For Healthcare Professionals Only
Like so many aspects of your medical practice, personnel management and human resources (HR) are just a few activities that you surely didn't spend years in medical training to do — and you may just be happier avoiding them altogether.
While it may be scary to some, there's no avoiding the fact that it takes well-trained and motivated people to help you deliver top-notch medical care and process the mountains of paperwork required for reimbursement.
Here are suggestions for a stay-involved approach for physicians whose responsibilities include management and oversight of employees.
To get started, suggests David Holloway, MD, senior vice president and chief quality officer of Parkview Health Systems in Fort Wayne, Indiana, locate current survey reports such as those published by the Medical Group Management Association (MGMA) that describe the median staff salaries and benefits for your specialty, group size, or group ownership structure.
Setting pay ranges for clinical and administrative staff positions is the next step. The ranges are typically based on what is paid for similar positions in the local market. Regional information is available from sources such as the Staff Salary Survey published annually by The Health Care Group consulting firm (www.health-caregroup.com). You can also get an idea of what various positions earn from the U.S. Bureau of Labor Statistics (www.bls.gov), as well as from your state medical society, national organizations for the various professions working in your office, and local hospitals. Another simple and easy way to judge the local market is to check the local newspaper's classified advertisements for healthcare jobs.
For example, a goal to provide each physician with 2 clinical support staff instead of 3 may require a practice to rethink how it deploys other staff in tasks such as rooming patients and taking medical histories, and in other tasks related to the patient's visit.
"The physician owner is the one who's going to be liable if harassment or discrimination occur, so they and their staff need to be educated on these issues," says Jennifer Moore, an Atlanta-based attorney specializing in labor and employment law for the international law firm Jones Day.
When it comes time to interview job applicants, keep in mind that it's no time to get chatty. That's how inappropriate questions like, "Are you planning on having more kids?" or even, "How old are your children?" can get asked, says Joan Roediger, an attorney with the Philadelphia law firm Obermayer Rebmann Maxwell & Hippel LLP. An unsuccessful applicant might conclude that she failed to get the job because you won't hire women who have small children.
What you should ask are questions that relate directly to the job, such as, "This position's hours are from 7 a.m. to 3:30 p.m.; can you work those hours?"
According to Nicholas Giampetro, an attorney who advises several medical practices in Maryland and surrounding states, the safest way to conduct an interview is to avoid all discussion of personal matters, even if applicants volunteer information.
Once employees are on board, harassment accusations can still be troublesome for employers — and the attorneys who defend them.
Moore and others suggest documenting any harassment and discrimination complaints — formal or informal. Note the problem, the name of the person making the complaint, what was investigated, who investigated it, what conclusions were reached, and what was done to resolve the issue.
Many times discrimination complaints turn out to be merely personality clashes or disagreements with performance evaluations. But without documentation, the practice has little with which to defend itself later on, Moore explains.
"Create a respectful environment and treat everyone like teammates."- David Holloway
Consider the human resources policy manual as a general description of the practice's rules of the road. "[It] tells employees what's expected of them, the rules of behavior we expect from you; this is how our practice operates and these are our policies," Roediger says.
There is no one-size-fits-all manual, she warns. "A personnel manual should be very customized to your particular practice and how your practice really works. A manual is only as good as your willingness to live up to the terms that are in it," says Roediger.
She also suggests that personnel manuals contain explicit statements that:
Keeping tabs on the entire spectrum of human resources is probably much more effort than most physicians are willing or able to put forth. So is there really a middle ground between micromanaging and neglecting human resources?
When it comes to day-to-day issues, the best role of the physician is to show respect, he says. "Create a respectful environment and treat everyone like teammates," Holloway says.
Finally, knowing what you don't know also is important. "More knowledge is always better," Holloway says. "But physicians at least need to agree that when an issue comes up, they will refer it to the administrative director and not get into areas they don't know about."
Motivated and qualified employees are critical to running an efficient medical practice, but most physicians take little time to consider what role, if any, they should play in setting personnel policies. Somewhere between daily micromanagement and complete ignorance of human resources issues is a middle ground for physicians that includes:
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