For many years, I delivered presentations on human resources (HR) at the management sessions held during the annual meeting of the ESCRS. Prepping for those sessions often prompted me to reflect on my own HR mishaps over the years. In fact, much of what I have presented on this topic reflects what I learned from those mishaps. Let’s face it, whether you are running a business or a medical practice, it is much more appealing to focus on growing revenue, taking care of patients, and performing surgery than on whether your HR policy should be updated. One of the most important lessons I learned, however, is that this part of the business is crucial to its success.

This article presents four steps to keeping your HR and practice on the right track.

No. 1: Hire a Professional

HR is an increasingly complex business area—and one that is easy to get wrong. To keep things on track at Medevise Consulting, we hired a part-time HR director we share with another local company. She works 2.5 days a week for us and 2.5 days a week for the other company.

Her job duties range from hiring and onboarding new team members to establishing company policies and ensuring that employees are aware of and adhering to these policies. Additionally, the HR director oversees payroll, insurance plans, and pension plans, and she regularly checks in with team members to make certain that everything is on track and to identify potential issues. Importantly, she also serves as a sounding board for me, and she is someone with whom I can speak confidentially when there are employee issues.

An HR director plays a crucial role in managing disciplinary issues, potentially sparing you from participating in disciplinary actions. I had previously thought that the cost of hiring an HR professional for a business with fewer than 15 employees would be too high. Based on my experience, however, hiring someone part-time can be cost-effective because it can free an MD to focus on being a doctor and a surgeon.

No. 2: Get the Basics Right

HR policies? Employee handbook? Quality management system? All of these, none of these, or some of these? Ten to 11 years ago, when I delivered presentations on putting a quality management system in place to establish a standard operating system in a practice, few attendees had ever considered doing so. Today, I routinely walk into clinics and see an ISO:9001 certificate on display.

You do not necessarily need to go through the ISO:9001 certification process, but at minimum, your practice should institute a set of policies to govern how it is managed, from reception through the ordering of supplies. HR policies should be included as well as, ideally, a handbook or resource center for employees on policies and procedures. Medevise Consulting uses Dropbox Professional for file sharing, and HR policies are housed in a folder accessible to all of our employees (Figure). When we add a policy or update a current one, our HR director makes a company-wide announcement and provides a link to the document. This is an efficient and paperless way to inform the team of any changes.

At a minimum, your HR policies should include the following:

• A vacation policy;
• A policy for the escalation of issues/emergencies; and
• A travel and expense policy.

During the current pandemic, we also developed a policy that governs business travel.

If you already have HR policies in place, it’s a good idea to revisit and update them at least annually. Employment law changes, and it can affect your policies.

No. 3: Hire Smarter

Reviewing my early talks on hiring makes it clear that my approach has changed over the years. For example, my company no longer checks references provided by job candidates. Too often, a person who was described as the best or as someone the reference “would hire again” has turned out to be a management nightmare. We have also scaled back our approach to interviewing job candidates: They no longer interview with someone from every area of the company. Despite going through that rigorous interview process, a couple of new hires underperformed in their roles. Being interviewed by six different people didn’t answer the central question of whether the candidate could do the job.

Today, we use an iron-clad probation period that is clearly described during the onboarding process. This probation period lasts 90 days for entry- and midlevel employees and as long as 6 months for senior- and executive-level employees.

Our HR director holds regular meetings with new employees during the probation period to ensure that things are going well, and she regularly speaks with the line manager. Any performance issues are quickly identified, discussed, and managed. If necessary, employees are released from their contracts during the probation period.

Old-school tactics such as checking a candidate’s social media postings and doing a simple Google search remain valuable, but my favorite strategy is getting candidates to ask questions about the job, the company, and the work that they will be doing if hired. Good candidates have done their homework, and their questions will reflect this. A bad candidate asks open-ended questions or, worse, admits to not having visited your website or given thought to how they would contribute.

No. 4: incorporate Tools the Team Will Use

Even in a practice with 10 employees, it can be challenging to keep everyone informed, particularly if some of your team members work part-time. In addition to using Dropbox Professional for our documentation system and file sharing, we use a project planning tool, Airtable (www.airtable.com), that is customizable and enables team collaboration on tasks and projects. We also have a company subscription to Slack, software that allows quick communication between team members in groups or in private and by topic. At first I was skeptical, but Slack has become my preferred method of communication because it’s quick and enables me to avoid digging through my email inbox!

Free versions of each of these tools are available, so you and your team can see how they work before paying for them. I recommend appointing a member of your team to help implement tools of this nature, oversee their use, and troubleshoot issues as a way of ensuring that these products are used.

Conclusion

Changes in HR best practices notwithstanding, practical, straightforward policies and tools help establish a firm foundation and keep a team focused and working well. An HR director can elevate your practice and make you and your team more effective.