Chiropractic management is as much of an art as it’s a science.
Raise your game by observing two basic rules for organizing your team.
Rule number one: You manage systems and you grow people. Rule number two: Culture always wins.
Turnover in the chiropractic profession both in staff and associate doctors is a major topic anytime doctors of chiropractic get together. And when I’m teaching, the process of onboarding staff and doctors is one of the most frequently asked questions.
But before exploring this issue, first consider some of the problems that can cause high turnover. Before you hire either a staff member or an associate doctor, you need to have a well- thought-out plan.
Do a thorough needs assessment of your practice. Also review if everyone is currently in the right position. After performing the needs assessment, next look at the needs and skill sets for each position; each employee should have the right skills for their position and their skills should complement the clinic in general.
Based on the needs assessment, you can develop a well-defined job description with clear responsibilities and determine how those responsibilities can be measured. Your employee handbook should cover benefits, holidays, and all routine policies and procedures for the practice. A comprehensive and detailed onboarding process is essential for both the short- and long-term success of new employees.
A recipe for stress
It is common for doctors to be frustrated after they go through the effort of hiring and training a staff member only to lose them shortly thereafter. They can be flustered by the employee’s departure, but in reality it’s often their poor preparation that is creating the revolving door.
Too often, a doctor will place the blame for why an employee is leaving on other reasons—higher wages, better benefits, or perhaps better hours, but this might not be the case at all. When you do an exit interview with an employee, pay close attention if they tell you they started looking for another job because of your lack of systems, poor management procedures, management by crisis, poor review procedures, etc. Because in a real sense, your employees are talking with their feet.
Back to square one
So back up a moment and consider the better path. It is critical to have an effective evaluation system that identifies your practice needs, clear job descriptions, well-structured onboarding processes, and easy-to-understand and up-to-date employee handbooks.
Now you have the pieces in place for mentoring your employees, and note the word is mentoring, not managing. You manage systems, but you mentor and grow employees if you want long-term relationships.
As mentioned in rule number two, culture is what is created when you mentor and grow the people around you. With a great culture, long-term relationships with employees become possible.
How do you create great culture? By understanding the strengths of each employee, and recognizing the dynamics that are created through those strengths.
At the same time, it is also important to understand an employee’s weaknesses. Often, conflict in the clinic happens because people do not understand the differences among themselves. For example: When you’re naturally gifted at organization, a person who is not skilled in that area can drive you crazy—especially if it is the lead doctor.
But the person who’s not gifted in organizational skills might be gifted in interacting with people, and that is a vital skill too. It would be nice if we were all balanced and had the same abilities, but that’s almost never the case.
Given that your employees each have unique abilities, if you can appreciate and understand their individual qualities, you can play off their strengths. Then your whole practice will benefit, including your patients.
So if handled right, the differences among your staff can be a tremendous asset to your practice. But if mishandled, they can lead to a rotating carousel of new hires.
You’re the coach
The last topic is the ongoing relationship you have with your employees; you need to have something you can measure, a performance point at each position that you can use for coaching. Without a system of coaching, employer-employee interactions tend to focus on things going wrong.
When the numbers are up in patient care and you’re paying your bills with the extra left over, everybody is happy. When things get tough, you might be tempted to start micromanaging. You can avoid this by applying consistent and agreed-upon systems to interact with each employee individually and your team collectively.
Some clinics, whether large or small, may want to outsource this process because they don’t have the time or skills available to enact them. New clinics may need expert advice to accomplish the process of coaching employees effectively and efficiently.
It’s been said that DCs spend too much time working in a clinic, and take too little time to work on a clinic. Without continually evaluating your systems and mentoring and growing your people, your practice can become something like the movie Groundhog Day: the same problems, repeating over and over again.
You can sidestep that outcome by engaging in a well-thought-out needs assessment for each position that relates to the goals of your practice. From that needs assessment, write up a concise job description and expectations for each employee. From the job description and expectations, develop your onboarding process.
And a key part of the onboarding process is your developing an under- standing of the strengths of the employee you just hired. All current employees need to learn the new employee’s natural skills and abilities, and vice versa. Then you can nurture your ongoing relationships with a structured process mentorship, evaluation, and growth.
Scott Bautch, DC, DACBOH, CCST, CCSP, is the director of business development for Best practices Academy. He is the former CEO and board member of Allied Health Chiropractic Centers. He also co-authored the manual Industrial Carpal Tunnel Manual for Physicians and the book Carpal Tunnel Syndrome: A Practical Guide for Those Who Work With Their Hands. He currently maintains an active practice in Wausau, Wisconsin. He can be contacted through bestpracticesacademy.com.