How Do You Best Motivate Employees?

iStock_000004504118XSmall-423x281Despite our efforts to recognize staff members for their outstanding work, the feedback we often get is that employees don’t feel appreciated enough. In other words, we appreciate our practice’s team members, but they don’t feel we recognize their work enough.

Apparently, this is not something unique to our practice. I’ve read research that shows that most employee leave a company because they don’t feel their bosses appreciate their hard work, commitment or dedication.

Research has also shown that when employees leave a job, many times it isn’t the money. Workers reveal that raises and promotions are great, of course, but what they would really like, is to feel valued. And not feeling valued enough is what led them to leave the jobs.

At the bookstore the other day, I came across a book titled The 5 Languages of Appreciation in the Workplace by Gary Chapman and Paul White. If you ever have attended a marriage seminar, you may have heard of Gary Chapman before. He is the author of the popular book The 5 Love Languages.

The title intrigued me so I bought the book.

The authors of the book discuss that in the work place, people have different ways in which they feel appreciated. Some employees like it when their boss acknowledges them publicly for a job well done, while others would prefer a gesture of recognition done privately.

Others feel appreciated when co-workers or managers step in to ease the burden of their work load, while others feel special when they are able to spend time with their bosses and be heard.

Another example the authors illustrate is the employee that is publicly recognize in front of the entire company time and time again for his outstanding work. During the recognition, his boss goes on and on about how great the employee is and that if it weren’t for him, the company would have failed in that area.

Sounds like a great way to show appreciation, right?

As it turns out the employee feels uncomfortable having the spot light shining on him and receiving public praise. His appreciation language is actually what the authors describe as “acts of service” which is when the person feels appreciated when others recognize the overwhelming amount of work he does and offers to help him out.

Understanding how each of your co-workers, team members, employees or partners are wired in terms of how they feel appreciated, is just one of the many ways that can help an organization increase the level of job satisfaction.

It also increases employee engagement by making staff feel truly valued. Not to mention that it reduces cynicism which creates a positive work and productive working environment.

I would encourage you to pick up the book. It was a very easy read and I’ve even started implementing some of the things I learned with great results. The book even offers a questionnaire for employees so that you can find out what is each employee’s appreciation language.

To learn more about this book, check out the link below:

#12 How Do You Know When To Hire Your Next Physician? [Pediatric Practice Management MediaCast]

Recently, Chip and I saw a question posted on the SOAPM listserve that addressed this notion of when is it the right time to bring on a physician. We thought it was a great discussion topic so we decided to dedicate an entire episode surrounding some of things one ought to consider when bringing on a new doc. To give you a heads up, below you’ll find part of the email that was submitted to the listserve.

I recently interviewed a potential MD candidate. She looks fine on paper and was nice enough in the interview. But how do you know if someone is going to be right for your practice? My practice is small so bringing in a bad apple would cause a huge problem. Plus, she is the only person I have interviewed. I would love to have more choices from which to select. How does everyone else go about recruiting? I can’t exactly run a want ad in the local paper…

…since I have never done this before nor have I ever been solicited by a practice for employment, how do I structure a new MD package? Salary vs production? Salary for a while and then production? At what point? And how much? What benefits? How specific do I outline work hours, call duties, etc? What happens if I can’t stand the person I hire after 3 months?

Finally, how do I even know if my practice is ready to bring in another MD? What numbers do you look at? Perhaps I should just get a scribe and bust my butt for the next 6-12 months to see if I can absorb the patient load myself without adding someone else right away?

We hope you enjoy this episode and remember, give us feedback.  Positive or negative. We don’t care (well, actually we do care). We’d love to hear from you.

Here are ways you can catch the episode. Enjoy!

Pediatric Practice Management MediaCast


Google+ PPMM Community Page

Hiring Stars: 8 Steps to Help You Through the Process


Not long ago, I was asked if I could provide some insight into hiring competent staff. I told the person that we were embarking on a similar journey to find top notch employees and the best that I could do, was share the steps that we’ve taken so far. Below is what I shared with the gentlemen that asked the question:

Define Improvements

Jot down, on a piece of paper, areas in your practice you need improvements. Don’t just say, I need administrative oversight, but rather, dig deeper in your assessment. For example, one area in my practice that needs improvement  is with follow-through. We have good ideas, but don’t have staff that picks up the vision, makes it their own, and sees it though.

Ponder… what is it that your practice needs exactly (ie. improve marketing, start an asthma clinic, improve budgeting, implement clinical work-flows, increase the number of patients, pay the bills on time, etc.).

In our practice, one of the things that didn’t meet our expectations, was the handling of chronically ill patients. Thus by determining areas of improvement, we decided we wanted someone that could help us manage chronic patients. For this role, we needed an experienced RN (or an exceptional MA, although that is less likely, but still an option if somebody were to show up) to take charge of a project like this.

Define Candidate

Next, sit down with a pen and paper and jot down what would your perfect candidate look like. That is, what skills should the person have, character, work ethic and of course experience.

I particularly put a lot of emphasis on the character and work ethic description. Some people have the gift of leadership, others have the gift of administration while others are very good soldiers (the kind that follow orders very well, but don’t always have initiative).

In our chronic care management position, we knew that any nurse would not fit the bill. So we wrote down what were the character traits the person needed to fill this position like a glove.

Remember, you may not get it all in one person, but that is why this exercise is of value. Because by jotting all “wants” you start to get a better picture of the person you are looking for.

Create a Job Description

Then, you are ready to create a job description that goes beyond the regular blah, blah, blah of the common job description.

For example, for our chronic care coordinator position, we wanted somebody that had implemented something similar on their own, from scratch and little direction or oversight. Why? Because we never have had a position like this before, so we don’t know exactly what needs to be done. At that point, we only had the vision for the position.

Therefore the person not only had to be experienced in chronic care coordination, but also demonstrate the ability to implement processes and find answers to questions that we may not have, go the extra mile as well as embrace the position with the understanding that we wanted somebody to implement a vision

Our job description was worded to address that the person needed to have certain qualities.

Interview Process (Cross interview)

After advertising the job description, you’ll begin the interview process. In this process, I interview the candidate first. If I think they are good enough, I have them interview with 2 or 3 of my top staff members. It doesn’t matter if not all the interviewers  work in the discipline the candidate works in. I’ll have a clinical RN interview a front desk position or vice-versa. The point of the exercise is for you to have a complete understanding of the candidate. An office manager may pick up different things from the interview than the MA will, for example.

By the way, I also wanted to share that doing the cross-interview process has also shed light on my employees’ ability to identify the better candidates. Some of them have surprised me with their knack to read candidates’ verbal and physical cues.

Meet with Providers

Then, I have the candidate interview with my providers. These are short interviews (20 minutes). If you have a lot of providers, this may not want to have them interview with all of them.

But having the candidate meet the provider and the provider meet the candidate is, I believe, an important part of the process. One additional piece that helps complete the puzzle.

Interview Questions

The interview process is more about finding character traits than anything else. Of course experience is important, but we want know what the person is made of. Not how well they can talk up their resume.

Thus, the questions we ask the candidate are two-fold. One, does the candidate have the skills for the job that we outlined. And second, does the candidate have the character traits we want.

Here are 100 potential questions to help you get started:

Personality Test

After the interview process is complete, and we are in agreement the candidate is a strong candidate, we have the candidate perform a personality assessment test. This helps us identify personal characteristics that would otherwise be hidden in an interview settings.

We use a personality assesment test called DiSC. You can find it by going here:

It is helpful if your entire staff has done the personality test because then you are able to identify where the candidate fits in. It also provides context. When I receive a candidates results, I see their placement and compare it to the rest of the employee’s results giving me a different kind of glimpse into the candidate’s personality.


Lastly, we have the candidate spend an entire day with the staff shadowing them. Naturally, if you are hiring an admin or manager, you are not going to have them sit with the triage nurse, but it would be beneficial for the candidate to sit with the front desk staff to see how they work, handle phone calls and treat patients among other things.

This phase also has several intentions. I’m looking for the type of questions the candiate is asking, how they are interacting with the staff and their demeanor (bored, interested, etc). This also gives an opportunity for the candidate to see the working conditions. It is one thing to say you like kids and it is an entirely different thing to work in a place where there are crying kids, temper tantrums, angry and frustrated parents all over.


This process takes a long time. And although you may have an urge to skip some steps because of the pressing need to fill the vacancy, I would encourage you to exercise extreme patience. I have to remind myself of this too. Especially when we are short staffed.

However, When we’ve rushed to place a warm body without doing the due diligence, we have regretted it almost every time.

The long process also test the patience of the candidate. Which can be very reveling as well.

Lastly, I’ll share that all my research in this regard has pointed me towards creating a comprehensive interviewing process that helps us identify who is truly the best candidate for the position. If you look at something like navy seal training, or anything that is high stakes, you’ll notice that they too have an arduous process. And the best companies are not exception to this.

Good luck

What is your hiring process like? What are some of the lessons you’ve learned over the years ? Does your hiring process rock solid or does it need improvements. Explain it what what ways.

#5: Company or Practice Culture [Practice Management VideoCast]

Chip and I finally got our act together and recorded another video cast. This time, we talk about company culture.

There is so much to say about company culture. Chip and I only focused on few items of course.

I mostly talked about what are some of the efforts I’ve been employing in an effort to not only strengthen our company culture, but also grow it.

I share some of the tools I used un order to accomplish this.

Chip shares some of the implications of having a less than stellar company culture. He also talks about how company culture comes from the top of the organization.

What does he mean by coming from the top? Well, you will have to see the video to find out.

The video is only 32:22 minutes.

Chip and I however, go on for longer than 32:00 minutes. So, for those of you that want to hear us give further insights, thoughts, or simply hear our discussion, we’ve made the entire hour long conversation available in podcast form.

You can search in iTunes for Pediatric Practice Management or you can go to which is where we host the podcast.


Resources referenced during the mediacast:  

DISC Assessments

Zappos and “Deliver Happiness”

The Netflix Employee Guide

Management By Baseball by Jeff Angus

The Advantage by Patrick Lencioni

Hiring 101: Finding and Keeping the Right People For Your Medical Practice

Written by guest post blogger, Jill Fahy

In preparing for a presentation on hiring strategies a few years back, healthcare consultant Tim Rushford gained some wisdom from the late Dr. Charles Houston – a Vermont physician and mountaineer who led the first American Karakoram expedition to K2.

And it was during the recent PCC Users’ Conference that Rushford, who also owns PedsOne Billing Service, relayed this information to pediatricians and practice managers as part of his class, “Finding and Keeping the Right People: Making a Great Practice.”

“When Dr. Houston was planning his expedition team, he was in a position to know who all the mountaineering hotshots were, but he chose people he could get along with,” Rushford told attendees. “He said he wanted a team with chemistry. Not the great people, the right people.”

And this strategy, employed by Dr. Houston in 1953, is similar to the message touted today by Jim Collins, a business consultant and author of the best-selling management book, “Good to Great …Why Some Companies Make the Leap and Others Don’t.” In it, Collins likens a company to a bus, advising that great companies will first get the right people on board, then decide where to drive it.

Hiring smart is the key to growth for any business, said Rushford. Employing the right people results in decreased turnover, improved performance and a growth in profits. Bringing in the best talent for the job also fosters innovation and creativity and serves to attract a flow of new applicants.

Hiring 101 – Dos and Don’ts

If your practice provides employment applications, said Rushford, use a standardized form. And when reviewing it, make sure to look for breaks in employment, check references and do background checks.

The ultimate goal of the interview, said Rushford, is to learn about the applicant’s character. Focus on what she “has done,” not what she “will do,” and challenge her; don’t permit any “I don’t know” answers.
Rushford offered up the following interview questions:

  • “Are you familiar with (the practice name)?”
  • “What do you think it takes to be a good (job title)?”
  • “If we called your previous supervisor, what would they say about you?”
  • “If you were offered the job today, would you accept it?”
  • “Finish this – “My personal motto is …”

Further screening techniques might include giving the candidate homework or a pre-interview test on the practice’s website. It may also be wise to talk about money and benefits up front, which helps weed out certain applicants early on in the process, Rushford said.

Eliminate Do-Overs

Let’s say you’ve completed the initial screening process and whittled down the number of eligible applicants. Remember that your office has likely already spent a lot of time and money on the hiring process, so it’s critical that your final choice is based on the best information.

Common Hiring No-Nos:

Taking people and information at face value – Don’t hire someone just because he says he is diligent and hard-working. Call his last employer and get the real scoop. Also, conduct a background check. The time you spend doing this could mean the difference between finding the right employee right off the bat and having to hire for the position all over again, Rushford said.
Keeping it loose and chatty – Remember, the person you’re interviewing could be the employee you end up working next to, so don’t spend your and the interviewee’s valuable time chatting about the weather. Ask the kinds of questions that will lead you to the best candidate.
Skills Over Attributes – This one speaks directly to what Dr. Houston, the mountaineer, and author Jim Collins said about finding the “right” people, not necessarily the ones that look perfect on paper. Rushford said 67 percent of the abilities deemed essential for successful performance were linked to emotional competencies. IQ isn’t always the best predictor of the best candidate for the job.

Finders Keepers

OK! Your practice has done its due diligence in searching for the right candidate. Now that you’ve made the hire and placed your new employee in right position, don’t rest on your laurels. The right people are hard to get and will always be in demand out there in the job market.
Make sure your practice has a “wow” factor, said Rushford. It could be that you’ve got a fantastic technological support team, or the friendliest front office for miles around, or perhaps you’re known for staff trainings that are second to none. Whatever the “wow” factor, it is often part of what attracts and keeps the applicant on staff for years to come.

Jill Fahy is a writer. She works for Physician Computer Company. To read more of Jill’s articles, click on this link

How To Take Care of Your Most Valuable Assets

Organizations often talk about how their employees are the company’s strongest assets. Which is absolutely true.

But very few actually take the time to ensure that their most valuable assets have what they need to perform their best. We believe they have what they need; we think they are comfortable; we assume they are happy, but how do we really know?

We have a small group in our office that has been with us for a long time and for the most part, I have always assumed I have a good understanding of how they feel about their jobs, their coworkers and the company in general.

But then I realized, I’ve always assumed. Never have I asked direct questions about  how they truly feel about me (as their leader, boss, or manager) or the medical practice.

So I decided to change that.

I drafted a series of questions to ask our employees. The questions were designed to  get a better understanding of their feelings about me as their manager, the office, their co-workers and the company in general. I also wanted to determine if our most valuable assets have what they need to continue being our most valuable assets.

And here is what I asked them to complete:

  1. What is most satisfying thing about your job?
  2. What is the least satisfying thing about your job?
  3. Do you receive enough training to do your job effectively?
  4. Do you receive adequate support to do your job?
  5. Are you satisfied with this company’s merit review process?
  6. Does this company help you to fulfill your career goals?
  7. What can we do to make your position better?
  8. If you could define our practice philosophy in one sentence, what would you say?
  9. How does the management do at treating you and others employees as their first customers?
  10. Has management been fair and consistent when dealings with employees? I not, explain why not.
  11. What could management do better to express loyalty to the staff and to gain loyalty from the staff?
  12. Do you feel you are adequately informed ahead of time about changes?
  13. Do you feel in control of your workload?
  14. Do you feel your bosses are open and honest in dealing with employees?
  15. Do you have a clear understanding of what is expected of you?
  16. Do you dread coming to work everyday? If so, why?
  17. Is the office environment between employees and physicians comfortable?
  18. Name 3 things your boss could do better to serve team members.

I asked the staff to answer the questions to the best of their abilities. I told them that the more they shared with us, the better. Not only will the responses give me an idea of areas where we can improve on, but it also is a way to gauge how satisfied they were with their job; which is crucial in helping us achieve our mission at the practice.

I could tell they were a little hesitant to fill it out the questionnaire. They wanted to know if it was anonymous and if their would be consequences if we didn’t like the answers.

I explained that it was not anonymous. Second, I told them that this was an opportunity to tell me what I could do better as their boss. And lastly, I told them that if they weren’t truthful, the exercise was worthless.

I did get very interesting responses. I’m still going over them, but some of the things that jumped out was how we/I reprimanded the staff. They don’t appreciate it when one of them screws up and all of them get reprimanded.

I’ll have to reassess this issues as it conflicts with my all for one, one for all management philosophy (if one fails, we all fail; if one succeeds, we all succeed).

They also pointed out that we/I did not do a good job of letting the staff know of changes within a reasonable time frame. So now, I know to announce things sooner rather than later.

I still need to go over them in detail, but overall, the feedback went well I think. I learned there are areas I need to work on and I also got to know my staff a little better.

Do you think this is a valuable exercise you could do in your practice?

Exit Interviews Before They Exit

Exit interviews are done when an employee is leaving the organization. The intent of the interview is for the employer to gather data for improving working conditions and retaining employees. Theoretically, I understand why one would want to do exit interview. But I don’t understand why one would wait until the employee is leaving to ask their opinion. Seems to me that at that point, it is too late.

Asking employees exit interview type questions while employees are working at your practice can also be a good tool to gather employees’ feedback on their work experience in and effort to improve working conditions and retain employees.

Examples of exit interview type questions that can help one get a sense of how employee perceive working at your practice. For example:

What is most satisfying about your job?

What is the least satisfying thing about your job?

Do you receive enough training to do your job effectively?

Do you receive adequate support to do your job?

Are you satisfied with this company’s merit review process?

Does this company help you to fulfill your career goals?

Performing exit interview type question to employees on a regular bases gives employers an opportunity to learn the same things one would learn from a traditional exit interview process but only this time, the employees has not left yet. Consequently, as a manager or employer, one is able to address issues with the employees as well as learn ways one can improve the working environment.

The process is actually quite simple. Just jot down those 6 questions above and either print them up for the staff to respond or send them an email. I’ll bet you will gain really good insight.