Staff Management

Your Top Staffing Mistakes–and How to Fix or Avoid Them

Mike Rothschild, OD

You can improve staff productivity by becoming aware of–and correcting–common staffing mistakes. Learn ways to maintain open lines of communication.

Your staff is one of your most important business assets. They are literally the face of your practice, and most of them have direct contact with your current and prospective patients. From the time your patients call to book an appointment to the time they check out of your optical (hopefully with product), it is your staff whom they rely on.

Here are five staffing mistakes that I noticed are too common in optometric practices. I also include ideas for fixing or altogether avoiding these mistakes in the first place.

MISTAKE #1: Not Planning Ahead
The biggest mistake made in hiring is failure to plan ahead. It is typical for us to hire when we are in dire straits. The number one reason we are shorthanded is that an employee has left, either voluntarily or because they were not meeting our needs. Other reasons for lack of necessary staff may be growth, a new location, a new doctor or a new strategy to increase the level of personalized service.

So, we typically are in reacting mode and don’t have the time to think through staffing decisions. Thus there is not a plan and the our only staffing guideline is our memory of the last time we hired a new employee.

To put a well-thought out staffing plan in place, consider the following questions:
• What is your budget for staff? Are you currently under/over budget?
• If money didn’t matter, how many staff people would it take to do the job perfectly?
• What are the positions (seats) within your practice and who are the perfect people to fill those seats?
• Since money does matter, what efficiencies can be put in place to do more with less?

Action point: Take the time to plan ahead, including determining staffing needs at the beginning of the year and setting aside the necessary funds to make those new hires.

MISTAKE # 2: Lack of a Strong Orientation Plan

Studies show that one of the most stressful days in a person’s life is the first day at a new job. It is also one of the most memorable days. It is the only opportunity you will have to start this person’s career at your practice with a positive experience.

To build an unforgettable orientation program, you have to plan it ahead of time and save your work so you can make it better next time. At the Ritz-Carlton hotels, new employees have their cars valet-parked and are escorted, like important guests, to the conference room where orientation is being delivered. The meeting is led by the hotel manager. The goal of this protocol is to show new employees how important they are to the organization. Orientation is planned ahead with the intention of making them feel important, comfortable and special.

Our offices may not have valet parking available, but we can have someone greet the new team member at the front door to show them around the office. We can anticipate their needs by showing them where to put their purse and where the restroom is.

To prepare for the content of the orientation, list all of the values, priorities and missions of the practice. The purpose of the orientation program is to teach new employees about the personality or brand of the practice. If you don’t know what to say about your practice’s culture, you have to start thinking about it both for your sake as well as the sake of new employees. If you don’t reflexively know how to define your practice’s culture you have a practice identity crisis that probably is leading to confusion beyond staffing. If you have a mission statement, a good topic for the orientation program is to discuss it, line by line.

A facilitator needs to adjust his or her schedule to be able to lead the entire orientation. First, designate a facilitator. This should be someone with a really good understanding of both the vision of the practice and the general operations. That means it should probably be a doctor or an office manager. In other words, someone who is too busy to do it. So, adjustments to the schedule or to job duties will need to be made. It can never be led by the person who is leaving.

Action point: Don’t leave new hire orientation to chance. Plan out exactly what you want each new hire for each job role to know and be able to do. Then put in writing orientation plans for each new hire and a plan for delivering the orientation to each of these new employees.

MISTAKE #3: Not Having a Good Training Plan
A training plan is different than an orientation plan. Orientation teaches new employees the practice’s culture, vision and long-term goals. Training is the specific steps needed to get the new employee’s job done and to reach your larger practice goals.

Training typically is done by having the new employee shadow another employee. Then the new employee does the job until someone yells at them for doing it wrong. There is a better way.

A training program is a chance to ensure that your patients are taken care of the way you would take care of them yourself. The training needs to match the process guide used by the practice in day-to-day situations. A training plan should contain about three weeks worth of structured content.

The training plan should begin with a list of the tasks that need to be performed for new employees to do their job. Next, document what needs to be known, before those tasks can be taught (Prerequisites – for example – to teach measuring seg heights, first you need to know: “What are seg heights and why do they matter?”) Then put all of the items to be learned on a schedule and fill up at least three weeks’ worth. Continue adding items to the calendar until you have finished the list.

When you finish the list, add to the list. Now you have started an ongoing training plan. If a team is constantly being taught how to be better and how to grow they are more likely to remain fulfilled and engaged in the job. Keeping the learning process going for everymember of the practice may be your most important job as practice leader.

Action point: Don’t rely on unstructured training “plans” like learning on-the-job or shadowing a dissatisfied out-going employee. Put a formal, structured curriculum for each job role in writing, and determine who will deliver the training and when exactly it will take place.

MISTAKE #4: Unclear Direction – Lack of Leadership – No Guidance

This advice often is given by saying: “Give very clear job descriptions” or “Establish clear expectations.” This is certainly a very important component of leadership and guidance, but I think it goes much deeper than that. It is unusual in a practice for circles of responsibilities not to overlap. Many times technicians need to help with a frame selection or an optician needs to answer the phone. Staffers frequently must go above and beyond their “job description.” Clear direction and leadership empowers every member of the team to think bigger than their job. It allows everyone to do what is needed to accomplish practice goals.

At LeadershipOD, my optometric leadership consultancy, we developed an online program that helps you solve this very problem. It allows practice leadership to create a strong vision and share it with the rest of the team. Then, it pulls insight from each member of the team and compiles it for a true and honest look at the current state of the practice. It also builds on leadership, communication and management skills.

Action point: After new hire orientation and structured training, each employee needs to know what you expect fromthem to be considered successful in their new position. Don’t leave employees guessing about what it takes to put in a stellar job performance for the position you just hired them for.

MISTAKE # 5: Failure to Deal with Under-Performers
“Hire slow and fire fast.” I don’t know who said it, but I like it.Face-to-faceconversation between doctorandemployee about sub-par job performance isn’t fun,but it is an essential ingredient in building any team worth being a part of. Doctor-employee conversations aboutweakwork performance are easier and more effective ifthey aredoneaccording toa structured and organized method.

Annual reviews, immediate correction of mistakes, or routine reminders are all effective methods that can be used to ensure you have regular, structured discussions about job performance with employees. But ongoing communication about performance related to expectations is vital. If performance is a little below standards today, and you do nothing, it will be worse tomorrow. It is unusual for job performance to get better without intervention.

A well defined set of processes and expectations makes this an easier component to monitor. For instance: Let’s say the check-in process includes the simple, but critical, step of verifying the patient’s date of birth. If it doesn’t happen one time, it may be easy to let it go, but it is imperative that you react, as a leader. The firsttime it happens trya non-confrontational inquiry.Many times the response will be, “I thought I did that. Sorry.” (If the reply is “I don’t even know why we do that,” you have a bigger problem.) Each episode needs to be documented, no matter how minor.

If it occurs again, the response needs to be a bit more direct. “I noticed you failed to verify the date of birth at check-in again. It is the third time this week this has happened. Is everything OK?” This opens the door to conversation and allows the employee to share what the true barrier may be. But it also shows that details do matter. At the end of this meeting, a new expectation needs to be shared with the employee and a consequence if the violation recurs. You have to stick to the consequence.

To work, this method must be consistently followed for every expectation that is not met. Every, single one.

By beginning these steps with a small problem, you can avoid it turning intoa problem that results in termination.But when you do find yourself in the position where firing an employee is necessary, go ahead and do it.Documentation from your efforts will help you with the trouble that is bound to follow.

Action point: Don’t put off dealing with under-performers because you think improving their performance isn’t important or–worse–because you dislike confrontation. Do your best to help under-performing employees improve, and if they are not able to improve and you are not able to find another job role that better suits them, let them go.

Related ROB Articles

Training the New Hire: an Action Plan

Non-Discriminatory Recruitment Language: Find the Right Employees and Protect Yourself Legally

Maximize Staff Productivity with a Workforce Efficiency Analysis

Mike Rothschild, OD, is founder and president of West Georgia Eye Care in Carrollton, Ga., and founder of To contact him:

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