Staffing: Your greatest asset, Your Greatest Challenge (Part 1 of 2)

One of the most challenging aspects of practice for many clinicians is staff management. Why do some offices have contented, long-term team members, while others seem to have a permanent ad in the newspaper continually attempting to fill open positions? In this two-part series, we will examine three things that affect team satisfaction and longevity.

It's five o'clock on Thursday afternoon. You have just completed another tough week of drill and fill, and you are looking forward to having a long weekend to spend time with your family and relax. Just as you are preparing to leave, one of your team members appears in your doorway.

"Doctor, could I speak with you just a moment?"

Uh oh! This feels like trouble. This better not be a request for a raise! You notice that the team member is visibly nervous and appears on the verge of tears.

"I'm here to give you my resignation. I will stay for two more weeks to give you time to find a replacement. I've ... accepted a position in another office."

By this time, you feel a knot tightening in your stomach. In fact, you feel as though you've just been punched in the gut. You finally stammer, "But why do you want to leave? I wasn't aware there was a problem!"

"It's not you, Doctor, but lots of things that have been building up. Please don't take this personally. I feel I need a change ..." And your team member turns and leaves quickly.

So much for a great weekend! What happened? Why didn't you realize that this valuable team member was unhappy? Were there subtle clues along the way that you should have been sensitive to, things that would have alerted you that something unpleasant was brewing?

If you are like most doctors, you desire to have a loyal, dedicated group of team members who wouldn't think of leaving you for another job. The good news is, you can! But what does it take?

Finding the right people

From the outset, it is important to find the person who best matches the position. Here are some good sources of potential team members:

1. Your own patient base. Sometimes patients are in the job market and will ask if you have any openings in your office. Consider it a compliment when a patient likes you enough to want to work with you. If there are no openings at that time, encourage the patient to give you a resume to keep on file for future opportunities.
2. Referrals from other staff members. When openings occur, ask your current team members if they know of potential candidates who might be interested in the job.
3. Resumes on file. Keep a file of the resumes you receive from people who stop by your office.
4. Waitresses.
5. Bank tellers.
6. Local job/temporary agency.
7. Local high school.
8. Newspaper ads.
9. Local community college.

Newspaper ads that work

If you decide to run a newspaper ad, place one that will attract the kind of person you wish to hire. The following ads spell out some of the qualities you may desire in a new team member.

Dental chairside assistant — Our family dental practice needs one enthusiastic, experienced, and caring dental assistant to complete our dental team. If you are dependable, personally stable, and X-ray certified, call 123-4567, between 10 a.m. and 12 p.m.

Front desk assistant/financial coordinator — Our exceptional dental practice is looking for a person who has excellent communication skills in person and over the telephone. If you are enthusiastic, caring, dependable, and have experience with computer scheduling, insurance, and collections, please send a resume and cover letter in your own handwriting to P.O. Box XXX, c/o this paper, or fax to 123-4567.

Dental hygienist — Our patient-centered practice is seeking a caring, dependable, and enthusiastic hygienist. If you possess these qualities, call 123-4567 between 10 a.m. and 12 p.m. only.

Dental hygienist — We are seeking a caring, competent dental hygienist. If you would enjoy working in a practice that focuses on high-quality patient care, please fax your resume to 123-4567. Complete confidentiality guaranteed.

Administrative assistant — Our dental practice is seeking a self-starter with organizational and communication skills to manage patient and business activities. Prior dental experience not required. Professional training will be provided. 36-hour week. Fax resume to 123-4567.

Please be certain your ad is worded correctly and has the correct phone number. By having the applicant fax a resume, you have time to review it before the interview. Do not neglect to check references. You might be surprised at what you can learn about an applicant.

The best time to run ads is usually Friday, Saturday, and Sunday. Ads are generally placed in alphabetical order, so "Dental hygienist" would come before "Hygienist."

Employment testing

Many different tests are available for applicant testing. However, there are four basic types: integrity tests, values evaluations, behavioral-style evaluations, and job skills tests.

→ Integrity tests — These tests query applicants about their attitudes regarding theft, uncover admissions of employee theft, and explore other work-related wrongdoings. Integrity tests focus on what impacts the behavior of theft, substance abuse, and response to authority. There is disagreement over whether these tests truly assess an individual's propensity to theft. However, some employers attest to their validity and helpfulness in assessing candidates.

A good book for all employers to read is "Employment, Embezzlement, and Fraud in the Dental Office," by Donald P. Lewis, DDS, available from JdSG International, P.O. Box 35640, Monte Sereno, CA 95030-0640, (800) 366-7004.

→ Values tests — These tests measure the individual's drive to move forward or, more specifically, what makes the person "tick."

→ Behavioral-style tests — These tests help determine if the candidate possesses certain behavioral characteristics that suit him/her to a certain job. For example, if an individual has a natural tendency to become abrupt or harsh, this candidate would not be a good choice for the front desk. One of these tests can be found online at www.kiersey.com.

→ Job skills testing — These tests measure an applicant's ability to perform certain tasks. There are tests available to measure fine motor ability, deductive reasoning (which is needed at the front desk), computer skills, organization, etc. Many testing companies provide packaged tests that are inexpensive and easy to administer. However, before using any test, make sure the test is job-related and reasonable.

Even though pre-employment testing can be valuable in providing you with excellent insight and a great deal of information, tests alone should never be the sole determination in a hiring decision.

A good source of employee-testing materials is Wonderlic Personnel Tests, Inc. (800) 323-3742, or contact Mark Bussone at (877) 607-7747.

Checking references

The number one trait that is predictive of whether an employee will be a good employee is work ethic. A job candidate's past performance is the best indication of his or her future performance. Surprisingly, studies show that doctors check references for only 10 to 20 percent of the people they hire.

The applicant should provide at least three references. These may be former employers, peers at previous positions, fellow members of professional associations, or former teachers or professors. Rarely would a family member be a suitable reference.

When checking references, talk to those who best know the job performance of the individual, such as the doctor or office manager. Instead of using the word "reference," say, "Mary Smith is being considered for a position in our office. She suggested I contact you to verify a few facts about her background. Can I ask a few questions?"

If you encounter resistance from references about providing information, it could be that the former employer is fearful of being sued by the candidate for defamation of character. Generally, when performance is good, there is no problem getting someone to share information. If no one will speak for the candidate, this is a red flag. The most critical question to ask is, "Given the opportunity, would you hire this person again?"

Smart interviewing

Smart hiring starts with smart interviewing. When interviewing prospective candidates, there are certain questions that can help you evaluate whether or not a person may be a good employment choice. Of course, asking open-ended questions encourages conversation.

You should be aware of certain legal considerations related to interviewing. Guidelines of the U.S. Department of Labor and the Equal Employment Opportunity Commission prohibit discriminatory hiring based on race, creed, color, sex, national origin, handicap, or age. Some states also include weight, height, and physical appearance.

Informing applicants not chosen

After you have completed your interviews and made your hiring decision, send a rejection letter to the other applicants. Here is a sample:

Dear _____________,
Thank you so much for your interest in our practice. While you certainly will be an asset to a future employer, I have chosen an applicant whose qualifications more closely match the position we have available. However, I would like to keep your resume on file for future consideration.
I wish you success in finding a position where your skills can be used to their greatest potential.
Sincerely,

Part 2 of this article will focus on creating the right environment for a new team member.

Dianne Glasscoe, RDH
Ms. Glasscoe is a national author, speaker, and consultant to dental professionals. Her company, Professional Dental Management, is based in Frederick, Md. Visit her Web site at www.professionaldental mgmt.com, send email to [email protected], or call (301) 874-5240.

During an Interview ...

Questions To Ask

• What was your absentee record at your prior place of employment?
• Do you know of any reason (for example, transportation or any other reason) why you would not be able to get to work on time and on a regular basis?
• Are you available to work overtime?
• We are looking for employees with a commitment to this position. Are there any reasons why you might not stay with us?
• What are your career objectives?
• Have you worked in a situation where there was conflict? Tell me what you learned from the experience.
• Where do you see yourself in five years?
• What did you like best about your last position?
• What did you like least?
• Why did you leave your last position?
• In your last position, what was your most significant accomplishment?
• What is one of your most significant personal accomplishments?
• What subjects did you like best in school? Why?
• What subjects did you like least? Why?
• Why do you want to work in dentistry?
• Given an opportunity, what changes would you make in your former practice?
• How do you feel about asking people to pay their past-due account?
• Occasionally, we have an out-of-town weekend seminar that our staff is asked to attend. How would you feel about this?

Questions NOT To Ask

• Where were you born?
• Where and when did you graduate from high school?
• Do you have any handicaps?
• What religious holidays do you practice?
• Are you married?
• Do you plan to have children? How many?
• Do you own a home?
• Do you own a car?
• Do you have any debts?
• Can you provide three credit references?
• Is your spouse likely to be transferred?
• Is your spouse from this area?
• How old are you?
• How do you feel about working with members of a different race?
• What language(s) do your parents speak?

Interviewing Tips

1. Don't talk too much. A good rule of thumb is to let the candidate talk 80 percent of the time.
2. Give short, noncommittal responses. Don't be elaborate in response to the candidate's questions.
3. Limit interruptions. Schedule uninterrupted time for interviews where you do not accept telephone calls or leave the meeting.
4. Take notes while the candidate is talking. This helps you stay focused and provides material for follow-up questions.
5. Listen carefully to responses. Don't think ahead to the next question; listen all the way to the end.
6. Don't rush questions. Pause after the response to ensure the candidate has finished.

(Used with permission from Smart Staffing, Wayne Outlaw, Upstart Publishing Co., 1998)