Congratulations! You are ready to hire some people, build your staff, and create the culture you want at the office. I say congrats, because if you are here, then I know some things about you already.
First, you have launched your practice and are on your way.
Second, you have mastered the Daily Core Activities of scheduling, providing therapy, billing, collecting, and marketing.
Third, you now have grown to where you are facing the inevitable problem—more referrals than you can take care of by yourself.
Every practice that grows goes through this same process. Unavoidably, doing things well leads to problems. (Read more posts on many of the issues that come from growing in Stage 4.)
Table of contents
Waiting until we are exhausted
Most of us probably wait too long to hire our first employee. We have our heads down and are doing our work without much vision as to what is coming. Nevertheless, at some point, we realize that our options are these.
- We either stay in this semi-exhausted state forever, or
- We change the way we do things.
Furthermore, as I face these challenges, I realized that if I did not change, my schedule would be chronically overbooked. I would have no option but to refer the clients I could not schedule to therapists in other practices. That would not help my referral relationships much.
More on this issue in this post:
But what to do instead?
Hiring support staff
We could hire support staff to help with phones, scheduling, billing, and collections. We still have to do marketing.
(Check out, “Why mental health providers cannot hire out our marketing.”)
Hiring support staff would make a difference. But to do that, we have to recruit, train, supervise, and manage the support person we hire. Where does that time come from?
And even if we find the right support person, the fix is temporary. The clinical load is still heavy and will continue to build adding to our exhaustion.
Adding clinical staff
Adding clinical staff has the virtue of easing my clinical load and helping with the sense of isolation. But adding staff means also means adding many other skills as well including the focus on our organizational culture.
Here we will introduce you to a series of other articles on building your staff and culture, the ultimate solution to this problem.
Managing this area and doing it well, is about recruiting, hiring, training, supervising, and managing, and then supporting your team with the human resources your organization needs. Let’s take a quick look at each of these.
1. Recruiting & Interviewing Staff
The first challenge in building staff and culture is finding people who might become excellent teammates. I have spelled out the recruitment and interview process we used into two articles:
- Recruitment methods for finding excellent staff
- Conducting excellent job interviews for clinical staff
- Five ideal employee types in mental health
2. Hiring staff
Once the interviews are complete, then we are ready to make our choice and work on building the staff we need. The first post gives an overview. Then we get into some of the problems that may come up with difficult employees and finally how to fire an employee, if necessary.
- Hiring new clinicians: Building a staff one hire at a time
- When an employee leaves: Saying goodbye well
- Addition by subtraction: Types of difficult employees
- When we need to fire an employee
3. Training staff
When I began hiring staff, I did not realize how much of my time would be spent on training and then supervising staff. Nor did I realize how much these tasks shaped our staff culture that was emerging. However, hiring was just the beginning of years of effort in training and supervising staff. I discuss these topics in the following posts.
4. Supervising and managing staff
I was not a business major. Consequently, I never had a course on supervision or managing staff and our culture. It was on-the-job training spiced with lots of reading on this topic. Some of my favorites books are on the Resources page here. The lessons I learned are summarized here.
- The training we never had–Managing staff
- Understanding staff complaints
- Our philosophy for working in community
- How to become a community of clinicians
- Managing leaders
5. Supporting your staff with excellent Human Resources
Eventually, we realized that to attract the quality of employees we wanted, they needed additional support via benefits. Larger companies have Human Resource departments to build these benefits programs. We did not. We had two options:
- to develop and maintain it ourselves
- contract it out
We tried both options. Here is what we learned.
In summary, put all these skills and resources together, and you have staff and culture to support your team. Happy building.