On Monday March 5th 2018 Canadian Eye Care Business Review hosted a panel discussion entitled The Perfect Fit, Finding and Keeping Great People. Drs. Jeff and Tina Goodhew, independent practitioners from Oakville, Ontario, guide the discussion of current best practices with three subject matter experts in the HR field. Jan van der Hoop and Tim Brennan of Fit First Technologies and Kelly Hyrcusko of SIMI (Simple Innovative Management Ideas Inc.) share their views on the subject. The webinar is rich in practical tips and advixe for eye care professionals on a wide array of topics from candidate screening to best practices in onboarding a new employee into your team. New data driven objective decision models are discussed which can help in providing better insights into candidates and improve hiring success rates.

The webinar was sponsored by eyeployment.com, Simple Innovative Management Ideas, and Optik Magazine.

Click to watch the video recording, or listen to the audio below.

 


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Successful hiring is a bit of an art. But experts say “Never put the Art before the Science” in order to improve your success rate.

If you’re like me, you have hired a good number of people over the years. And you have likely had your share of surprises and revelations along the way. A few have likely been pleasant, where people have shown unexpected qualities that have contributed to your business, and a few have led to, well, disappointment.

Statistically speaking, if you are “getting it right” even half the time, you are beating the odds. Research in larger corporations suggests that only 20% of hires are an unqualified success, where both the new hire and the manager who hired them rate it a “great decision” after six months.

That represents an 80% failure rate.

What that costs an organization is a topic for another day, but it does beg the question: what are we missing?

“Fit” is the Key

If you dig further into the research, you discover that nearly 9 times out of 10, the reason for the failure has nothing to do with the person’s competence or their skill level. It is directly attributable to their ‘fit’.

If you think of it in terms of the hiring process itself, people are admitted into conversation with an organization on the basis of what they know (skills, qualifications and experience, as expressed in the résumé); while the overwhelming reason for failure is who they are as individuals – their core attitudes, traits, standards etc.

In fact, academic research bears this out. Research over several decades at the University of Manchester into the relative validity of various predictors of job performance shows clearly that the items contained in the résumé have a far lower predictive value than the individual’s core traits and how they process and use information.

Further research into the concept of “fit” reveals that there are actually four critical aspects of fit to consider:

  • Fit with the Manager – this is perhaps the most critical chemistry to get right. Do the two share similar standards, and is the manager’s natural style going to bring the best out of the new employee?
  • Fit with the Job – to what extent does the role draw from the person’s natural strengths and interests, rather than asking them to spend their day doing things they will never be better than “adequate” at?
  • Fit with Co-Workers (and Customers) – again, is this aspect of the “chemistry” right? Does the employee genuinely like and respect the people they spend their day with, and do they feel liked and respected in return? This one seems like a particularly soft factor, but the quality of the “social fabric”, so to speak, is the aspect of fit that correlates most strongly with team productivity. Where relationships are strong and positive, the team will overcome any adversity.
  • Fit with the Practice – can the individual see how what they do contributes to overall success, and does that success matter to them? Do the organization’s values and mission resonate with them?

Science can accurately predict someone’s likely fit, or compatibility, in an environment. There are new platforms that are designed specifically to help organizations screen candidates for fit in the reality that would be awaiting them on their arrival.

The big mistake most organizations make is in relying on conventional techniques to crunch through a stack of résumés (or the old “A pile, B pile, and C pile” technique which I used for most of my career), then do phone screens and interviews, and then administer an assessment with the shortlist.

This method relies on the factors with the lowest predictive (read: nearly meaningless) value in the front end, then investing in science to screen a shortlist that might as well have been assembled by a random-number generator.

When you look at it that way, it’s absurd.

Far better in my opinion is to let the science do the heavy lifting up front by screening ALL your applicants for their likely fit in your open position; then, once you have identified the best people—those likely most compatible—at this point you can check their résumés to make sure their knowledge, technical skills and experience is in the right ballpark and take them through the interview process.

There’s room for both Art and Science in hiring. Using them in the right sequence will yield you a better, more consistent outcome.

 

JAN G. VAN DER HOOP

Jan is the co-founder and president of Fit First Technologies, a company that applies its predictive analytics to the task of matching people to roles. Those algorithms drive platforms such as TalentSorter, FitFirstJobs and Eyeployment.com, which are relied upon by organizations to screen high volumes of candidates for “fit” in their open positions.


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Much has been written about Millennials, those of us born between 1982 and 2002, in how to attract and keep us as patients. But what about attracting Millennial ODs as associates?

I am a freelance optometrist in California, seven years in practice, and I also have been a full-time associate OD. In that time, I have developed the following checklist for evaluating employment opportunities.

Online Reviews
When thinking of joining a new practice, I first look at online reviews on Yelp. I do not always judge the practice by these surface impressions, but it’s a good place to start when you have never been to an office.

What patients have to say about their experiences says a lot about a practice. Not all reviews are representative of how an office operates, but you can see patterns that may indicate a problem, such as online reviews consistently noting long wait times, or frequent mentions of unfriendly staff. I also Google the owner-doctor to see how patients feel about their exams.

One office I applied to had six reviews only, and four were awful, but were also from years ago. I couldn’t take the reviews seriously because they were so outdated and so few. I ended up working at that practice for five years, and helped them promote use of Yelp to patients, so their reviews would be more current and positive.

Patient Flow
After reading online reviews, I always schedule a working interview. This is important to find out if the office will match your style of practicing. If, after spending the day practicing in an office, I realize it’s not for me, there usually are no hard feelings if I decide not to come back. Working interviews are paid, with the rate negotiated between applicant-OD and practice.

I recently started working at a new practice a few times a month, and I was not happy with the flow of patients.

I felt like I was unable to connect, and give my best optometric guidance, with the large number of patients scheduled. For that reason, I politely declined the offer of a full-time position. There is nothing wrong with a practice that chooses to see a large volume of patients. I respect that mode of practice, but I know it’s not a good fit for me.

A working interview also is helpful from the practice’s perspective. It gives the practice a chance to see if the doctor is able to connect with patients, and how well the doctor gets along with the other doctors and support staff. Key questions to ask about a prospective associate or freelance OD: How knowledgeable is the doctor about products? Can the doctor handle the office and patients when the managing doctor is not there? And, importantly, does the prospective associate treat the practice as their own?

Salary Potential
I set my own per diem. I usually do not budge. It is important for doctors to know their worth, and not settle for less. If an office is not willing to meet our pay standards, then most of us feel it’s OK to move on to other options. I usually ask for a bonus structure, as well. I want the practice owner to feel like I am contributing to production.

Bonuses help motivate us. I find myself educating patients more about spectacle lens upgrades at offices that offer a bonus structure.

For example, an arrangement could be made in which bonuses for associates are given for days the office makes over $3,000 in production. For instance, $3,000 in production practice-wide would mean a $50 bonus for the associate, and every $250, the bonus goes up another $50.

Schedule Flexibility
I used to work weekends for many years. However, when I got married, I noticed I wasn’t able to spend much time with my husband, so I made the decision to only work four days a week. At that point in my career, I knew I had a lot to offer the offices I worked at, so I asked for a raise to compensate the lost day. In the end, it worked out great, and I feel refreshed after my weekends. It may be harder to find jobs that are only weekdays, but for me, it’s worth it.

ARIAN FARTASH, OD

is a freelance optometrist in California, who has also gained expertise in social media marketing. To contact: arianfartashod@gmail.com


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Satisfied patients who return and refer others, and the retention of employees, are two separate goals that have something in common: Effective new employee training can help you achieve both.

My 2 full-time doctor practice, which has 10 support staff members, takes a structured approach to training new employees. This helps keep turnover low and customer service high. We have an annual employee turnover rate of about 5 percent compared to the Management & Business Academy average of 20 percent annually.

To keep turnover low and ensure successful onboarding, my office manager and I are both involved in the training. I am usually more involved in the initial process, and my office manager and other support-staff members are more involved in training new employees in the specifics of their job roles.

According to a 2016 study by the Society for Human Resource Management, employers can expect to spend between 6-9 months of an employee’s salary to replace a new employee. Forbes estimates the minimum cost to be one month of salary (and in some cases as much as seven years!). In a typical optometric office, I would expect that figure to be closer to three month’s salary, or about $7,600.

Dr. Cass (center) with members of his staff. Dr. Cass says a structured new employee training program ensures that every new hire is able to provide a consistent patient experience.

Show New Employee Patient Experience
New employees in our office are introduced to each staff member and given a tour of the office.

The tour walks the new employee through the process that the patient would go through, so the employee can understand the part their job plays in the process. I then personally visit with the employee and explain our practice history, mission statement and philosophy.

The new employee is then paired with the employee who has the most experience doing the things the new employee will be doing. The first day is typically spent with the new employee watching the experienced employee while taking notes. Questions are strongly encouraged and time is taken to thoroughly answer any questions.

Provide Job Aids
The new employee is given printed copies of:
An employee manual
An office manual
Compliance manual (Privacy, Security, OSHA)

They also are given a checklist of tasks they will be expected to learn during training and specific training guides for their position. Click HERE to see an example of one of these checklists.

For further help, we give employees training guides related to tasks required for different patient encounters. For example, here are some guides we gave the technician we just hired (Click on these links for complimentary PDFs).

Comprehensive Exam

Contact Lens Follow Up

Dry Eye Exam

Set Probationary Period
During the first week the doctor, or office manager, meets with the trainer and the new hire at least once per day. The checklist is reviewed daily the first week. After the first week the doctor and office manager check in with the employee once or twice per week until the checklist is completed and the employee’s work is reviewed and spot-checked.

We consider new employees probationary for the first 90 days, but have not had to let someone go during the probationary period thanks to our thorough hiring process. We usually have employees integrated well within the first 30 days, and are refining the training process during the next 60 days.

Elicit Feedback from New Employee
We recognize that employees come to us with unique experiences, knowledge and perspectives. We actively seek feedback from the employees and suggestions for ways to improve our processes. We also give employees a significant amount of freedom in how they complete tasks related to their job. We want them to be trained well, but we also want them to make the job their own.

Taking the time to properly train and onboard staff is well worth the effort. Your practice can only be as good as your staff. And as good a doctor as you may be, it is important to keep in mind that your staff members are the first voices your patients hear when they call, the first faces they see when they arrive, and the last interactions they have before they leave.

 

PETER J. CASS, OD

is the owner of Beaumont Family Eye Care in Beaumont, Texas, and president of the Texas Optometric Association. To contact: pcassod@gmail.com


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This article makes reference to labour laws. Readers should ensure that they are familiar with the applicable Canadian Provincial Labour Legislation.

My practice prides itself on the high level of customer service that we deliver to patients. That service begins with recruiting the right employees to serve patients. Over the years we have developed a system to decide when new employees are needed, and then to find and hire the people we feel are best matched with our practice mission and patient needs.

 

Our practice has grown over the past 16 years to over $2 million in gross annual revenues, 11 full-time employees, one full-time OD and two part-time ODs. We have tried to stay ahead of, and encourage, growth by hiring customer service-oriented personnel when opportunity warranted it, and the financial metrics indicated it was the right move.

Our office manager is in charge of our hiring process. She approaches me when she feels there is a need for a new staff member and we discuss the situation. If the numbers confirm the need for a new hire, she begins the process, keeping me updated, and consulting with staff members who will be helpful in the decision.

Staff photos and certifications in the hallway near the practice’s pre-testing room.

It  is important to carefully screen applicants, by e-mail first, then by phone, and then up to two times in person. Our office manager, and sometimes the out-going employee, are involved in the hiring process, in addition to me.

DETERMINE THE NEED TO HIRE

Our practice focuses heavily on customer service, so when we find that our staff is overloaded we begin to look at the financials to see if the numbers justify including another staff member. One of the first numbers that we look at is employee expense.

Employee expenses should be around 20 percent of gross revenue. While not a hard number, it can serve as a guide–anything lower may indicate that our staff is stretched too thin, and anything higher may indicate inefficiency.

Staff are usually quick to tell the practice manager, or owner, when they think additional staff are warranted. When this occurs in our office, it would be discussed at our monthly staff meeting and we would look at the numbers with the staff to see if an additional employee was justified.

I always point out to staff that if we hire an additional staff member, we expect revenues to go up, and therefore, would increase monthly collection goals. Since we bonus our staff on monthly collections, they are less likely to make an unnecessary recommendation for additional staff.

We also look at gross revenue per staff hour. Management & Business Academy statistics list the median revenue per staff hour at $83. Anything above $100/staff hour could indicate the staff is stretch thin, and anything below $70 could indicate inefficiency. Additionally, a rule of thumb is four staff per full-time equivalent OD. These numbers are just guides, though, and practices like ours, that focus on customer service, are not afraid to be slightly over-staffed.

PROTECT YOUR PRACTICE: KNOW WHAT NOT TO ASK

Languages spoken. In general this question should be avoided unless the need to communicate in a given language is essential, but even in that case, be careful not to imply that it is a requirement.

Age. The Age Discrimination in Employment Act technically applies only to employers with greater than 20 employees. Despite this restriction, regardless of staff size, it is a very bad decision to ask an applicant’s age, or make any hiring decision based on the stated or perceived age of the applicant.

Medical history. There is no universal prohibition on obtaining such information, but the Genetic Information Non-Discrimination Act of 2008 specifically prohibits any employment decision based on any information obtained regarding applicants genetic data, medical or family medical history. Obtaining medical information only sets up an employer to explain hiring decisions they would likely wish to avoid having to explain.

Criminal arrest and conviction records. This is a growing area of discrimination retaliation, and should be approached with caution. The Equal Employment Opportunity Commission has challenged the use of background checks, and is encouraging a “Ban the Box” movement, eliminating any potential investigation into an applicant’s records. Unless a mandate of state law, arrest record checks are a bad idea, and criminal checks should be conducted only if allowed by state law, and then only if truly necessary.

Credit checks. This should be avoided unless the position the applicant is interviewing for would require such scrutiny. The Federal Fair Credit Reporting Act does not prohibit obtaining credit checks on job applicants, but it does establish that an employer has liability if conducting a credit check in any way could, or does, adversely affect the applicant’s credit status. Some states have specific laws related to credit checks.

Aptitude tests. While not illegal, or even a bad idea, you need to be careful you are not imposing a discriminatory situation based on the construction of the test. Basic math, spelling or general information tests are all fine as long as they do not pose an advantage to one applicant over another.

Drug testing. Legality and application of drug testing for job applicants is almost exclusively regulated by State law. In the absence of State-specific law, employers should be careful in the application of drug testing for applicants. In most cases, it would be advisable to mandate drug testing only after a job offer is made with that offer contingent on a negative drug test outcome.

CREATE & IMPLEMENT A SYSTEM TO HIRE PERSON YOU NEED

When a new staff member is needed, we follow a step-by-step approach for searching and hiring. Having a system in place is essential, as the average job listing brings 250 resumes, with each requiring five minutes to sort through, according to Local Eye Site’sreport, The Real Cost of Unqualified Applicants. That totals 20+ hours of work basically to sort out the unqualified.

POST OPPORTUNITY. We use a local site.  A single ad is free, premium ads, or multiple ads, are available for a small fee. We give a clear description of the job, and ask for applicants to e-mail a resume to our office. We also ask existing staff members to encourage people they think would be a good fit for the practice to apply.

SUBMIT BY E-MAIL. All the resumes submitted by e-mail are reviewed by my office manager, while any resumes submitted by fax or mail are shredded. The ability to follow instructions and use a computer are job requirements.

CALL FINALISTS. Applicants with resumes that show promise are called for a phone interview. We typically call about 20 percent of the applicants who properly submit a resume.

NARROW FIELD. Applicants who do well on the phone interview are invited to the office for an in-person interview with our office manager.

MEET IN PERSON. Applicants who do well in the in-person interview are invited back for an interview with myself and the office manager.

BREAK A TIE. In the case of a tough decision, we might ask two applicants to come and work with us for one day and be paid for that one day. We let them know that it is also an opportunity for them to see if they would really like working in our office.

INVOLVE EXISTING STAFF IN RECRUITMENT

If an existing position is vacated under good circumstances (moving, taking another position elsewhere, wanting to be at home with children), we try to include the out-going employee in the process. We ask the staff member to write a description of what they do and make notes for the new team member. We would also discuss good applicants with them to get their opinion.

Having the out-going staff member sit in on the interview can be a good idea, however, it is generally not advisable to have the applicant “interview” with other members without the office manager present. The applicant can be introduced to the staff member as part of the interview process, but an applicant should not be left alone with a staff member who is not trained in what may or may not be appropriate to discuss with the applicant.

NARROW DOWN APPLICANTS

We often have 100, or more, applicants apply. We would typically call about 20 of those for a phone interview. We would usually have about five in for an in-person interview with my office manager.

We usually ask about salary requirements in the initial phone call. We confirm the amount needed at the in-person interview. We try to be very competitive with pay. We want to pay more than our competition, so that we get the best candidates. We also let potential applicants know that we have many perks and offer a bonus system which can typically boost income by the equivalent of almost $2/hour, or more, in a good month.

I think it is very important for the office manager to like an employee and take ownership of the decision to hire the employee. If a doctor makes a bad hire, it creates tension between the office manager and doctor, and it can be more awkward for the manager to approach the doctor about the mistake. However, if a manager makes a bad hire (which happens with even great office managers), the doctor can easily forgive the manager and move on in the hiring process.

I usually share my opinion with the office manager and let her know what I like at each step of the process. I review the resumes she picks, I talk to her about her notes from phone calls, and her notes from interviews, and give her my honest opinion on the in-person interview I am involved in. I stop just short of telling her who to hire. That was even true even when a friend of a friend applied for a job. The applicant made it all the way through the process, and it was down to the final two, before my office manager asked my opinion. She was hired, and has been a great employee.

CHOOSE DISCUSSION TOPICS FOR INTERVIEWS

Recommended discussion topics during the interview include describing the business to the applicant and the general aspects of the job they are considering, asking them about their past job experiences, asking them to describe their strengths and weaknesses as an employee and asking them to describe how they would handle particular job situations or challenges.

The goal of the interview is to get the applicant to talk, not to talk to the applicant.

Research from the Management and Business Academy, showing staffing levels according to practice size. Dr. Cass says he would always rather be slightly over-staffed than under-staffed, as having slightly too much staff gears the practice toward growth and ensures topnotch patient service.

The applicant interview process is a time to get to know the employee as a person and potential member of your team. We look strongly at communication skills, how the applicant carries themselves, their attitude and professionalism.

NARROW DOWN TO FINALISTS

We usually do two in-person interviews, which are an important part of our process. We ask for references, but don’t always call them since most applicants will choose people who will say great things about them. We are more concerned with past work experience, and would prefer to call a previous employer.

Obtaining references is a standard practice in the hiring process, but no applicant in their right mind would ever provide a reference who would not provide a stellar recommendation for the applicant.

We want to know from past employers if the employee was dependable, friendly, and got along well with other staff. When talking to a prior employer, simply asking if the applicant would be eligible for re-hire at their business is often the most telling piece of information.

RECRUITMENT RESOURCE: QUESTIONS FOR APPLICANTS

CLICK HERE to download a complimentary PDF with questions to ask applicants for employment in your practice.

HIRE FOR PERSONALITY & TRAIN FOR SKILL

Skills and experience can be a plus, but personality, and how they would fit with our team, count for much more. We can train someone to do most of the tasks in our office, and in fact, we often prefer to train them rather than work to correct habits or processes that don’t work for us.

We require all of our staff to be certified through AOA, ABO or JCAHPO. Employees not certified are not eligible for bonuses, so we provide full support for certification. We have training materials in the office, we will work with and tutor employees, and will pay for the first attempt at the certification exam. We also constantly train, partnering with vendors to provide training in our monthly meetings and taking staff to education meetings (in fact, we just took three staff to Vision Expo West 2016).

MAKE THE OFFER

My office manager calls to make the job offer. These are very pleasant phone calls usually, as the applicants who have made it through our process are sure they want to be employed by us, and therefore, happy to hear they have been chosen. We let the employee know that employment is probationary for the first 90 days, and that permanent employment will be offered after successfully completing 90 days.

PETER J. CASS, OD

is the owner of Beaumont Family Eye Care in Beaumont, Texas, and president of the Texas Optometric Association. To contact: pcassod@gmail.com


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