Recruiting and hiring a new physician is a critically important and time-intensive process for the practice. Choosing the best candidate to join an ophthalmology group, however, is just the beginning of the journey. (See “Considerations for interviewing and hiring”.)

A comprehensive, well-thought-out strategy for the orientation and training of new recruits is crucial — not just to set the provider up for success but also to ensure they are integral to the practice’s bottom line, according to the Healthcare Information and Management Systems Society (HIMSS). Delays and hiccups when new associates are getting started can have a substantial impact on their ability to contribute to the group, derailing the trajectory of even the best hires.

Ultimately, a poorly planned orientation can lead to unwanted turnover. To avoid missteps and ensure a smooth onboarding process, consider incorporating a systematic strategy for bringing on new talent.

Onboarding essentially means familiarizing and orienting a new provider to the group and its culture. It includes introducing them to the community and integrating them with the staff, so they can successfully establish their own practice and quickly achieve firm financial footing. Those interviewed say the onboarding process should address five key areas.

CREDENTIALING

Getting necessary licenses and credentials with facilities and insurance payers is the most time-consuming aspect of the onboarding process — and the most critical. A physician cannot start seeing patients, bill for services or operate without these materials in place; therefore, it makes sense to start the process in advance of the new hire’s start date.

“This needs to be started as soon as possible because it can take 3 to 4 months,” notes Vipul C. Shah, MD, a cataract and corneal surgeon at Charlotte Eye Ear Nose & Throat Associates in North Carolina. “At our practice, we have an administrative team that takes over this duty to ensure the new hire can swiftly begin taking on cases.” Some practices outsource this function.

Licensing and credentialing tasks include applying for a state medical license number, setting up a National Provider Identification Number, a DEA license (if applicable), Medicare and Medicaid numbers, malpractice application, ensuring hospital privileges are applied for and credentials for all insurance plans.

ORIENTATION

To kick off the orientation aspect of onboarding, the practice leaders should set their expectations regarding the number of patients the new physician is expected to see and when they should reach this benchmark, says Eric W. Schneider, MD, in practice at Tennessee Retina Physicians in Nashville. This discussion would include processes like managing workflow and the time allotment for new and established patients.

“What we will be looking for is, are they able to keep up with what we think is a reasonable pace for their period of experience to date in our practice,” Dr. Schneider says. “This is pretty knowable by looking at the schedule. We rely a lot on the staff to let us know if there are any red flags.”

The associate will need to be equipped with an office or workstation that includes a phone, computer and other necessary supplies and equipment, like a signature stamp or lab coats, notes HIMSS. In terms of paperwork, along with an executed contract and an employee handbook, the new provider should review the group and hospital bylaws, procedures and policies. To save time, practices may want to consider setting up a portal for paperwork to be completed after the orientation process, HIMSS advises.

The billing staff will introduce the new physician to the practice’s documentation and coding process, and an experienced staff member should be identified to help train them on the practice’s EHR system, Dr. Shah notes.

STAFF INTEGRATION

The associate should have a tour of all office locations and the hospital to meet the staff and spend time with key employees,” says Dr. Shah. Also, it must be determined whether the new physician will have dedicated technicians or share from a pool.

“At our large, multilocation practice, we have multiple office managers for various regions,” he says. “The new ophthalmologist will meet the office managers who will be assigned to him or her. They will then start the process of staffing and hiring techs to build their team.”

Next, the new hire begins constructing a schedule. “We usually start fairly slow in their clinic volume for the first week or two, then we open it up to whatever is appropriate for their level of staffing and what we expect for them” Dr. Shah notes.

New physicians also start out slow at Tennessee Retina Physicians, in terms of the patient load. “We are used to seeing 60, 70, 80 patients a day — that would just be overwhelming for a new doctor,” says Dr. Schneider. “We want to get them comfortable seeing patients slowly and then work up. We do not want them to feel like they’re being rushed.”

Pairing new associates up with the most experienced staff members is another strategy that can be effective for onboarding success. “They can help guide them through clinic because they’re as knowledgeable as any of us are in terms of how the clinic works or the EHR works. We find it benefits new hires to give them good help,” Dr. Schneider says.

MARKETING

The practice should have a plan for external marketing of the new physician to the community and start executing it in advance of the start date. HIMSS says marketing could include announcement cards and updated signage and website along with creating personalized stationery and business cards.

Members of the practice should introduce the new ophthalmologist to referring providers and practices to spread the word, build rapport and establish relationships. “We have a physician liaison who takes them around and sets up meet-and-greets with referring doctors,” says Dr. Shah.

SHADOWING

Beginning surgeons at Dr. Shah’s practice spend several half days with various doctors in their specialty as they get the hang of seeing their own patients. “It’s a good way of seeing how different people run their clinics. They can get a sense of what works for them and what doesn’t work or help the patient,” he says.

When it comes to surgery and clinic, some practices may have new surgeons shadowing veteran doctors for longer periods of time. “Our senior partner has performed more than 60,000 cataracts, so everybody that we bring onboard shadows and follows that surgeon,” says Matthew Lowrance, DO, the medical director for Retinal Care at Tennessee Eye Care in Knoxville. “That is not to say they have to do the same; it is so they can learn.”

With retina patients, Dr. Lowrance says take a team approach as it is more important for a patient to be treated emergently rather than see a specific doctor. Having new physicians shadow instead of jumping right in “puts the burden financially on the practice because we’re going to pay him or her,” says Dr. Lowrance. “But they learn that team spirit and the buildup of tension works like a slingshot — these surgeons launch!”

CONCLUSION

Smooth and successful onboarding doesn’t just happen — it requires a process. “We try our best to be proactive in thinking about everything, from credentialing at the surgery center, to opening up a schedule, to making sure they have space in the building,” Dr. Shah says. “We work it all out 3 months in advance — because there are a lot of boxes to check when you hire a new person. Having everything lined up means that you can have them producing as fast as possible.” OM