Building a strong health care team: A physician's quick guide to hiring and retention

Building and maintaining a strong medical team is crucial for the success of any medical practice. Yet, with increasing competition for talent and rising burnout rates, hiring and retaining skilled medical professionals has become more challenging than ever. 

This article provides practical strategies for attracting top talent, implementing effective hiring processes, and fostering a work environment that encourages long-term retention. By focusing on these areas, you can build a cohesive, motivated team that enhances your practice's success and improves patient satisfaction.
‍

Attracting top talent

Creating an appealing workplace culture is often the foundation for attracting high-quality candidates. This is especially true for attracting millennial and Gen-Y workers, who often put a greater focus on maintaining a healthy work/life balance and working in an environment and culture that shares their values. For example, many nurses enter the profession to make a difference in patients’ lives and in their communities; they want to work in a culture that reflects their values and “gives back” in meaningful ways. ¹

To attract top talent, focus on fostering an environment that encourages collaboration with staff; meaningful professional development opportunities; and mutual respect. Highlight your practice's commitment to work-life balance and professional growth during the recruitment process.

Offering competitive compensation and benefits is essential, but to demonstrate your commitment to staff well-being and the work/life balance, you may also consider offering such perks as flexible scheduling, wellness programs, or opportunities for research and publication. These offerings can set your practice apart from others.

Leverage your practice website and social media in your recruitment efforts. Maintain an updated, professional website that showcases your practice's culture and achievements. For example, share your practice’s volunteer efforts with website articles and social media posts about staff volunteerism, local good works, and donations. ²

Also use professional sites and platforms, such as LinkedIn, to network and share academic research, success stories, collaborations, or insights to position yourself as a thought leader in your field. These types of posts will also help you build a brand for your practice.

‍

Effective hiring strategies

When searching for candidates, create clear, detailed job descriptions that not only outline the required qualifications but also the soft skills and cultural fit you are seeking. 

Consider including an “about us” paragraph in the listing that describes your practice’s work environment and commitment to providing high-quality, patient-centered care within a team environment that supports professional growth and work-life balance. Include details of your practice that are unique to you, your culture, or place in the community. ³

Use multiple recruitment channels to find the right candidate, including professional networks, medical job boards, and referrals from current staff. Each channel can bring different types of candidates and broaden your talent pool.
‍

Conducting effective interviews

When conducting interviews, look beyond assessing clinical skills. Below are some practical tips to help you evaluate a candidate’s problem-solving abilities, teamwork, and adaptability.

1. When interviewing, ask a mix of questions such as: 
   
   • Behavioral questions that ask the candidate to describe how they handled a situation in their past work or life experience using such “soft skills” as communication, problem solving, and flexibility. These types of questions will also offer insight into how well the candidate may fit into your office culture. 
     
     1. “Tell me about a time you had to deal with a difficult patient. How did you handle the situation?” 
     2. “Have you ever disagreed with a colleague’s treatment plan? How did you address it?” 
     3. “Can you provide an example of how you helped develop or improve patient care processes in your previous role?"
        
        
   • Situational questions that provide the candidate with hypothetical situations or problems to solve.
     
     1. "If a patient's family member became argumentative about the patient’s care plan, how would you handle the situation?"
     2. "How would you approach a staff member who consistently arrives late for their shift, affecting patient handover?"
     3. "If you noticed a potential medication error, what steps would you take?"
        
        
   • Technical questions, adapted based on the candidate’s specific role, to verify medical knowledge and experience:
     
     1. "What's your experience with [specific electronic health record system]?"
     2. "How do you stay updated on the latest developments in [relevant medical field]?"
     3. "Can you walk me through your approach to diagnosing [common condition in your practice]?"
        
        
   • Traditional, cultural fit, and additional experience questions, to help you gauge how a candidate thinks and works, and whether they will fit into your office culture: 
     
     1. "What do you like most about working in health care?"
     2. “Why do you want to work here?”
     3. "How do you prefer to communicate with team members?"
     4. "How do you prefer to receive feedback – whether it be positive or negative?"
     5. “What is your idea of effective patient and family education?” ^{4, 5}

2. Allow sufficient time for candidates to ask questions. The questions a candidate asks you in return can help reveal their level of interest, preparation, and priorities.
   
   
3. Consider involving current staff members in the interview process to ensure team fit and to gather different opinions and perspectives.
   
   
4. Develop interviewing and hiring methods to combat unconscious bias that may affect hiring decisions. Biases — unconscious or not — can affect a practice’s ability to hire and retain strong candidates. Biases may exist based on a candidate’s gender, age, race, ethnicity, sexual orientation, or religion. And it’s important for a variety of reasons to recognize and remove biases in the workplace.
   
   According to the Harvard Business Review, promoting “diversity within organizations fosters better problem-solving, innovation, and thoughtful strategic planning [and] … studies have shown that talented candidates seek out diverse work environments. Overcoming unconscious bias in your hiring has a ripple effect of building an exceptional team that attracts exceptional candidates.” ⁶
   
   One way to address unconscious bias in hiring is to standardize the interview process “so that each candidate answers the same questions and performs the same work tests to ensure a fair performance review.” Consider adopting a scoring system in which candidates’ responses to questions are graded using a consistent standard that ensures objectivity.
   
   
5. Compliance considerations: Ensure all interview questions comply with state and federal employment laws. Avoid questions that could be interpreted as discriminatory or unlawful, such as those related to age (unless used to verify legal requirements), race, religion, marital status, gender or sexual orientation, family planning, disability, or alcohol or drug use.
   
   

Keep in mind, the interview is a “two-way street.” It is not only assessing the candidate's suitability for the role, but it is also an opportunity for you to showcase your practice. Be prepared to answer questions about your work environment, team dynamics, and opportunities for personal and professional growth.

Consider assigning mentors to new team members. This provides them with a go-to person for questions and helps them integrate more quickly into the team. Set clear expectations and goals for the first few months with the new hire and their mentor; schedule regular check-ins to ensure goals are on track and your new employee feels supported.

‍

Retention strategies

A positive work environment is key to employee engagement and retention. Consider adopting the following retention strategies. 

• Encourage open communication by asking for feedback. Conduct regular staff meetings that provide opportunities for employees to express their thoughts and ideas without fear of judgement or retribution. Also consider calling impromptu meetings after a challenging day or patient encounter to compare notes and share thoughts or concerns.
  
  Address concerns promptly to demonstrate your commitment to taking staff feedback seriously and to building a team of professionals whose views and opinions are heard and valued.
  
  Opening channels for feedback creates “a culture of empowerment and continuous improvement … A robust communication and feedback system fosters collaboration, strengthens teamwork, enhances employee engagement, and ultimately contributes to better patient outcomes and a positive work environment.” ⁷ 
  ‍

• Recognize staff achievements in meaningful ways. Public praise, written notes of gratitude, or recognition programs — such as employee of the month/year — can help you show your appreciation for your team members’ hard work. “[M]eaningful recognition establishes a culture of appreciation and camaraderie, leading to higher job satisfaction and a reduced likelihood of turnover. As a result, your practice will have an easier time retaining top talent.” ⁷
  
  
• Offer ongoing professional development opportunities by supporting attendance at conferences, providing access to online courses, or organizing in-house training sessions. These efforts will help you show your staff your investment in their personal and professional growth.
  
  
• Establish work-life balance initiatives, such as flexible scheduling options, adequate time off, and policies that respect personal time. Consider offering sabbaticals or extended leave options for long-term employees.
  
  Several studies point to how effective flexible scheduling can be in reducing stress and burnout, increasing retention, and improving performance. But with these advantages comes a new set of responsibilities. Flexible scheduling can potentially cause confusion or stress among your team. Therefore, physician practices will need to emphasize and focus on clear communication, scheduling, and documentation to track physician coverage/availability and patient progress, tests, and medications.
  
  It is important for practice leaders to model this behavior for team members. 
  
  • Establish clear boundaries between work and personal life by scheduling personal time on your calendar or avoiding checking work emails or work-related calls during off-hours.
  • Take regular breaks through the day to rest and recharge, even if only for a few minutes.
  • Prioritize and focus on the most critical tasks at work, and delegate or eliminate tasks when possible. This will help you (and your team by example) better manage their workload and reduce stress. ⁸

• Implement strategies to prevent and manage burnout, such as promoting self-care, providing mental health resources, and ensuring workloads are as manageable as possible.

It is also important to effectively manage interpersonal conflicts. Workplace discord can disrupt team dynamics, create more staff turnover, and even negatively affect patient care.  Develop clear conflict resolution processes, such as how to report a conflict, expectations around how and when the conflict will be resolved, and how to keep all processes positive and solution oriented. Consider offering staff training in interpersonal communication or conflict management.

‍

Medical staff checklist

When managing medical, nursing, and support staff, consider the following hiring and retention strategies. 

1. Conduct thorough background checks and credentialing verification ⁹

• Implement comprehensive background checks for all new hires.
• Regularly verify and update staff credentials.
• Comply with state board regulations on physician and staff licensing.
  ‍

2. Provide ongoing training and education

• Offer regular training on patient safety protocols.
• Keep staff updated on changes in state and federal health care laws and regulations.
• Offer continuing education opportunities to ensure staff maintain competency and to help them meet their professional development goals.
  ‍

3. Establish clear policies and procedures

• Develop and regularly update employee handbooks and policy manuals.
• Ensure all staff understand and follow HIPAA compliance measures. ¹⁰
• Use clear protocols for handling patient complaints and adverse events.
  ‍

4. Promote a culture of safety ¹¹

• Encourage open communication among staff members regarding potential risks or safety concerns.
• Implement a non-punitive reporting system for near-misses and errors.
• Regularly conduct safety audits and involve staff in improvement initiatives.
  ‍

5. Address burnout as a risk factor

• Recognize that staff burnout can lead to errors and increased liability.
• Offer wellness programs and stress management resources for staff. When possible, eliminate barriers to accessing care and identify support services to provide to staff members. 
  
• Make efforts to remove stigma around mental health care by educating yourself and others. Talk openly about mental health using non-discriminatory language. Normalize treatment for mental health issues, just as you would any other health care treatment. ¹²
• Monitor workloads and ensure adequate staffing levels to prevent fatigue-related errors.
  ‍
  

6. Documentation and communication

• Train staff members to properly document all patient care.
• Foster clear communication channels between all team members. Schedule and maintain regular group and “one-on-one” meetings with staff. 
• Regularly review patient records for accuracy and completeness. 
  ‍

By integrating these management strategies, you not only help to create a more stable and satisfied team, but also significantly reduce your practice's liability exposure. 

‍

Sources

1. How to recruit and retain millennial nurses. Monster.com. Available at https://hiring.monster.com/resources/recruiting-strategies/talent-acquisition/how-to-attract-millennial-nurses/.
   Accessed August 29 .2024.
2. Scanlon J. How to leverage social media to help you with recruiting. Forbes. September 24, 2021. Available at https://www.forbes.com/councils/forbesbusinesscouncil/2021/09/24/how-to-leverage-social-media-to-help-you-with-recruiting/.
   Accessed September 9, 2024.
3. Recruiting.com. How to write effective job postings: Job description and skills. Available at https://www.recruiting.com/blog/how-to-write-effective-job-postings-job-description-and-skills/.
   Accessed September 9, 2024.
4. Inglis J. Situational vs. behavioral interview questions: how to master them both! Career.io website. 2024. Available at https://career.io/career-advice/situational-vs-behavioral-interview-questions.
   Accessed September 5, 2024.
5. Griego E. Four common types of interview questions. LinkedIn. November 30, 2021. Available at https://www.linkedin.com/pulse/four-common-types-interview-questions-elena-griego/.
   Accessed September 9, 2024. 
6. Carnahan B, Moore C. Actively addressing unconscious bias in recruiting. Harvard Business Review. Recruiting. Insights & Advice. June 16, 2023. Available at https://www.hbs.edu/recruiting/insights-and-advice/blog/post/actively-addressing-unconscious-bias-in-recruiting.
   Accessed September 9, 2024.
7. Smith K. 10 strategies to improve healthcare staff retention for your practice. The intake. August 18, 2023. Available at https://www.tebra.com/theintake/staffing-solutions/tips-and-trends/10-strategies-to-improve-healthcare-staff-retention-for-your-practice.
   Accessed September 9, 2024. 
8. Sermo. Guide for doctors: Work-life balance best practices. July 20, 2023. Available at https://www.sermo.com/resources/doctor-work-life-balance/.
   Accessed September 9, 2024. 
9. Redstar Backgrounds. Background checks for Texas healthcare facilities. July 19, 2023. Available at https://redstarbackgrounds.com/news---blog/view/297/background-checks-for-texas-healthcare-facilities.
   Accessed September 9, 2024.
10. Alder S. HIPAA policies and procedures. The HIPAA Journal. November 7, 2023. Available at https://www.hipaajournal.com/hipaa-policies-and-procedures/.
    Accessed September 9, 2024.
11. Institute of Medicine (US) Committee on the Work Environment for Nurses and Patient Safety; Page A, editor. Keeping Patients Safe: Transforming the Work Environment of Nurses. Creating and Sustaining a Culture of Safety. 2004. Available at  https://www.ncbi.nlm.nih.gov/books/NBK216181/.
    Accessed September 9, 2024.
12. Greenstein L. 9 ways to fight mental health stigma. National Alliance on Mental Illness. October 11, 2017. Available at https://www.nami.org/education/9-ways-to-fight-mental-health-stigma/.
    Accessed September 9, 2024. 

‍

‍