Over the years, I have had the pleasure of working closely with a number of refractive practices. It's always a privilege to get a look inside the practice and learn what issues are hindering its success. Beyond the numbers and behind the programs are the people—whether called staff, employees, or team members—upon whom the surgeon and administrator count to get the work done day in and day out. Without question, staffing the organization is the number one issue in virtually every refractive surgery practice I've come across. In this column, I'll examine four critical elements of staffing.

With the baseball season upon us, indulge me as I sprinkle this column with analogies from America's favorite pastime.
BATTING PRACTICE: THE HEARTACHE OF HIRING
Strategies for Finding the Right Person

Simply stated, hire well. Finding employees who can hit the ball is a complicated process. Of all the employee-related concerns, I find hiring to be more art than science, because luck indeed plays a role in finding good people. I've observed complex interviewing processes involving outside hiring firms that, in retrospect, were not much more successful than a coin toss. I have conducted numerous interviews myself and find my predictive batting average to be less than desired.

It's extremely difficult to predict how well a person might perform as an employee from a sheet of paper and a 20-minute discussion. It's much easier to meet the person, find him likeable, and then offer him a job. But a new hire can be very costly, not just in terms of lost performance, but also the potential ripple effect on the morale of the entire team. Like the Four Seasons hotel chain, you should hire for attitude. Attitude is the one skill you cannot teach. Furthermore, the right attitude can often best be found outside the traditional sources of potential employees. Look beyond those who have “ophthalmic” attached to their resumes and you will find people from other industries (for example, airlines) who have well-developed personal and organizational skills.

I also favor allowing current staff members to participate in the interview and hiring process. It gets them more involved in the organization and gives them a say in who joins their team. Such shared responsibility boosts teamwork and morale. It also sends a strong message that you want your employees' help in developing your own all-star team.

One way to test the fit of an interviewee is the occupational tryout or minicamp. Invite a strong candidate to spend a few days working in your practice and pay him for his time. This investment on both his part and yours will tell more than the first impressions gathered in an interview. Don't forget to ask all of the staff members who will work with him what they thought of the new person.

SINGLES, DOUBLES, AND TRIPLES
Training and Job Descriptions

Hiring well is the first step in building an all-star team. Simply finding good people isn't enough, however. They need to be trained, and that training process must be formalized. I fear that most new employees get placed next to a current staff member who is then told to teach the new one the ropes. This approach doesn't suffice in today's fast-moving workplace. Formalized training programs should be developed for each position. These programs should list goals for the first 30, 60, and 90 days of employment by which the new employee may measure his success. The key to developing a training program is to create formalized job descriptions for each position. Such descriptions are lacking in even the best practices I encounter. I'm not sure why, except that everyone is too busy to put them together. Far from bureaucratic, job descriptions can be simple, 1-page “living documents” that help define each person's responsibilities. They give team members accountability and enable management (ie, the doctor and/or the administrator) to ensure that the workload is balanced across the team.

Even if you aren't a baseball fan, you can't help but notice how the game uses statistics to measure every aspect of pitching, batting, and fielding, with the goal of improving those averages over time. As a refractive surgery provider, how well are you measuring the performance of your team? Are you able to create performance standards that are objective and measurable, or are you left with offering only your subjective impressions (which can be biased and misleading)? Adequately measuring how well employees perform should be a combination of task completion (ie, did they perform to their job description?) and an assessment of the quality of their performance. Judging the latter can be accomplished by surveying customers as well as fellow employees. These data points allow every employee to work on his batting average.

SIGNALS FROM THE DUGOUT
Practicing Good Communication

Poor communication is responsible for so many of the foul balls your players hit. As a leader, have you clearly defined and relayed your expectations for conduct in the practice? Do you follow these values yourself? Once again, these seemingly simple tactics often get left behind in the wake of a busy day. The best means of communication I know of is the regularly held staff meeting. It need not be every week, but once per month is often too infrequent to successfully reinforce the practice's goals and priorities. A great meeting occurs when everyone attending knows what to expect and what is expected of him. It is a great opportunity for your staff to raise issues and for you to acknowledge great contributions and announce upcoming events. It's the one forum where everyone, regardless of title or tenure, should be encouraged to speak up. This habit, once developed, becomes another essential means of enhancing employees' performance and morale when it comes to communicating key news in your practice.

CELEBRATE THE VICTORIES
Acknowledging Performance

Perhaps you don't need to spray each other with champagne as some teams do after a victory, but you should celebrate your staff members' successes within the practice. Recognition can range from a small gesture of appreciation for work that goes above and beyond the call of duty to shutting down the practice for a day and taking a trip somewhere. I think most employees tire of the annual holiday party or monthly birthday cake. Put some pizzazz in these events (or let the person on your team who enjoys doing this type of thing have the opportunity to show his stuff!). An element of surprise is what can keep these celebrations fresh, meaningful, and impressive over the long term.

IT'S A LONG SEASON

Your practice has no off-season. Every day, you have a game to play. The baseball team's manager can't win games by himself, and neither can you. Surgery requires a team effort, and it takes your leadership in hiring, training, communicating with your employees, and rewarding them consistently to play the game well … day in and day out.

Shareef Mahdavi draws on 20 years of medical device marketing experience to help companies and providers become more effective and creative in their marketing and sales efforts. Mr. Mahdavi welcomes comments at (925) 425-9963 or shareef@sm2consulting.com. Archives of his monthly column may be found at www.crstoday.com.

For a downloadable pdf of this article, including Tables and Figures, click here.