To be considered a “young ophthalmologist,” youth is a necessity, but a job is not. Having a practice certainly helps pay the bills, though. To this point, most of the emphasis of this column has been on job acquisition. Before too long, however, you may be in a position to look for another young ophthalmologist to join your growing practice. Here are a few things to consider when you contemplate bringing on an associate or future partner.
Before we go any further, it is worth briefly pondering the question: When is your practice ready for another doctor? At the risk of oversimplification, you are ready for another doctor when an existing physician is routinely booking out more than 2 weeks (in a well-run practice) and exceeding the weekly revenue. Another way to look at it is your backlog of appointments is future revenue that could be coming in now.
While on the flip side, I should also acknowledge the surprisingly high cost of hiring and firing people who work with us. Unfortunately, training programs offer little in the way of managerial or organizational training, which has become an integral part of the medicine that we practice. As a result, we are ill-equipped to handle the administrative and legal aspects of a new hire.
You should also familiarize yourself with the goals of your associate pool. According to Dan Schawbel’s book Promote Yourself, The New Rules for Career Success, “the Millennial generation is perceived to have unrealistic expectations for salary/compensation, a poor work ethic, and are easily distracted.” In case you missed that: Today’s young ophthalmologist is lazy, greedy, and selﬁsh. Oh yeah, fringe beneﬁts are also important. Millennials want to work for a company that’s in tune with nurturing employee happiness.
So, if all of this describes your practice environment, then you are ready for a new hire.
With that said, let it be known recruiting a new doctor, whether it be an ophthalmologist or an optometrist, and getting him or her up to full speed, takes time, is costly (head-hunters/placement agencies, signing bonuses, moving expenses, continuing education, licensure, etc.), and there is a loss of productivity at the outset.
Employee retention is a key issue that underscores the importance of hiring carefully and properly. Thankfully, with the help of the Internet and social media, there is a plethora of ideas on what makes a suitable staff member that you can quickly learn about with minimal sweat equity. No doubt, in the world of practice development there is a singular message: You can pretty much train a doctor to do almost anything, but you can’t change his or her personality, character, or attitude. The core of your decision should be to hire someone with whom you get along, and he or she better have good patient skills.
I value maturity, reliability, and natural cheerfulness as three key elements when considering an associate. Everyone wants an employee who does good work, but this includes teamwork as well as patient-related services. Someone who is competent and shows up for work is different from someone who shows up to work competently. In most practices, the physician is the quarterback and therefore in a position to set the tone for the rest of the practice. His or her demeanor and composure when the going gets tough will be important.
Invariably, we as ophthalmologists are under time and economic pressure, in addition to the considerable responsibility for our patients’ well being. Despite the fact that ophthalmology is considered a sophisticate’s subspecialty, many of us are working on less than adequate amounts of sleep, sacrificing our health, having difficulty achieving spiritual enlightenment. Aside from all that being counterproductive and unhealthy, it costs us money—a lot of money—in team inefficiency and preventable turnover. Unfortunately, we have no training on which to fall back in these areas. All of us have been trained to do PRP, but not personnel PR and practice HR.
Times have changed, and with the ever-looming threat of shrinking reimbursement, increasing oversight, and demands for long hours and income uncertainty, many excellent doctors are not looking to own their business. However, there are still a few good apples out there. Not all of the Millennials are waiting for the PlayStation 4 release and validating their existence by running to Wimp.com. My point here is that if you hire and partner well, you will be able to minimize the (expensive) need to fire. It’s your business, your reputation, and your nickel.
When the time comes, I recommend developing an employee partnership agreement that clearly spells out the details, which include the usual terms outlining duties, hours, salary, benefits, restrictive covenants, and how either party can terminate the relationship. Part of being a good employer/partner is providing an office culture that respects the team. Standardization of office policies is a wonderful place to start in preparation for a new associate and potential future partner. Create an environment capable of “plug and play.” Make it easy.
Discuss practice procedures in detail, but allow and be prepared for difference in practice style. Millennials aren’t going to stick around if the environment isn’t right, and these folks tend to leave their post twice as quickly compared to the national average. That doesn’t mean you replace the exam chair with a bean bag chair, but you might want to consider an iKettle. So appeal to the sense of self-value and their smoldering desire to contribute; personal engagement and connectivity is at the heart of the matter.