: Decide what candidate selection methods will be used and prepare for the interview. Develop standardized interview questions for each candidate and select who will participate in the interview process.

Step 9: Check references.

Step 10: After hiring a candidate, send a confirmation letter outlining the conditions under which the person was hired. Always quote the hourly wage or salary, benefits and PTO time offered.

Step 11: Create an employee personnel file. File everything having to do with hiring the new employee and keep these files for five years after termination.

Step 12: Schedule a new employee orientation, at which personnel policies, procedures and benefits are reviewed and an employee handbook distributed.

Teambuilding Strategies

Physicians, office managers, team leaders … everyone struggles with managing difficult staff who just can’t seem to get along with others.  Sometimes their actions are aggressive, but usually their behavior is more passive aggressive, a behavior that seeks to manipulate indirectly rather than confronting directly.  Both personalities can induce stress within your practice and neither can be tolerated. When involved in engagements focused on personnel management, I usually center our discussions on the following processes:

  1. A proper orientation for new & existing staff lays a foundation of employer expectations. Managers must state expectations through positive directives and consistent follow through.
  2. Staff need to know what is expected of them.  Every employee deserves to know their job parameters, expectations within the practice of other employees, and how these duties interrelate.  All staff members must be expected to work cooperatively, whether or not that is their preference. When opposing behavior is exhibited, the office manager must express their expectations.
  3. Staff will push boundaries until they know what behaviors will not be tolerated.  Gossip is one of the most damaging elements of a medical practice and it must be nipped in the bud.  Those who are prone to talk about other people’s personal lives must be reprimanded.  On a broader sense, employees respond well to a well-written policy manual that is administered fairly and consistently.  Likewise, staff members must receive immediate attention to objectionable behaviors.  If they persist in aggressive or damaging behaviors, they must be terminated.
  4. Staff respond well to adequate praise and feedback.  Managers must take time to give frequent words of approval and continuing comments to those whose work they oversee.  The operative word here is to give praise and feedback on the “work” employees do.  Appreciation for efforts and accomplishments should be plentiful, as well as offering insight into where improvements can and should be made.  These remarks are fundamental to generating productive responses.  Keep comments work related and not personal.
  5. Work hard but also have fun.  The workplace atmosphere should be challenging, creative, and fun for all employees.  Define what fun is in your practice and what it is not.  Harmful humor, off-color jokes, sexual humor, and humor tarnishing the practice are not to be tolerated.  However, it is fun to laugh at ourselves and take ourselves lightly.  Add fun to your meetings.

Having a tension-free workplace where employees peacefully coexist should be the goal of every employer. However, considering that we all fall short of perfection, getting to a place of perfect harmony is at times difficult. Nevertheless, striving to implement these principles will improve your staff dynamics and deselect those employees who like to stir the pot and create chaos.

A team is made up of a group of people working together to achieve a common goal. An effective team has certain characteristics that allow the team members to function more efficiently and productively. An effective team develops ways to share leadership roles and ways to share accountability for their work products, shifting the emphasis from the individual to several individuals within the team. A team also develops a specific team purpose and concrete work products that the members produce together.

Effective teams will have open-ended meetings and develop active problem-solving strategies that go beyond discussing, deciding, and delegating what to do; they do real work together. When necessary, individuals in a team will set aside their own work to assist other members of the team. In a well-functioning team, performance is based not on an individual member’s ability to influence other members, but rather is assessed directly by measuring the work products of the whole team. Rewards based on the whole team’s effort help underscore the importance of team responsibility.

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