You Get What You Pay For!

Kiki Herfert brings more than 30 years of worldwide chiropractic experience to her columns, convention presentations, and management work.

The following is part of a letter I received recently:

"I seem to have trouble finding and keeping good help. I feel like the people I'm getting are those who couldn't get a job anywhere else. They don't seem to have even the basic skills. When I do find someone, they eventually want more money than I can pay and some left for a better paying job. Any ideas?" -- a DC in Missouri

If I were going to put "the curse of the cat people" on someone, I'd wish that they had continuous problems with their staff. Few things are more exhausting for the doctor, hurtful to the bottom line, and generally destructive to a practice than constant crisis and turnover. Some staff "problems" are the inevitable changes that come with marriage, babies, spouse transfers and other life "events." But, in my experience and opinion, a real chunk of the responsibility lies with the doctor.

Initial hiring practices are often driven by wanting to find someone "quickly, cheaply, and teach them what they don't know." Right. Well, actually that's quite wrong! I can understand and overlook this attitude when you hire your first person in your first practice. You don't know much, you don't need much, and it might work for a while. Why not go for quality from your first C.A. right through to a full staff?

Meet (or beat) the market price if you want to hire people with skills. Look at it from a staff point of view. Why would they want to work for you for minimum wage (or barely more) when they could do the same at a fast food place and get benefits or flexible hours you can't offer?

Seriously research what good office help is making in other small offices. Scan the Sunday want ads. Call a few of the numbers and ask what they get besides their salary. Call an employment agency where the prospect has to pay the agency. You will find serious prospects who actually have the skills you need and more. It is a humbling experience to have someone you want turn you down because you don't run the caliber of office they are used to! Don't let ego blind you from the facts.

Avoid diamonds in the rough. You can't afford to do social work in your office. It's so tempting when you see the sparkle there, but if they don't shine quickly, it probably isn't going to happen. Do you want to help people reach their true potential, or do you want someone who will help you reach your true potential?

Fish or cut bait! If someone isn't working out, do not delay their departure. Have a probation period from one to four weeks and use it. Denying there is a problem and hoping for improvement doesn't work. It is my gut feeling that if the new person isn't showing signs of catching on after a week, they probably won't. This is assuming that "Here's the desk, here's the cash drawer" is not what constitutes your training program. The smaller your operation, the less time you have to decide.

Tell people exactly what you expect of them and exactly what they can expect from you. Keep your word. Have an accurate job description when they hire on and give yourself and them a period of time (30-90 days) to adjust the job description. Staff people feel crazy when you tell them one thing today and another thing tomorrow. This doesn't mean that things can't change; they often need to, especially if your practice is growing.

Communicate to new (and old) staff that every job from hamburger flipper to nuclear scientist has a salary cap. No matter how good you are at your job, you won't earn more unless (and this is an important distinction) you are able to generate additional income through effort or creativity. Just showing up and being reliable doesn't get you endless raises. You have to learn more and do more. And if staff are already paid at the top level, they will have to settle for "cost of living" increases unless they can think of (and deliver on) income-producing ideas.

Don't be cheap. You can't run 6-7 figure practices with unskilled and untrained help. Accept that good staff is as important an investment as the best equipment you can afford. Your management people must offer a serious level of competency. They are what keeps track of lesser skilled staff and push you solidly back into the black ink at the bottom line. Inadequate (or non-existent) management creates dozen of small money "bleeds" that add up to chronic financial hemorrhages.

Responsibility equals greater success and income. When I hear, "I just want to adjust patients," I know there the underlying cause for many management problems lies. As a doctor, you are eligible to earn three "salaries" or payback for effort or investment. If you own your own building, you get a salary as an investor. You are paid for being the "adjusting machine" and you also earn a salary as the manager/financial planner of your own practice. Why lose additional profit you can have by being involved in the management of your office?

Don't treat your staff like the "help." These people are your support team. They will help you succeed because there is. or should be, something in it for them. Treat them as courteously as your most valued patient. When there is a conflict, do your best to work it out. When you finally have to say "Because I say so," do it reasonably and rationally.

Hire smart, evaluate quickly, treat staff as valued people, fire when needed, and pay well. Good people will come to you!

Dear Readers:

I'd love to hear your thoughts. I want my column to reflect real life -- your real life! You can talk to me or write me at:

Kiki Herfert
15852 Jefferson Avenue
Grosse Pointe Park, Michigan 48230
Tel: (313) 822-9199