HR for M.D.s:
Physicians Key in Setting Staff Policies

By Bob Redling
Bob Redling is a writer for Physicians Practice

Human resources (HR) may be most physicians’ least favorite practice management task. Yet, the goal of personnel management — attracting, retaining and motivating productive workers at an affordable price — is critical to clinical and financial success in medical practice.

Most physicians gladly — and perhaps wisely — hand off personnel duties to a practice manager or management firm. That doesn’t mean physicians can wash their hands entirely of personnel management concerns, said Robert Harvey, who manages family practice clinics for Lawrence (Kan.) Memorial Hospital.

“Staff is one of the more important resources that physicians have to support their activities that produce revenue,” said Harvey. “Human resources is just that: a resource, and a pretty important one.”

“Physicians should be more involved in the oversight of HR policies and the setting of employee performance expectations, but should really avoid day-to-day intervention,” cautioned W. David Holloway, M.D., of Fort Wayne, Ind.

Holloway said physicians can benefit from knowing how to:

• Set staffing benchmarks
• Monitor personnel policy-making
• Reduce legal risks
• Improve staff retention and performance

The physician’s management role
When it comes to day-to-day personnel management, the most valuable thing a physician can do is to show respect for staff, said Pamela Beach, human resources director for Healthpoint Management Services, a hospital-owned medical services organization that serves some 60 physicians at several primary care practices in Tampa, Fla.

“A simple ‘thank you’ from the physician really goes a long, long way to improve morale,” she said. “We have some physicians who are really good at it; others don’t think about it at all, and you can really see what a measurable impact these behaviors have on turnover rates when you look at what departing employees say in exit interviews.”

If physicians are perceived not to care, then how can they expect employees to care? Harvey of Lawrence (Kan.) Memorial Hospital admits: “We have one physician who still cannot remember the name of a receptionist who’s been with the practice for five years.”

Set staffing goals and benchmarks
Making decisions about staff benefits can prompt questions that are critical to meeting a practice’s financial and clinical goals. Before deciding what to pay or how many vacation days to grant, Holloway advises setting broader financial goals for staff spending.

Holloway believes that one way to set a staffing goal is to decide what percentage of annual net patient revenue will go to staff salaries and benefits. For example, primary care practices typically spend 25 percent to 35 percent of these collections on staff, while medical and surgical specialties spend between 15 percent and 30 percent, according to annual survey data from the Medical Group Management Association.

Other organizations look to industry benchmarks for the number of clinical and administrative employees per physician according to specialty. “Benchmarks for FTE (full-time-equivalent) staff-to-physician ratios do work, so our physicians are willing to adapt their work styles to meet those benchmarks because they know it is from real industry data, not an arbitrary spending goal,” said Patricia A. Bedlion, human resources director for Integris Health System in Oklahoma City.

Regardless of the approach, annual targets for staff spending can guide the more finite decisions about wages, benefits and even setting job performance expectations. For example, a spending target can help a practice figure out whether it will meet seasonal fluctuations in patient volume by paying employees overtime, implementing innovative patient scheduling or using part-time staff.

Know the risks
The policies that result from pinpointing spending targets, such as overtime and scheduling, should be well documented in personnel manuals. Although a personnel manual is a valuable and necessary part of any business, it cannot prevent all mishaps and problems that could arise. Unfortunately, some of these problems can start with the HR staff if it is not properly trained or informed. Physicians shouldn’t take the potential risks of human resources too lightly, said Jennifer Moore, an Atlanta-based attorney specializing in labor and employment law for the law firm Jones Day.

“Practice owners are going to be liable if harassment or discrimination occur, so they and their staff need to be educated on these issues,” Moore said.

That’s all the more reason for physicians to have a general understanding of their medical practice’s approach to human resources management. Physicians do not need to know every detail pertaining to HR law and regulation, but should certainly know the basics.