Dr. Scott Jens is joined by Dr. Steve Vargo, and Dr. Samantha Hornberger for a panel discussion on how to build a team that helps you build your practice.

Hiring for Fit and Training to Suit

Dr. Hornberger, as a solo practitioner at Bright Family Eye Care, generally tends to hire for “fit” in her practice culture, rather than for experience or skill set. She uses a comprehensive training program, including shadowing other employees, online resources for training, and one-on-one mentoring from more experienced team members.

Dr. Vargo agrees that 3rd-party resources can be extremely helpful, but none are more successful than having a solid, internal training program available. There simply is no substitute for hands-on training to develop the skills that make team members successful.

Following the pandemic, optometrists and their practices have learned to adapt more successfully. It has prompted owners and managers to ask more useful questions in the hiring process. One of the most important questions to ask yourself as a practice owner is “what do I need to do to keep my staff happy?” which can lead to better leadership. There are still challenges surrounding payroll and compensation, as well as benefits packages. Hard decisions have to be made about whether or not to raise compensation to retain staff.

Being Your Practice Leader

ODs have a lot of resources, but how do they choose those tools that help them become a better leader? There’s often a leadership void within a business, and when that happens, someone will inevitably step forward, but that tends to be the most vocal person in the practice, which isn’t necessarily the best person for the job. Setting clear expectations for people and having great training systems are important tools for solving some of these issues. It’s also important to be somewhat flexible in terms of your hiring and expectations. Not every team member is suited for every job, so finding the best fit for each person is critical. It’s also very important to have solid accountability and follow up in place to help keep the team moving forward.

Leading by example, even with small tasks, like taking out the trash, will help communicate your involvement and engagement to your team, and help solidify your position as the team leader. Dr. Hornberger has taken this very seriously, and has learned how to perform every task in her practice. This gives her staff a sense that she is “in the trenches” with them. She finds that her ability and willingness to do these small tasks, as well as her ability to delegate, contributes to the cohesiveness and productivity of her team.

How to Hire Successfully

When hiring, sourcing through multiple channels helps to generate a wide variety of applicants. Initial interviews by phone and / or Zoom meetings are a great first step to screening those initial applications before an in-office interview. Dr. Hornberger has found it useful to allow prospective employees to spend time alone with existing team members, through shadowing and one-on-one meetings, which may reveal more of their genuine character than might be obvious during a more traditional interview. This is so important to her hiring process that she’s willing to pay the applicant for their time, just to ensure the best fit. She follows this “working interview” up with a brief meeting between herself and the candidate before making final decisions.

Training from within is still a great way to identify candidates who are willing to learn, or want to “level up” and pursue professional advancement. This is one way to attract a wider pool of candidates, since it allows you to advertise that “no experience is necessary” for starting positions in your business. That option tends to yield a larger group of applicants.

Staff Retention

According to Dr. Vargo, the larger challenge at the moment is finding staff – especially qualified staff – rather than retaining them. A number of practices have actually reduced their staff, which seems counterintuitive to a growth mentality. They may also be being more selective on which plans to carry, and where to expand their services. Many practitioners are actually a little gun-shy about finding staff, and have really begun to focus on keeping the best staff they have. An internal training program, and being willing to start from ground zero with new hires can eliminate some of those challenges. There’s simply no guarantee that more experience will produce a great employee. The number one reason new-hires don’t work out is because they aren’t coachable. This statistic validates Dr. Hornberger’s approach to hiring for fit and willingness to learn.

In regards to compensation levels, says Dr. Vargo, it’s important to understand what is reasonable within your area, but the more important question is how valuable that employee really is to your practice. It may be that a practitioner simply needs to become more comfortable with a higher payroll. Most people don’t actually like change, and if they feel they’re being paid fairly, they are less likely to step away from the job they have for an outside offer.

Lean Staffing

Dr. Hornberger is actually working with a reduced staff, but is still achieving excellent culture and efficient practice growth under that leaner model. That’s one of the major benefits of these commitments to training. She’s also been open to outsourcing some functions within the practice, like insurance billing and verifications. As they move forward, other options like virtual employees may become an option to help lighten the load for existing staff, and reduce the payroll load somewhat. This does allow staff who are physically in the building to spend their time on value-based tasks, customer service and patient care.

Measuring Performance with KPIs

Analyzing and measuring staff performance is a key part of good leadership. The first step is figuring out what KPIs are a priority for the practice and each individual. It’s important to communicate your production expectations, and provide feedback, ideally from a mentorship stance. Building a collaborative effort can open new pathways for improved performance, which translates to additional revenue. The leader needs to have the vision, but the team needs to be involved in fulfilling it. Just remember, nothing ever changes without accountability and follow up on those measurements.

Data helps the practitioner identify where they may themselves be under-performing. Oftentimes, dips in some KPIs may indicate that communication in the exam room is flagging.

Performance Incentives

Revenue goals may be used to effectively create and maintain bonus programs for employees. Tying incentives to performance, in conjunction with clear goals, not only rewards employees financially, it expresses clearly how much they are appreciated by the business owner. Break your overall goals down into small tasks or objectives that are actionable and achievable, and will help staff understand how their performance feeds into the cohesive results. It’s not only the outcome that matters, but the collaborative process that allows employees to gain ownership of their processes.

When the staff doesn’t hit the mark, how can a practitioner keep that from being a derailment? Dr. Hornberger has a unique program that allows her team to “earn back” a missed monthly goal, if they make the quarterly goal. Find a creative way to provide built-in motivation to keep the momentum rolling, so staff members are inspired to keep moving forward, rather than dwelling on past failures.

Practice Culture for Success

Performance in the office, and good leadership, is often a result of being consistent, even if it means saying the same thing over and over. Follow up, train, develop, hold accountable (“rinse, repeat”) may begin to feel like an endless treadmill of repetition, but that’s really the only way that performance standards evolve and become sustainable. Even expensive employee development programs are no substitute for consistent, focused leadership. Development of your staff becomes an investment, not only in them, but in your business.

Happy, successful offices do not all “look the same.” It’s absolutely critical to understand what’s going to work for you, and what’s going to keep your staff enthused, and happy to come to work each day. The foundation for this isn’t necessarily being your team’s best friend, but they need to know that you care about their well-being.

Final Thoughts

Dr. Hornberger: Staffing, hiring, and training is probably the most difficult job a practice owner faces. It not only affects the bottom line, but also impacts the way we are able to offer care to our patients. Don’t be afraid to train on the job, make sure you have a solid training program set up, be available and asking for feedback, and try to find the positive aspects of hiring when necessary.

Dr. Vargo: Leadership is no longer a luxury, it’s become an absolute necessity. Leadership ability is a skill that can be learned and there are dozens of good resources to help. If you’re going to own any business that has a team, you have to figure out how to do that successfully, so you can drive the organization in a positive direction.