When doctors express ongoing difficulty with keeping staff, one of the first questions I ask is: "What do you pay them?" In many cases, the answer is a variation of "as little as possible."
I understand the need to keep overhead under control, but there's a real downside to offering low pay. When I ask doctors complaining of staff problems whether they have reviewed the local papers to see what comparable jobs in the area are paying (positions like receptionists, secretaries, and general office help), most reply that they usually check with friends to see what they are paying rather than looking at the classified ads.
As I continue, I want to remind the enforcers of political correctness that I'm simply stating the obvious: For many married females, their income is often supplemental income for the family. These women are more likely to give up their jobs with you when they move or have babies, simply because their husbands have better-paying jobs. In short, your staff people are generally not making more than their spouses. Their jobs are, if not disposable, at least easily replaceable. In addition, family concerns such as babysitters, extended or evening hours, and weekend work limit the number of people willing to fill your job opening. Many single women/mothers can't afford to work for you because you may not pay enough for them to survive.
In my area, even the Burger King and McDonalds are advertising jobs that pay $8.50 an hour, yet I know doctors who are currently offering less. Think about what we require compared with a fast-food restaurant. They probably offer flexible hours, uniforms, some benefits, and video-taped job training. Only a minimal educational/skill level is required. You require long hours, offer generally few benefits, and rarely have a formal training program. Most of you require (or at least hope for) well-mannered people with computer skills, business savvy and the ability to make countless decisions that will affect your patients, your practice and your profitability. Given the choice between the long hours, higher stress and skills required by your office, or a cut-and-dry, "leave it at the door" job, almost everyone will take the easier job for the same money.
Many of you offer free care for staff and their families. While that is a nice bonus for the employee, I've never met a staff person who told me that's why they wanted the job.
To get quality, you have to pay for it. You are competing with larger offices and companies offering good benefits and working hours. Look at the situation from the viewpoint of a person considering a job with you. Be realistic. Their main reason for working is that they need money. If they just wanted to keep busy, they could find volunteer work. They scan the papers, ask friends, and possibly contact an agency that will charge them to find a job. Because of the shortage of "good help," other employers are also trying hard to attract good people. If you're only willing to offer low-end wages, you will, with rare exceptions, find only minimally qualified workers willing to join your staff. You will end up with those who couldn't make the cut for higher-paying jobs.
I have a letter from a woman who says she worked in four chiropractic offices before finding a doctor who would pay her what she felt was a salary reflecting her abilities. She expressed frustration with unorganized, unreasonable and unrealistically low-paying doctors. Eventually she found someone who recognized her abilities and paid for them. Based on her qualifications, she seemed like the kind of person most of you wish you had in your office.
If you've been successful hiring, but not in keeping people, ask yourself:
Kiki Herfert
Grosse Pointe Park, Michigan
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