practice management

How to Create the Best Team for Your Practice

Behind every successful pediatric practice is a group of people who bring a unique set of skills and strengths to their work. From front desk staff and billers to nurses and pediatricians themselves, patients rely on this team when they visit your practice for an appointment. They expect staff members to communicate effectively and the team to function smoothly. Hiring the right people is key to realizing this positive experience for your patients. How do you find employees who will thrive? How do you build a team that meets the unique needs of your practice? How do you know if your partnership is working? Check out some tips for the hiring process and to assess potential partners in a Q&A with Chip Hart, director of PCC’s Pediatric Solutions consulting group.

You've said during webinars and conference presentations on this topic that an important first step in hiring the right people is to understand your practice's culture. Why is this so important? How do you know you're honestly assessing your practice?

The most obvious analogy I can make is to compare the process to getting married.  Successful marriages aren't constructed randomly. They are a combination of communication and hard work. In a successful marriage, you need some kind of compatibility and mutual understanding. The same is true with employees. If your practice puts a premium on formality, punctuality, and competence, then you need to communicate that with your existing and potential staff. Otherwise, you may end up with someone who unintentionally adds friction to everything in your office, every day, and neither of you will be happy.

Honestly assessing your culture is a great challenge, as I think every practice has two cultures: the culture they aspire to and the culture they actually have. Ideally, you will hire people who support your aspirational vision and not necessarily the culture you have today. For example, you may be waking up to running your practice for the first time and realize that you have a practice where personal responsibility isn't baked in yet. People leave shifts early, staff waits for someone to tell them what to do, messes are left for someone else (you!) to clean, et cetera. What you want is a practice where everyone understands they are part of a team with a common goal. Hire employees who fit in to your aspirational culture.

How do you tell the difference between your practice’s current culture and aspirational culture? I think there are a couple exercises to consider, but the primary sources you have are your patients, your staff, and the formal testing resources. In other words, you can ask your patients and staff to describe your practice, to tell you what they like and don't like, and you'll get amazing feedback. You may have to set up something that works anonymously, of course.

How can pediatricians and practice managers set up their interview and hiring process to assess cultural fit? Any tips?

There's an entire industry devoted to doing things like this well. There's nothing special about pediatric offices in this regard. I say that so pediatric offices stop thinking about themselves as something outside of the small business arena. The local florist or college or law firm has the same challenges. A Google search will lead you to plenty of articles and books that help guide this process. My biggest piece of advice is to be active: figure out how to engage the applicant and help them understand what you do. Anything that can get them to understand you and you to understand them is good. Pay them to shadow your staff for a day, for example.

You are a proponent of pediatricians using assessment tools such as The Myers-Briggs Type Indicator, the Keirsey Temperament Model, or the Clifton Strength Finder to help understand the strengths and weaknesses of their team. Can you point to an example of a practice using one of these tools to improve the functioning of their team or to address a challenge?

I know a small handful of practices who have used one of those tools to gain insight into their culture. My takeaway is that the primary importance of the tool is to serve as a gateway for communication. I usually call them "horoscope toys" because I think it's impossible to truly categorize people easily, but the discussions that ensue from people sitting down to say, "Hey, I feel X, and you feel Y, and that's okay as long as we still respect each other," is great.

You’ve suggested the approach: "Hire slowly, fire quickly." Why?

Because too many practices get it backwards.  They hire too quickly in an emergency and then take too long to fix their regretful mistake. Again, the marriage analogy serves well here.

Great employees don't necessarily arrive fully formed. They must be nurtured, mentored, and allowed to grow into their role. How can practices make sure they're supporting their employees in ways that help them succeed?

There are plenty of books, and webinars, and blogs about this subject. My biggest piece of advice is to simply invest in your employees. I've had too many conversations with pediatricians who complain about their front staff being sub-optimal yet they pay $10 per hour for that key role. What kind of quality can you expect for minimum wage? Make sure your employees have the support they need. Create programs and policies to help them succeed. Identify mentors; encourage them to build on their strengths and address their weaknesses.

You've likened finding a compatible business partner to embarking on a marriage. Why is this an apt comparison? Where should a pediatrician start when seeking out a partner?

There are two things a pediatrician should look for in a practice partner: clinical compatibility and business compatibility. First, you have to trust each other clinically. That's the one thing I can't even help a practice work through. If you don't trust a partner's ability to care for the kids in your practice, you need to break up. Period. You will always be miserable, and it's the worst kind of misery. If your clinical partner over prescribes antibiotics or doesn't want to mandate vaccines (while you do) or has horrible chart notes, or any number of other problems, it’s time to leave the partnership.  Would you trust your own child with your partner? If not, break up.

On the business side, it's a little more complex and there is more room for symbiosis. What I mean is that not everyone is great at every aspect of running a business. In fact, few pediatricians are good at it at all. It's okay if partner A takes care of certain aspects of running the business while partner B knows nothing about them as long as they both understand that relationship. If you love to talk to the accountant and the EHR company and your partner loves to do HR (who loves to do HR?), then you can have a great business relationship. The problems occur when one of the partners doesn't value the work being done to maintain the business.

What are some tips for making sure a partnership stays strong over time?

One tip: communication. Constant. And especially when things are easy and working well. As I say in my seminar, when is the best time to discuss fire safety? When the house is on fire? No, have those discussions when the drama is at a minimum.

What should a pediatrician do if it becomes clear a partnership isn't working out?

Break up. Nicely, cleanly, quickly. I know too many pediatricians who are stuck in "bad marriages." You have one life to live. Why make yourself miserable?

Are there trainings or educational offerings you'd recommend to pediatricians related to hiring well and/or sustaining a business partnership?

Google. The internet is full of them. Just remember that there's nothing magic about being a pediatrician here. Join the American Academy of Pediatrics Section on Administration and Practice Management (AAP SOAPM) and the Pediatric Practice Management Alliance (PPMA). Your local AAP chapter is also a good option. PCC is also a resource for clients. Call anytime and we can have a candid conversation about your practice, your partnership or any other issues you’d like to discuss.

This blog post was written using excerpts from Chip Hart’s webinar, "Do You Work with the Wrong People?" Watch the full recording by clicking below:

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Erin Post

A resident of Burlington, Vermont, Erin Post has a B.A. degree in English from Hamilton College, and is a graduate of the writing program at the Salt Institute for Documentary Studies. She is currently working on her master's in public health at the University of Vermont. In her spare time, she likes to bike, ski, hike, and generally enjoy the Green Mountains of Vermont.