Job descriptions form the foundation of the practice staffing structure and provide concise organization of duties and responsibilities within the practice. Position descriptions also form the basis for a rational evaluation of staff performance. This chapter has been designed to explain the essential elements for writing effective job descriptions and how to use the descriptions as part of the employee performance evaluation process. Instruction regarding methods for employee review and the performance review process are also provided in this chapter.

A successful employee selection process is a key component in ensuring an efficient and productive practice operation. This module is designed to provide the information needed for making an informed hiring decision. A stepwise approach is presented to illustrate the comprehensive process required for successful recruitment.

At some point, almost every practice confronts the need to add a new associate. In some cases, additions are prompted by the need to increase capacity to match patient demand. In other cases, recruitment occurs in anticipation of a current physician’s slow-down or retirement. In any event, successful, long-term placement does not occur by accident; a number of critical factors must be handled to ensure the highest probability of success.

Proper training is intrinsically linked to practice success as it increases staff efficiency, boosts employee confidence, and results in a higher level of care for patients. Equally important is the fact that effective training reduces staff turnover. While training new employees is one of the most important responsibilities of an administrator, management of ongoing training programs for existing staff is also vital. For instance, staff members may require additional training to excel at their current position, while others may need training to transfer to a different position.

A well-documented counseling plan is one of the most important human resources processes a practice can have today. A counseling or performance-improvement plan can give the staff, the managers, the physicians, and outside labor auditors both structure and clear expectations. When goals are established, the practice is better equipped to help employees understand expectations and how to improve performance. Counseling programs give managers a clear path to follow and also can help the employees and managers know if someone is not a correct fit for the team. When an employee does leave the practice, proper documentation of the counseling process can help protect the practice from future unemployment claims, Equal Employment Opportunity Commission investigations, or possible litigation.

This chapter identifies the steps required to develop a compensation system that will attract and retain a quality staff. A poorly planned staff compensation system can cause turnover, and staff turnover has hidden expenses beyond the upfront and obvious recruitment costs. Quality of service and staff productivity both suffer when practices are not fully staffed or constantly have to hire and train new staff. A practice that takes the time to perform market and internal research, forms a meaningful compensation philosophy, develops a written wage and benefit policy, and reviews the program annually will benefit through lower staff turnover, greater work accuracy, and reduced overall costs. This effort necessarily will include conversations with the practice’s accountant, attorney, health insurance agent/broker, and benefits administrator to ensure the compensation program meets the needs of the practice and the staff. The process listed below outlines the steps a management team can follow to build a comprehensive compensation program.

From the moment a practice hires its first employee, it establishes a compensation philosophy. Unfortunately, this philosophy is too often created by happenstance and receives little review or clarification. Before a practice incorporates any type of incentive program, it should take the time to review its philosophy regarding staff compensation and determine whether or not an incentive program will produce the expected results and enable the practice to achieve its goals.

Today’s medical practices face continued challenges in providing excellent service in an environment of decreasing reimbursements, increasing expenses, and rapidly expanding technology. With ever-increasing expectations for efficient and excellent service, the pressure to succeed is not only on physicians but also extends to all employees. As practices look to the future, physicians and practice leadership must: develop processes that enable staff to work together cohesively; provide opportunities for improvement; increase education; foster a stable working environment; and boost productivity.

This chapter is designed to help practice administrators and managers learn how to prevent and reduce workplace conflicts, identify common mistakes made during conflicts, understand and be able to use specific communication techniques that will help resolve conflicts by reaching common ground within the team, and know how to coach others to resolve their own conflicts.