Top Challenges Number 10: Hiring quality clinical staff

It has never been such a challenging time to be a physician. Every physician, whether they own their own practice or are employed by a hospital or larger health system, must navigate a host of obstacles each and every day: Payment hassles, staffing issues, patient communication obstacles, technology burdens, long hours and burnout, and much more. 

Each December, Medical Economics presents its list of the top challenges facing physicians going into the next year. This year we focused not only on the challenges, but also practical tips physicians can start using right away to make practicing easier.

Challenge 10: Hiring quality clinical staff

Physician practices need non-physician clinical staff to grow their practices, implement team-based care, and achieve success with quality metrics.

But it’s often extremely difficult for practices to find talented clinical staff that are not hired first by larger practices health systems. Experts say it’s often difficult to compete on pay and benefits.

“At a small practice, there’s only so much money that can be spent on compensation, so they have to consider the types of the benefits they can offer, like flexibility and work-life balance. Those are big perks that money can’t buy,” says Jillian Schneider, MHA, manager of practice support at the American College of Physicians.

It’s also important to make sure your clinical staff have a chance to grow professionally.

“Not all employees are interested in doing the same job forever; many people are aiming to progress,” says Laurie Morgan, MBA, a practice management consultant and partner at the practice management consulting firm Capko & Morgan. “Enabling employees to pursue more education conveys that your practice is investing in your staff.”

Adding clinical staff can relieve physician burdens and help alleviate feelings of burnout. Medical assistants (MAs) can be among the most cost-effective additions to practices’ staff because of their lower pay relative to nurses or physician assistants. Ideally, a practice would aim for two MAs for each physician, says Marie Brown, MD, MACP, an internist at Rush University Medical Center in Chicago.

According to the Bureau of Labor Statistics, the median wage for a medical assistant in 2018 was about $16 per hour, or $33,610 per year. There were more than 634,000 MAs employed in 2016, with job growth expected to increase by 29 percent over the next decade.

Practices looking to hire MAs should consider each candidate’s education and certification, as well as past medical and administrative work experience. Getting a good read on a prospective hire’s interpersonal skills are key to understanding how the candidate would support the daily objectives of patient care. Brown suggests, for instance, that MAs should be comfortable enough to ask questions when they need more information.

Emerging roles for MAs include:

• Prevention outreach specialist or panel manager-identifies patients with care gaps and communicates with them to encourage adherence to recommended care plans;

• Patient navigator or patient advocate-acts as a liaison between the patient and the healthcare system in an effort to reduce barriers to care;

• Clinician-qualified to deliver certain services under Medicare’s Chronic Care Management and Transitional Care Management programs.

Tips for hiring clinical staff

Target the talent.

To attract physicians, independent practices should search for candidates who come from rural areas and are therefore likely familiar with life in those areas, the sense of community they often have and perhaps even how healthcare practices in those areas operate. Practices should use professional networks, medical schools or physician associations to identify clinicians who fit that profile.

Train future doctors.

Independent practices also should work with medical schools or regional medical associates to attract potential candidates. Reach out and offer the opportunity for students to learn about small-practice medicine, rural medicine, and form a program that exposes them to this environment.

Budget for competitive compensation.

An attractive compensation package includes a competitive salary and standard benefits, such as health and dental insurance as well as paid time off for vacations, sick days, and bereavement. Small and independent practices don’t often have the money to fund a new position as soon as they recognize the need for more staff, so plan strategically to start budgeting for new positions a year or two in advance of recruiting and hiring. 

Think outside the box.

While salary is important, small practices can also attract and retain staff by structuring compensation to reward hard work or finding other ways to boost the total compensation package. Consider creating bonuses for clinicians who meet productivity goals, or establish an employee profit-sharing program.

Offer growth opportunities.

Practices should determine ways for their physicians, non-physician providers, and support staffers to grow professionally. Enabling employees to pursue more education conveys that your practice is investing in the staff, and can save the practice money in the long run. The cost of the training plus a raise and promotion for the employee could be less than the salary you’d wind up paying an external hire. Don’t forget to use professional development opportunities as a recruitment tool.

Formalize it.

Although management consultants say small and independent practices should use individualized employment packages as a way to recruit and retain top talent, they advise practice owners to have policies and procedures in place to establish available benefits so that even if employment packages are individualized, they won’t seem capricious. Practice owners who want to recruit and retain skilled professionals need to focus on being good employers-not just good healthcare providers.