Whenever an employee leaves, you incur expenses to advertise the open position and set up and train a new employee. And, of course, there can be productivity losses in the interim.
Analyze the causes
It's also important to understand why employees are repeatedly leaving a key staff role of their own volition. You or your practice manager should be conducting exit interviews to understand why employees keep leaving. If, for example, conflicts are creating an unpleasant work environment, you'll have the opportunity to address this situation before the next employee is hired. Sometimes, training issues emerge through exit interviews. Learning this gives you a chance to take corrective action.
Often, the reasons for turnover are simple: Your lowest level jobs pay low salaries and don't really offer much variety or responsibility. While some people appreciate predictability in their work, others require a sense of growth and progress over time. In a larger urology practice, you may be able to address these issues by offering your employees a career path and possibility of promotion and new challenges. But there are often limits to what you can offer, and smaller practices may have little flexibility.
When some of your staff jobs are by-necessity routinized and require a limited range of skills, it can be difficult to find someone who wants to stay in them forever. What's more, you can't afford to sacrifice commitment to quality or attention to detail in exchange for longevity-and when you hire for those skills, somewhat faster turnover is likely, since the most attentive and committed employees will have more options and may be more ambitious.
In situations like this, your practice might be better off hiring, say, an energetic recent grad who wants to go to nursing school in a year-opting for completely predictable turnover-instead of trying to find the perfect long-term hire who just may not exist.
Plan for a revolving door
In situations like these, the key is to plan for the revolving door; accept that in order to have committed and energetic staff, you might need to incur the costs of replacing them more frequently. The goal is to minimize the costs and errors and maximize productivity. For example, cross training will help ensure you don't suffer productivity losses-or worse, errors-when an employee departs. (This can also help keep your more ambitious, variety-seeking employees interested in their jobs a bit longer.) Making sure your job descriptions, employee manuals, and other documentation are refreshed at least yearly will help accelerate training for new employees. To speed up replacement times for employees, analyze the effectiveness of the media you use for recruiting so you know what is likely to work best. (Get plugged into social media, too; tools like LinkedIn and BranchOut can be very handy for quickly getting the word out.)
Keeping open communication with all your employees can also help you manage turnover and transitions better. When you know an employee is planning a big step like going back to school, let him or her know that a long notice period-3 or 4 weeks instead of the traditional 2-would be appreciated, and not punished with a request they leave sooner. And, sometimes your ambitious exiting employees will also appreciate an option to work part-time while you look for a replacement-a win-win that can help everyone involved.
Joe Capko is a senior health care consultant with Capko & Co. who specializes in research, marketing, social media, business development, and strategic planning. Judy Capko is a health care consultant and the author of Take Back Time-Bringing Time Management to Medicine. They can be reached at firstname.lastname@example.org