Good help is hard to find

Tags: office management, practice management, staff, reiner

Good help is hard to find

And then you have to keep them

By Bradley K. Reiner
Practice Management Consultant, Reiner Consulting and Associates

Have you found it increasingly difficult to find good, competent, reliable staff for your practice? If you haven’t, consider yourself lucky. Why does it seem that it’s hard to find good staff in health care? Once you find the right person, why is it difficult to retain him or her? Could it be that you just don’t know how to hire the right person for the job? Are you doing something wrong in the way you hire that sets you up for failure? Are there inefficiencies in your workflow that hinder the practice?

Staffing a practice with the right kind of people can be a problem if you don’t use all your resources. Let’s explore these resources further. Here are things to consider when beginning your hiring process.

Where to look

I only use a newspaper advertisement if I have no other options and my other resources have come up empty. Advertising in the newspaper is extremely expensive. Why would you pay when there are many free job sites that often produce just as many prospective employees?

When I recruit, I often use a website called Craigslist (free plug). To access the city closest to you go to

You can post jobs for free and I have found them very helpful. You may still get some less-than-desirable applicants, but at least you haven’t paid for the ad. I also use the Texas Workforce Commission. They can be found at Follow the on-screen sign-up and you can post any job for any position for free. This is another great resource that doesn’t cost a dime.

You may also check at local medical training schools. In Austin, there are a number of them that can recommend people graduating as medical assistants or front-office persons. These people are green, so plan to spend time training, but at least you can train them the way you want rather than someone bringing in their bad habits.

Finally, call your local county medical society. Some keep a file of applicants looking for medical work.

Interview effectively

Ask the right questions. On top of finding out what their skills are, try to determine their personality. I believe you can train almost anyone to do a job, but you can’t change a personality. For the practice to run smoothly, employees have to work together. The most skilled person may not have qualities that fit in with your organization. Someone less skilled who is enthusiastic will be much better for your practice in the long run. Here are a few questions I use:

  • Give me an example of a challenging problem you solved. What were the obstacles you encountered? What was the outcome?
  • Give me an example of a disagreement you had with your supervisor. What was your role in this issue? What was the outcome?
  • Give me an example of a conflict you had with either a patient or a co-worker. What happened? How did you resolve the conflict?
  • What would your previous supervisor say about you?
  • How do you handle stress?
  • What interests you about this job?
  • What type of work environment do you prefer?
  • What is the most important factor in your choosing this position?
  • How would you handle employees who are apprehensive about your new position?
  • What did you like best and least about your last or current job?
  • What motivates you?
  • Why did you leave your last job?
  • What characteristics about yourself do you like best?
  • If you could design the ideal job for yourself, what would it be like?

Working interview

If you like someone, give him or her time to do a “working interview.” That is, show him the system briefly and see if he can schedule a patient or check someone in for the day. Give him a filing test and ask that he file charts back alphabetically. I hate to admit how many times I’ve seen people who don’t know their ABCs. If it’s a clinical person, have her pull a patient back and do vitals, etc. If she says she can draw blood, see if she can actually do it. If it’s a billing position, show him the system and see if he can post charges or payments. Give him a collection call to handle. The key is to see how he interacts with patients and other staff. You can get a lot of good feedback about this person with this type of interview.

Criminal & background checks

This is becoming increasingly more important. I have worked with practices that had staff embezzle money and I’ve heard of offices that hired criminals. Practices have to deal with unemployment claims, wrongful termination and discrimination. You can avoid many of these problems by doing a simple background check through the Texas Department of Public Safety criminal list, Here you can sign up and check out all the thugs. Hopefully, you won’t find one of your current staff on the site! Certainly you want to make sure any potential new hire is not on the list.

You can also review other online criminal-background Web sites that are more thorough, but cost money to access. If you have a payroll service, many times they have companies that they deal with that do background checks. These services can be very helpful in eliminating a potentially bad employee. Make sure you get authorization from the applicant before running a background check.


So, now you have found a great employee and he or she has accepted the job. How do you get that person to stay with the practice for the long haul?

Periodically meet with him and see if he has any questions or concerns. Have a true open-door policy where staff feels they can come to the manger to discuss any issues that arise. Review progress at 90 days of employment. Staff want to know when they are doing a good job and need to know where they can improve. A 90-day review can be an excellent communication tool if it is used appropriately. If there are conflicts, get people together to discuss the issues. Don’t let something stew without attempting to resolve the conflict as it will cause bigger problems.

Reward staff for a job well done. A simple thank you can help staff feel important. Appreciation from the physicians makes staff feel good about what they do. This cannot be overemphasized. In my experience, it is the doctor’s approval, not the manager’s, that makes the staff feel good about themselves and their jobs. Something so simple can make all the difference in retaining good employees. Of course don’t forget that everyone likes a bonus and a raise when he or she is doing good work. Remember, it is cheaper to pay a good employee a little more for what they do than to look for and train someone new.

Keep these things in mind and I hope you will see an improvement in your hiring and retention.

Web links

Employment sites
Craigslist—for the city nearest you:

Texas Workforce Commission:

Background checks
Texas Department of Safety:

Bradley K. Reiner, formerly with Texas Medical Association, is now owner of Reiner Consulting and Associates.

TAFP is proud to announce that Bradley has entered into a partnership with the Academy to provide practice management consultation, support and guidance to the staff, content for publications and conferences, and discounted services to TAFP members.

He can be reached at (512) 858-1570 or e-mail at