6 Ways to Maximize Startup Success: Hire an Employee from Day One
6 Ways to Maximize Startup Success: Hire an Employee from Day One
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
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
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 to
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 Employee
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
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 a check?"
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.
About the Author:
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
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