The perfect staff: How to keep your practice on track

In this second installment, you'll learn how to set benchmarks that will keep your office on track with other urology practices, and you'll find tips to help you stay headed in the right direction.

Set benchmarks to succeed

That being said, there are two key benchmarks that will clarify whether you are on target with your peers. The first is the percentage of income spent on expenses related to full-time staff (ie, salary and benefits). One size may not fit all, but if your numbers for staff and staff compensation fluctuate from year to year, take a closer look. These numbers, as shown in the table, are based on national averages per full-time urologist.

The second key benchmark is your turnover rate. If your turnover on a rolling 3-year average reaches 20%, you will need to explore how you contribute to this. Are you hiring the wrong people? Are you failing to provide new employees with the training, resources, and support they need? Does the culture in your practice fail to encourage employees and appreciate their contribution to it?

Assess your staff

Most of you have probably heard about the old 80/20 rule: Managers spend 80% of their time dealing with 20% of the employees: the ones with bad attitudes who don't do their share of the work, are irresponsible or disrespectful, or who don't follow rules. You don't have the time to dedicate to these employees, so don't do it!

When an employee's performance is slipping and his or her attitude is poor, give the person an opportunity to improve, but hold to your high standards and do not waiver. If the employee has skills you need, but isn't committed to the practice or doesn't fit in, it's best to deal with it as soon as possible. It doesn't take long for such an employee to affect the attitudes and performance of other staff members.

When performance problems emerge, begin the formal process of resolution. First, issue a verbal warning, outlining the unacceptable actions and clearly defining how and when they must be resolved. If, after this, the employee does not meet established performance criteria, proceed to a formal write-up and disciplinary action, letting the employee know the seriousness of his or her actions and the consequences of not resolving the performance issue. Set a time frame for resolution, and hold the employee accountable. If the employee does not hit the mark, proceed to the final step, termination.

I am surprised by how many managers and physicians stall at the second tier. They warn the employee, but fail to follow up with termination when the problem is unresolved. When you do this, you give the employee permission to continue the offending actions. It is unfair to other employees and compromises morale and productivity. It is your responsibility to create a no-tolerance policy for unacceptable performance.