Running a practice means going beyond clinical care to also set the tone for your staff
CHICAGO—Even if you hire human resources professionals, as a private practice owner, you still want to have a good grip on the basics of attracting great people to your practice and keeping them happy.
That’s what the speakers shared in the session Run Human Resources Like a Pro: Staffing Models, Conflict Management, and the Main Mistakes to Avoid to Lower Staff Turnover and Improve Office Efficiency during the Practice Innovation Summit before ACR Convergence 2025.
Dr. Karleen Su
For rheumatologists who are used to focusing only on the clinical side of their work life, this can be an adjustment, said Tien-I Karleen Su, MD, FACR, of Amicus Arthritis & Osteoporosis Center, Whittier, Calif.
“In my 10 years of managing the practice, it was in the fourth year that I realized I had a business. It’s such a strange concept,” Dr. Su said. “Your primary identity is as a physician. When you have the identity of being a businessperson, you think differently.”
Dr. Su and Adrienne Hollander, MD, Arthritis Rheumatic and Bone Disease Associates, Voorhees, N.J., shared pearls to build and keep the HR side of your business running strongly.
Dr. Adrienne Hollander
Run HR Like a Pro
- Have a mission and vision for your practice. At first, you may think that having a mission and vision for your practice sounds clichéd or generic. However, knowing your practice’s mission can determine employee priorities and behavior. For example, your mission may be to take great care of patients and have a great working environment. Then your vision should be forward looking. For example, your vision may be to serve rural patients in an underserved community. Or it could be to grow your practice into the largest and most profitable practice in your area. “Your vision will incorporate your values,” Dr. Hollander said.
- Create an employee handbook. Although you may think it’s common sense that employees will follow certain basic rules at your workplace, you’ll find as a practice owner that is not always the case. To help get everyone on the same page, Drs. Hollander and Su recommended working with your managerial staff to create an employee handbook. You may surprise yourself at what topics you need to address, such as not sleeping at the job or regulating social media use while at work. Expect to update your handbook regularly to comply with always-changing state regulations. Make sure that employees sign off on receiving and reviewing the handbook.
- Have an online employee portal. The portal will be a handy place for employees to check for news and updates within the practice. It also becomes an easy spot for everyone on staff to find relevant information as your practice grows, perhaps among multiple locations. Designate a person on staff to regularly update the portal, and use the portal to house important documents (e.g., the handbook), standard operating procedures, weekly news and birthdays. Another important document to have on the portal: Procedures for answering the phone. Even if you have specific employees to answer the phone, anyone on staff may have to pick up a call occasionally, Dr. Su said. Address how to answer a call and where to refer patients for questions about refills, new prescriptions, appointments and more. “Your phone is the face of your business,” she said. Another item to include on your portal: New standard operating procedures so both new and long-time employees are aware of any changes regarding how to do things.
- Screen potential employees with various types of checks. You probably already take this step, but Drs. Hollander and Su encourage practice owners to become even more intentional. For example, Dr. Su’s practice leaders realized that many applicants were likely applying for jobs casually, while on their lunch hour at another job. When the practice would follow up to further discuss the job with a candidate, they often were no-shows. Now, her practice does a questionnaire that requires candidates to rename the questionnaire file and send it back—helping ensure the candidate has basic computer skills. If that person is still a good candidate, practice leaders will schedule a virtual interview. This has decreased the number of no-shows. Reference checks, as well as background and credit checks when applicable, also are important. When it comes to references, rely on those from managers who are still employed at the candidate’s current or former company.
- Use an onboarding checklist. Once you find the right hire, work through a systematic checklist to make sure all types of training they need is completed. Dr. Hollander has encountered situations in which a new-hire is making mistakes in a work task, only to realize the person never received the right training for that task. A checklist with assigned people or resources for each part of onboarding eliminates the guesswork. Make sure to include some soft skills on your checklist, such as conversing with patients and fellow employees in a friendly manner, she advised. Her practice does yearly evaluations as well as quarterly check-ins with staff to see where they are doing well and where they may need more training.
- Be careful with what you use to motivate employees. While you want to reward employees for good actions, you don’t want them to become too extrinsically motivated. Drs. Hollander and Su discussed programs they have tried in the past, such as a token program with small rewards. That may push employees to focus on the rewards and not on better performance or patient care. Dr. Hollander’s practice has appreciation events, like a special breakfast each quarter or an annual ice cream truck. Dr. Su, who enjoys arts and crafts, once had a reward system that involved doing crafts, only to realize half the employees didn’t feel so crafty. Instead, PTO cards offering four or eight hours of time off have been more popular.
- Have a plan in place when employees are not doing so well. When an employee is underperforming, be prepared to work with them to do better. First, try to determine why they may not be doing so well, Dr. Hollander advised. Is it a bad cultural fit? A skill deficiency? Knowing the cause may lead to a solution. “If you can, deal with the problem as early as you can,” she advised. Try coaching if needed, letting them know that you (or your fellow partners/managers) want to help them be successful. Provide what they may need if possible, and follow up. “That’s the hardest thing,” Dr. Hollander said. Sometimes, “there’s no follow up, we’re not doing that accountability part.” Document all steps you’ve taken as a company to help someone improve so if you need to let them go, there’s proof that the practice has done everything to try to help them. Dr. Hollander’s practice will start with a verbal warning, then a written warning that the employee signs and possibly a performance improvement plan with a re-evaluation within a certain time period.
- Educate yourself about management skills. Just like you continue to improve yourself as a rheumatologist, expect to continually improve your human resources, managerial, and leadership skills. Read relevant books, listen to management or leadership podcasts, take classes, or connect with other leaders and managers even if they are outside of the medical field, Dr. Su advised.
Vanessa Caceres is a medical writer in Bradenton, Florida.
