Enhancing Practice Performance

Invest in your staff’s professional growth

The entire practice benefits when you retain your valuable and experienced employees.

A prominent trend, especially now that the unemployment rate is at or near record lows, is the difficulty practices face when they lose long-term, experienced employees. This applies to all positions, not only management staff.

When key employees leave, the remaining staff have to pick up the workload. The loss of just one key staffer can begin lingering gaps in patient flow and customer service.

Especially in smaller practices, the departure of one experienced staff member can significantly impact the collective knowledge base and strength of the department and practice. For example, if your most knowledgeable biller with nine years of experience leaves and the one biller remaining has only one year of experience, you have essentially lost 90% of your billing department, not 50%.

One way to help diminish the turnover of your most valuable and hardest to replace employees — and at the same time increase the overall practice’s human capital — is to invest substantially in improving professional growth throughout the practice.


With increased competition among employers in the job market, it takes longer to find a replacement, especially one that measures up to the experienced one you lost.

Additionally, as computerized systems get more elaborate, customer service standards elevate and clinical standards and regulatory requirements rise, training new employees takes longer than it did even a decade ago. This is especially true in practices constrained by unfavorable economics that must become leaner. These practices have to pack more knowledge into each individual team member.

It’s not unusual to hear practice managers express that, “Promoting employee professional growth just trains our local competitor’s future staff.” That occasionally happens, but investing in professional growth throughout your practice more often improves employee retention and skirts contemporary recruitment challenges. Investing time and dollars for individual professional development helps you retain your best managers and staff.


Here are some questions to help you explore if you are investing enough development resources in your employees:

  1. Are we a “learning organization?” What does that term mean in the context of how well or poorly prepared our average staffers are to do their job?
  2. On a 0-10 scale (“0” is terrible and “10” is outstanding), what is the average, global performance score of our workforce? What does that score need to be? If the score needs to be higher, how can we get there?
  3. What benefits would we get as a company if our staff global score was higher than it is now? How much easier would staff be to manage and direct? How much better would customer service be? How much less frustrated would our providers be?
  4. What percent of our lay staff leave the practice each year? (The typical figure in the average practice today is 20-25%.) Would staff retention increase if we invested more in training and skills development? Would the cost for extra training be more or less than the cost of our excessive turnover?
  5. As a learning organization, do we memorialize what we learn? Do we document how tasks are done so that when staff leave and their replacements are onboarded, we can preserve the agreed best way to do each job?


When you send your managers to national meetings, make plans to reap the benefits as an organization. Review the courses offered in advance, and make suggestions for attendance based on the new skills you want them to develop.

Also, assign each attendee the task of briefly summarizing the courses they attended, in writing, so they can share what they learned by presenting it when they return. This summary should also include a list of what they suggest the practice will benefit from the most and how they want to implement that in their department. Obliging staff to plan their off-site training and teach non-attending staff what they learned helps you squeeze more value from your training investment, even if the attending staff member subsequently leaves the practice.

Every practice has a different educational commitment, and many practices today are constrained in the time and dollars they can commit to training. But, no matter your resources, be as specific as you can in laying out each staffer’s allotted training budget and expectations. Do this in writing. Just as you track vacation time, track educational resources used and the return on these investments.

If faced with budgetary challenges, rotate attendance at educational meetings, giving everyone an opportunity to develop their skills — and to come back from such meetings as act as the trainer for the skills they just learned. Or, purchase one management book rather than one per team member and coordinate a shared experience, such as reviewing a chapter together monthly.

Other budget-friendly training tips include:

  • Assigning doctors in your practice to present clinical topics at staff meetings.
  • Inviting vendors and staff from non-competing practices to share their knowledge during lunch meetings.
  • Seeking out webinars and YouTube videos for a shared staff experience and discussion.


Being a “learning organization” comes from the top. Embrace a management philosophy that yours is an organization that is stimulating, not stagnate. The people you want working for you — people who make your work days great and wow your patients — are those who want and need to be continually challenged with new ideas, new tools and improved ways to do their jobs. It is in your control to build an organization where staff growth and improvement are core values. OM