Management Essentials

Staff Retention – Avoiding the Exodus

By Farrell "Toby" Tyson, M.D., F.A.C.S.

All organizations wish to retain their staff — if only for purely lazy reasons. There is significant cost and waste of production associated with staff turnover. Most analysts will concede that the cost of replacing one hourly employee is 150% of the employee's yearly compensation and rises to at least 200% for salaried or management-level employees. An ideal practice has 10% or less staff turnover per year.

Financial Compensation

To help retain your staff, you have to determine what it is that compels them to stay with you. The first thing that comes to mind is financial compensation. This is a great motivator, but can also be a detriment. One never wants to be the cheapest employer in the market. If you are, you are going to constantly be training new staff for your competitors. If you have the highest paid staff in the area, you will find you have created dead end for your staff. In today's economy, you have staff who may not like their jobs or employer, but are forced to continue to work in the practice as no other jobs are available. These negative feelings can then be carried over into patient care, which further detracts from the advancement of the practice.

The ideal place is to be somewhere in the middle of the pay range for the area. This allows you to attract quality individuals to your practice, but also allows those who are not a good fit or are unhappy to move on.

Additional Perks

Benefits can be just as attractive as hard dollars to employees. As most employers in the market have slowly reduced medical benefits, offering them may be a major attraction to your practice. Other benefits can be offered, such as retirement plans with matching contributions, travel to meetings, uniforms and educational opportunity.

Continuing education can be a win/win situation as it allows growth for the employee and added value to the practice. In our practice, we pay for educational classes, certification and testing as long as it does not interfere with the workday. In addition, we have set forth financial incentives to staff who successfully pass the JCAHPO Home Study course, Certified Ophthalmic Assistant/Technician/Medical Technologist exams, Certified Ophthalmic Coder and Certified Ophthalmic Administrator exams.

These certifications are open to all employees from the receptionist to the technician to the billers. This helps all staff members to become more knowledgeable about ophthalmology as a whole. These financial paths also help justify pay rates and separates the "go getters" from the "9 to 5ers." In return for this training, our staff signs a promissory note against future earnings that is prorated over a year of employment.

Work environment can be a major factor in an employee's desire to stay employed. Many practices fall into the trap of allowing one bad apple to ruin the bushel. Usually this is a highly valuable employee who has realized his or her worth and starts to abuse their status. The ones at fault in this scenario are usually the doctors who have allowed a "pet" to develop and be sheltered. This can also occur under administrators and managers. Pets should not be allowed and favoritism should be nipped in the bud.

Gossip can also destroy a practice quickly. Whenever gossip is encountered, all parties need to be brought together and the source discovered. In this way, there is a disincentive to spread rumors. If bad apples cannot be successfully rehabilitated, they must be terminated no matter how valuable or painful it might be.

Pride in one's work and position can be a great motivator. Doctors work hard to notice all the signs and symptoms of their patients. They need to apply this concern to their employees as well. Recognition and appreciation can go a long way, especially if done in public. This is probably the most cost-effective staff retention tool, but the hardest for doctors, administrators and managers to implement. In our practice we have a biweekly newsletter that goes out with the paychecks, informing the staff of the happenings in the practice and focusing on different employee accomplishments. These accomplishments do not have to be major, but everyone looks forward to seeing who makes it into the newsletter.

Successful staff retention is accomplished by a multi-pronged approach and leads to practice stability. This stability is seen and appreciated by your patients. Stability also allows management to tackle more far-reaching goals than filling the employee black hole. It ultimately leads to a more professionally and financially rewarding life for the physician. OM