6 Ways to Maximize Startup Success: Hire an Employee from Day One
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I talk with a lot of healthcare providers who are starting into practice, and invariably they say, "I'm not going to hire a staff person right away, until I'm making enough money to afford this person." This is backwards negative thinking. I get a vision of some young doctor running around on roller blades, with a headset and a stethoscope, trying to make copies, treat patients, handle bills, all the while drowning in a sea of paperwork and phone messages. YIKES! Why would you do this to yourself?
Having a staff person in your practice from DAY ONE is an essential element for your startup success. Going it alone is just not an option, if you want your practice to be successful. Here is my list of six reasons you need a staff person from the first day of your practice in order to be successful:
Reason 6: Having another person in the
office can keep you out of trouble. In other words, you
need another person in the office as a witness, to support
you if a patient accuses you of something. For years, gynecologists
have been taught to have a nurse present at internal exams.
I'm guessing other types of doctors have similar protocols.
This doesn't mean the staff person needs to be in the room
with you, but the staff member should be able to hear what's
going on and to testify about what both you and the patient
said or did. These are litigious times; it's better to have
someone on your side in a court case.
Reason 5: You need someone else to talk
with patients about money. Talking about money with a patient
interferes with the doctor/patient relationship. Hand the
patient over to your front desk or billing person at the
end of the visit, and let the money conversation happen
out there. Beside the fact that this staff person is trained
in billing and collections, it's much less personal than
having you directly confront a patient or beg to be paid.
Reason 4: Having an employee in your office
makes you look more professional and successful. When someone
calls and the phone goes to answering machine because you
are with a patient, it makes people wonder if you are in
the office...or are you even open? When people are in pain,
they want an immediate response. Even if you get back to
the caller within a few minutes, it sets up a doubt in the
If someone walks into your office and there is no one at the front desk, a similar question comes to mind: Is there anyone here?
First impressions are so important, and it only takes a minute to form a doubt in someone's mind that it might take many years (if ever) to dispel. Don't sacrifice your professional image trying to save a few dollars by not hiring someone as soon as you open.
Reason 3: More people = More gets done.
You can't do everything. You need someone to do all those
little things you don't have time for each day. For example,
you need to call patients to remind them of their visit;
reminders increase compliance. You need someone to send
out birthday cards. For marketing activities, you need someone
to handle all the details. For example, if you want to run
a Grand Opening, you need help with the publicity, food,
prizes, whatever you decide to include. The day of the event,
you should be free to talk with people and not worry about
having to answer the phone or deal with spilled drinks.
The saying "many hands make light work" is true in an office.
Reason 2: Patients need someone else to
talk to. During a typical office visit, patients see the
staff more than they see you. They see you as the professional,
and they may be reluctant to tell you things they might
tell a staff member. This is particularly true with members
of the opposite sex. Of course, a good staff person keeps
things confidential, but there may be things said that need
to be passed on to you. Having another person in the office
provides patients with another ear for things they need
Reason 1: You must focus on what you do
best. This is the most important reason for hiring a staff
person immediately. You must spend your time doing two things:
patient care and personal marketing. Any time you must spend
not doing those two things is time lost. How much could
you make if you see your maximum number of patients per
hour? Let's say you could gross $250 an hour on a good day
(before expenses). Why would you do $15 an hour work answering
phones and booking appointments when you could make $250
an hour treating patients?
To re-emphasize this important point: Any time you must take from your two essential activities of patient care and personal marketing is time lost, and time lost is money lost. It's about working smarter by finding a great employee who can help you get started faster and who can maximize your practice growth.
Here are some suggestions to get you thinking about how to use staff effectively.
How to Maximize Your Employee's Time and Minimize
1. Don't try to save money by getting an unskilled
person in to "help out." This strategy is not going
to help; you'll spend more time dealing with issues created
by an unskilled person than you will gain by having someone
answer the phone. This means family and friends, too.
2. Get an answering service. Find a local
service that will personally answer your calls when you
are in the office and can't get to the phone or when your
staff person isn't available. You will need an answering
service for evenings and weekends anyway. Give the answering
service a script and keep in touch with them so you can
respond quickly to patients, or train them how to make appointments.
3. Hire a skilled part-time person who is experienced
in healthcare practices. You don't need to hire
a full-time 40-hour-a-week person right from the start,
because you probably won't be seeing patients that many
hours a week. Pay an excellent hourly rate and make sure
the person has experience in front desk work, appointments
and billing. Oh yes, and a pleasant personality is also
a must-have asset.
4. Cluster Book. Set specific hours each
day and specific days each week when you see patients. When
someone calls for an appointment, give them some alternatives,
but control the conversation so you can have a steady stream
of patients. This is also a good reason to get a skilled
front desk person who knows how to maximize your time with
5. Set clear expectations. Most problems
with employees result from unclear communications. Before
you hire that staff person, write up a job description and
include all the duties you expect this person to perform.
Most important, tell the person what to do during non-busy
times. For example, if there is a day when few patients
are scheduled, what can the employee do at the front desk
to stay busy and advance your practice? This might be the
time to make reminder calls or do recalls of no-shows, or
to work on marketing activities.
6. Include scripts in your list of expectations.
Don't be afraid to tell the employee exactly what you want
said and when you want it said. For example, at the end
of every visit, you might want the front desk person to
say, "The cost of your visit is $67.00, Mr. Jones. Would
you like to use your debit card to pay, or will you be writing
7. Consider hiring a temporary employee.
You might want to start out by calling a local temp agency
to see if they have someone to help you during the first
few months. Sure, a temp employee will cost you more per
hour, but consider the benefits (above). If the person works
out, you may have found a great employee. If not, you can
simply say, "Get me someone else."
8. Consider "ad hoc" help. For marketing
or special events, you might find someone to do a specific
project for a short time. Set the fee for the project in
advance, to make the total cost reasonable for both parties.
Finding and using a great staff person can be a tremendous benefit to your startup healthcare practice. I hope this article has convinced you to staff your office from Day One.
Copyright 2007-2008 Jean Wilson Murray, MBA, PhD.
Dr. Jean Murray has been advising small business
owners since 1974. As the founder of Planning for Practice
Success, she specializes in assisting health care professionals
with business plan construction and startup details. She can
help you gain the knowledge to act and the confidence to begin.
Learn more at http://www.professionalpracticesuccess.com
Published - November 2008
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