How 4 spine practices recruit and retain staff

Practice Management

Soaring inflation, a rising physician shortage and workers leaving the healthcare industry because of the COVID-19 pandemic are some of the factors making it difficult for orthopedic groups, hospitals and ASCs to recruit and retain top-tier clinical and administrative talent.

Four spine surgeons share their strategies for recruiting and retaining quality staff in a challenging healthcare labor market.

Question: How is your organization recruiting and retaining staff in today’s challenging healthcare labor market? 

Louis Levitt, MD. The Centers for Advanced Orthopaedics (Bethesda, Md.): We are blessed to be geographically surrounded by top medical institutions such as Georgetown University, George Washington University, Howard University in Washington, D.C., and more. Many of our physicians are university-affiliated, so they are continuously interacting with talented residents. This enables us to recruit young physicians, particularly those who do not want to be employed by a hospital or corporation and are drawn to the private practice model of care. Because we are a truly independent private practice organization, we appeal to this population of physicians who desire the independence to practice medicine how they see fit, based on their expertise. Our innovative business model sets us up in the community to attract physicians, ancillary personnel, physician assistants, nurse practitioners and others who do not want to be "on the clock" delivering care based on cost rather than quality of care.  

The key to retaining staff is understanding the importance of your whole team. We stress a team approach at CAO because all of our employees engage in the patient experience in some way. Every employee is responsible for delivering care, from the moment the patient walks in our door to the moment they leave after their appointment. We train our staff at all levels and roles to ensure the best possible patient experience, and as a result, the whole team has a sense of pride in the care we deliver. It's important that leaders set the vision so staff can see where the company is going and know their role in helping achieve the mission. Additionally, in this economy, practices must recognize the cost of living is at an all-time high and offer frequent raises and bonuses accordingly.  

Brian Gantwerker, MD. The Craniospinal Center of Los Angeles: We have thankfully been very stable in terms of staff. What we have learned is three things:

1) Never skimp on equipment or processes that make things easier for your staff to do their job — get them the more expensive scanner that works faster and lasts six years instead of a $100 scanner you got on clearance that lasts six months.

2) Always ask your staff how things can go better and encourage them to tell you their ideas for things like clinic throughput, communication of information and data capture.

3) You get what you pay for, which seems to be a lesson lost in terms of the healthcare sphere over and over.  

Brian Fiani, DO. Weill Cornell Medicine/NewYork-Presbyterian Hospital (New York City): The challenges with recruiting and retaining staff in today's healthcare labor market is mostly felt in practices or institutions where the staff is feeling overwhelmed, undercompensated or undersupported. Recently, I have been involved with many organizations, including world-renowned academic institutions, community hospitals, county hospitals, military hospitals, and private practices. From my experience, the key to recruiting staff is making the staff feel welcomed and excited about new opportunities. Encouragement is crucial. 

The successful management concept to retain staff is to provide fair compensation for services provided and advocating for staff needs. The biggest challenge in healthcare labor markets is not necessarily the physician, but physician support staff. Opportunities for physician support staff are abundant, making it challenging and competitive.

Chester Donnally, MD. Texas Spine Consultants (Addison): We aren't — retaining is very challenging. Spine is a hard field for mid levels compared to others since the patient population has more challenging needs. The obvious thing is you just need to pay your staff more, but medicine is funny because we are the only field that can't simply charge our "clients" more as we rely on insurance to pay us. So where does that extra money come from? From the surgeon's take-home pay. Another aspect of recruiting is that we as surgeons need to be captain of the ship. We need to create the environment and make the members passionate about their job and understand that they are a true part of the team. 

A few years ago, I submitted papers about online reviews and what influences them. In my initial submission, I indicated that negative reviews were based on the staff, not the physician, so physicians aren't to blame. But the reviewers astutely pointed out that the physicians control the staff and they are a direct representation of us. So, any reviews that talk about our staff, but not the physicians are definitely a representation of us and something the physicians also control. It's a series of comments that has stuck with me. Of course I updated the discussion of the papers to reflect that mentality and this one that we preach in our own group.

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