Adding new clinicians to your practice: recruiting or dating?

Episode 26: Adding New Clinicians to Your Practice: Recruiting or Dating?

We’ve been talking about the people component of your practice for the last several episodes – today we’re going to focus on growth and adding new clinicians to your practice.

When making a decision about when to add a new clinician to a growing practice, it’s easy to default to making this on an emotional basis. You may think, “I’m crazy busy, and can’t possibly keep up this pace – we need to hire a new doctor!” Or, you’re hearing from your colleagues, “OMG, I can’t keep up – too many new patients – we need to add someone right away!” or you hear from one of your patients, “Wow, it took me 3 months to get this appointment!”

All of these things are important to consider, AND to measure. You and your colleagues may well be working beyond your capacity. The question becomes, is that because you’re at 110%, or are you all at 150% or beyond of your capacity? When you get that new person hired and everyone returns to 100% (or maybe a little less to take a breather), how much of a full practice is actually there? If there are three of you currently, and you all feel overwhelmed because you’re all at 110%, in reality, you have 30% of a new practice to hand to someone. The rest of it will need to fill organically over time. Even with some excellent marketing strategies, it will take many months, and there is a cost to that.

I strongly recommend measuring capacity using metrics like the 3rd next available appointment and length of time to the next new patient appointment and others like that. Determine when you’d like to add another clinician – you may want to work until the current practice is at 120% of capacity, and then bring on a new clinician. Or, you may not want to overwork yourself and your partners, and you might choose to add them earlier. This may cause a dip in income as you split it by a larger number, and you can decide ahead of time if you’ll reduce existing clinician take home pay, or if you’ll finance the startup of the new clinician. It’s imperative to be on the same page with your partners about how you’ll accomplish this.

When we work with groups who are bringing in new clinicians, we can see that there are not many folks out there willing to come in on a pure “eat what you kill” compensation formula anymore, so consider what makes a competitive offer when you’re meeting with potential new colleagues. You may not need to compete with the local health system, but you should know what they’re paying and at least a bit about sign on bonuses and benefits. I don’t suggest this so you can attempt to compete with them – you shouldn’t. You should know the market, be able to speak to it, and to discuss pro’s and con’s of private practice vs. larger systems or being employed.

Before starting the recruiting process in earnest, it is important to consider: How does your practice really look to an outsider? Remember, this part is like dating! Consider:

Your physical plant – the office itself – is it clean, up to date and well furnished and decorated? If it looks a little tired, perhaps a fresh coat of paint and some new artwork is in order. Be honest with yourself here.

How do your staff present? All in matching scrubs? With the practice’s logo? I love seeing this when I go into a clinic – not that it’s meant to be “cutesy” but rather to express some espirt d’corps.

You may not think about it often, but what is the level of formality or informality in the office? Are people on a first name basis? Do clinicians wear the long white coats? We send several messages about our culture in very subtle ways.

What does your use of technology say about the practice? Do you have updated online tools and resources for patients, and an EMR system that is interfaced with the community? Or, are you still reliant on faxes and a lot of paper processes?

What about your business’ financial fitness? Are your finances well managed with good internal controls in place, or does it feel like you’re bumping along?

Lastly, what are your specifics around compensation and  benefits and what does the partner track look like? We’ll devote a future episode to more specifics on this.

Your prospective new partner should be looking at all of those things carefully…get ready for some scrutiny.

As you think about your recruiting process, don’t rush it! If you’re looking to add a clinician who may eventually become a partner in your business. This is a big decision, and it’s a bit like getting married. You want to choose well, and take your time.

What are your group’s values? What qualities make a good partner? Get real clarity on these questions BEFORE you begin your search. It will be much easier to sort through candidates if you have this dialed in ahead of time.

And, I want you to have a large candidate pool! If you’re looking for new clinicians and not finding many people to talk with, it’s time to step back and seek to understand why.

Perhaps you are not looking in the right places – are there some job boards at the county or state level you could make use of? How about your professional college? Is it possible to advertise there?

Maybe you haven’t thrown the net wide enough – are you and your partners reaching out to colleagues in the community and friends from residency? Are you posting on social media in groups you hang out in? Is there a listing on your clinic’s website?

And, if you’ve had ads out there for awhile, with no bites, consider: is there something off-putting about your ad? Or about your communication? Perhaps seek input from colleagues, even if they’re not interested in the opening they could give you valuable feedback about your add. Check to see what the competition says in their ads too – perhaps you need to add more detail, or tighten it up a bit. Remember, every time you put something out there, it is a reflection of your practice. Make it count.

When meeting individually with candidates, decide how you’ll gather information about them. The optimal case is that you’ll have two or three finalists for each position. Again, it’s good to be clear about what’s most important to you and your group so you can easily make choices. I recommend using a ranking system that is standardized for all candidates. Then you can do the math, to see which candidate ranked highest. At that point, you can do a gut check – sometimes the mathematical answer is surprising, or it leaves you with a strong feeling. And now, oddly, since I’m a numbers gal, in this instance, I recommend following the feelings, not the numbers.

I also suggest involving your team in this too – everyone gets to work with the new clinician. You are likely to be surprised when you ask your team for feedback – if you stop to really listen, they’ll frequently have very insightful responses to share. And, we always like to see candidates in multiple settings, so have part of their visit at the clinic, perhaps part as a brief tour of the hospital if you routinely admit patients as part of your practice. Definitely include a meal in a restaurant – you get to learn about them the entire time. How do they interact with your team at the clinic? Are they kind to wait staff at the restaurant? What kinds of questions do they have about the hospital or the community?

Remember that recruitment is a two-way street! You need to learn about them, and they need to learn about you! So, it’s a bit like dating and a bit like sales. What information do you want to learn about them and what information do you want to share with them? Some groups will share financial information, and others will share quality or patient satisfaction scores or other metrics. We always recommend offering to share the information once the candidate has signed a Non-Disclosure Agreement or NDA – you can find an example at our Medical Money Matters Toolkit here.

Lastly, have fun with this! Adding a new clinician is exciting, a little scary and a necessity if you want your practice to grow. Take your time, communicate with the candidates you’ve engaged with, and always share information about your process with them so that part is transparent. That’ll keep them engaged and in the know.

Join me for our next episode when we’ll talk about the Bad Partner and how to handle that situation.

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