hiring new clinicians

Growing pains: Hiring and training new clinicians

Posted in Hiring & Firing Staff

Developing a good process for hiring new clinicians is essential to your health as an organization. It is one foundational to your success as an organization. And we need to get good at it because some staff with inevitably leave for other options. Our best option is to develop a good hiring process.

The reasons you have an opening usually is either growth or someone left. If you have done an excellent job of creating demand for your services, you will need to hire. When someone leaves your practice, you will need to hire. But before the interviews begin it is well worth asking, what are candidates looking for in an employer? And more specifically, what might be attractive about joining your practice?

Different strokes for different folks

Fortunately clinicians are attracted to all sizes and types of practices. Some like the idea of a start-up and want to have a larger influence on what emerges; Others want more stability and structure; or mentoring; or independence and autonomy. And there are those who are attracted to their particular supervisor. Others care about the location. The variables are many.

Be who you are

The goal then is to be who you are. Before hiring new clinicians, list out what you are offering someone who is joining. What are the opportunities associated with the position you are offering? What types of candidates might be interested in your type of organization? Where might you find those candidates? Are you looking for veterans who are looking for a space to do their thing and little else? Are you looking for the energy of youth and willing to invest in training them into more maturity?

Have a picture in your mind of the ideal candidate. You may not find an exact fit but knowing the type of employee you are looking for is a strong beginning.

Finding the candidates

I have written a more extensive post on this topic called: Recruiting the best employees for your mental health practice. You can read it here.

We have several strategies for finding good job candidates.  But my two favorites are these.

First, several of our clinicians who teach a course or two at nearby graduate schools, not for the income so much as for the exposure to graduate students who might someday be candidates for our organization.

Secondly, for over 20 years, we took 2 to 5 practicum students each year. These are students in graduate school who are inexperienced but will someday be out their building career’s for themselves. We are offering each practicum student a year-long job interview. By the end of it, they will know who we are. And we will know them. It does not always turn out to be a match but sometimes it does. When it does it is a very low risk hire for the both of us.

Now both of these strategies are quite long-term. One does not see immediate results from teaching or supervising. But these do build a reputation that spreads and creates an excellent foundation for our hiring.

And if that doesn’t work?

Even with the above strategies, there are times when we still are wanting additional applicants. Our best approach has been contacting local graduate schools. Accreditation bodies are now requiring graduate schools to do a better job of tracking their graduates. That means they usually have a way of posting job opportunities on a jobs board or email distribution. We have had great success in having graduate schools help us distribute a job listing. And we have found some experienced clinicians this way.

In my view, we ought always to be vigilant for candidates who might be a fit. To do so can help us weather the trying times when turnover occurs.

Honesty in the interviews

My organization got to the size that we were nearly always interviewing clinicians. We looked for those who fit, and generally we hired about 20 percent of those we looked at. The resume may tell us that the person is not suited for our setting.

We interview some good therapists that we do not think they would be a great fit with the rest of our staff. Some need more experience. And yes, we have times when we make an offer and the candidate rejects it. There is no magic. We just can be the keepers of the process and let the chips fall where they do.

The goal of any interview is to learn about each other, to see if there is a match. In another post, I have outlined our interview process.

See that post here: Conducting excellent job interview for clinical staff.

In my view one of the biggest mistakes we can make is “selling” a position. We must resist the temptation to try to talk someone into joining. Doing so only sets up the inevitable disappointment and disillusionment when the honeymoon is over. I want to especially talk about the downsides of our system. Over-optimism always backfires. And disgruntled employees are not fun to deal with. Do yourself a favor and be clear about what you can offer and then find people who fit.

Hiring new clinicians

After the interviews, it is time to lay share the employment contract and make to offer. We do this through an email where we outline which office, which position, the time frame we are hoping for a decision, and how they can let us know. We have them sign the contract and send it to the owner. Once they have given us a signed contract, we announce the hire to the rest of our staff.

See this post on the Five ideal employee types in mental health.

Orienting them

There is more to do after hiring new clinicians. We need to train them and to orient them to the habits that lead to success. An online software tool called Remarkable Start helps us present start-up materials. Remarkable Start distributes YouTube videos that we use to teach the effective use of our software. And we have about 30 documents that they can read and comment about. The system is fantastic for bringing new hires up to speed. They are more confident in who we are. They feel cared for. And they learn more rapidly than any other system we have tried.

And then the training meetings

But it doesn’t end when we hiring new clinicians. They need to be properly trained. When we hire someone they join a monthly 2-hour meeting where all our newer people get together to get oriented and to support each other. They will be in this meeting for at least 12 months. They graduate by accomplishing certain marketing and caseload markers. These trainings are our attempt to establish good work habits that will enable each experience success and stability.

Other posts:

Starting a new business? The start-up blues

The dilemma of success: Do it myself or delegate

Building culture through regular meetings

Enjoying this article? Share your thoughts.

  1. Cindy Lindeman says:

    Hello David,

    I’ve been operating as an independent practitioner (LPC in Texas) for 23 years. I moved to a new town 2 years ago and started up a private practice here which has flourished. I have more referrals than I can accommodate. I accept most of the major insurances and that is necessary for my rural community. In order to meet the needs of my local community I am looking at having an independent contractor perform the therapy services for some of my clients. The contractor that I am talking to is also an LPC. She has her own Malpractice insurance but she is not on any insurance panels. If we formed a 60/40 agreement I would not charge her rent (from what i read in your other responses) and I would bill all of the services she renders under my insurance information and contracts, correct? She is not on any insurance panels because she works full time for a school district and her only private practice work has been contracts with local agencies and some cash pay clients. Do I have to do anything new/different as far as my insurance contracts or malpractice insurance to bill for the services she renders on my behalf and be covered in the event of any legal issues that could arise from her work here? What about clients that are referred directly to her and which I don’t have to bill for. Can we have a separate clause about those clients where we agree on a lower per session rate to cover space/utility usage expenses?

    1. Dr. David Norton says:

      Hi Cindy. Lots of questions here but let me do my best. Typically when one hires someone as an independent contractor, they do a percentage of collections which covers the rent and all other expenses that the owner has. In all cases, the practice owner should require a copy of the malpractice insurance and a copy of the employee’s license.
      As for billing, that is trickier and depends on the rules of each insurance company. Some will allow what is sometimes called “incident to” billing (Google it) and others do not. And because she is an independent contractor, that muddies the water even more. Generally, as an independent contractor, she would do her own billing and not depend on your license and insurance contracts. For that reason alone, you might consider making her a W-2 employee and then explore “incident to” billing with each insurance company.
      I would NOT recommend a second system for handling fees when clients are direct referrals. Several reasons: (1.) It complicates bookkeeping. (2) It is messy to verify where a particular referral comes from. (3) As time goes on and marketing is more saturated in your community, referrals might come from multiple sources. So then what?

      1. Cindy Lindeman says:

        So for me to be able to do the billing would I have to modify my contract with the company and add her as a provider or a create a group practice? What would be the options I could consider outside of contacting each insurance company and asking about their acceptance of incident billing.

        1. Dr. David Norton says:

          Creating a group practice is best, though I understand it takes time to work through the insurance company bureaucracy. As a bonus, doing so sets you up for adding more employees down the road. Sort of depends on how big you want to get.

          The other option is that she does her own contracting and billing, truly functioning as an independent contractor. As an in-between, you can do the administrative work but still contract and bill under her own name. This means you are really running a “group” that really isn’t a group under 2 independent entities (i.e., yours and hers). A little messy but that can be done. In this scenario, part of what she is paying for is for you to administer her business as an independent contractor.

          Furthermore, I know that some fudge these things even more, for example, contracting and billing under one practitioner’s name and license but that is not good. I always think that cleaner is better. My motto was “Do it right and sleep better.”

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