When it’s time to scale your private practice, few tasks are more challenging than recruiting and hiring.
This isn’t just true in medicine. According to the Harvard Business Review, less than 20% of new hires across all industries are considered fully successful. After 18 months, nearly half are considered failures.
For those of us in the “Wild West” of concierge medicine, acquiring the right physicians can be particularly thorny.
Finding and hiring a new physician who is right for your practice typically takes 6-12 months (and in many cases even longer). This is a major investment of time and resources, but the repercussions for hiring the wrong person are even more costly.
In addition to new physicians, there are a host of other positions you need to fill when scaling:
- Medical assistants
- Office managers
- RNs
- Health coaches
- Dieticians
- Nutritionists
- C-Suite leadership
It’s critical that you make the right hires for your practice the first time around. To do this, you need to provide clarity around the roles you’re hiring for so you have a cohesive and purpose-driven onboarding pipeline.
The first step in this process is to create a job scorecard.
Why Is Clarity Important in the Hiring Process?
We’ll delve into what a job scorecard is, as well as its functionality and utility, but it’s important to first take a hard look at the pitfalls of hiring the wrong people. It goes beyond just the expense and hassle of wasted time and resources.
What Happens When You Hire the Wrong Person?
We’ve all heard horror stories about the fallout from a hiring the wrong person, and you’ve probably experienced it firsthand to some degree. No matter how hard you think it is to find the right person, it’s 10 times harder to get rid of the wrong one.
Hiring the wrong person for your practice can result in a host of short-term and long-term problems, not least of which are the erosion of your company culture and the derailing of momentum and growth.
In private practice especially, bringing in a bad-fit physician can jeopardize everything you’ve worked for. A provider who exhibits toxic behavior toward staff, for example, can destabilize your team cohesion. A doctor who dispenses conflicting medical advice to patients, or who is unprofessional, can tarnish your brand and chase away good business.
If you made this physician an equity owner (insert cold chills here), then to get rid of them you have to raise the capital to buy out their shares. And after the severance and non-compete clause are complete, this person could turn around and compete against you in your own market.
You taught them everything they know, and they turn around and poach your current and future patients and staff.
What Makes Someone a Bad Fit?
As we touched on above, one example of a bad fit for your practice is someone who destabilizes your team with toxic behavior. They might plant seeds of doubt with patients or stir up animosity among staff or physicians. Such behavior is an obvious red flag and can rapidly create division and hostility in your business.
Another example of a bad fit is more subtle: physicians who aren’t curious or willing to learn and ask questions. These aren’t the kind of peers you want to surround yourself with. They may have trouble adapting to your model of service and treatment. They lack either the humility or the confidence in themselves to be eager to learn and open to input.
One more major example of a bad-fit provider is one who lacks a true commitment to concierge medicine. This person is interested in the concierge lifestyle, but they don’t want to practice concierge-style medicine — the relationship-based, above-and-beyond model of health care. Their mindset is rooted firmly in the transactional, fee-for-service model that is the antithesis of your mission.
Some of these may seem like abstract qualities, and maybe they are. But an effective job scorecard not only allows you to objectively evaluate KPI metrics, it also distills the essence of your organizational values down into unambiguous job descriptions that help you assess for these qualities and hire the right people.
How Job Scorecards Strengthen Your Team
The job scorecard is an internal resource you can use to objectively compare job candidates and set expectations around key performance indicators (KPIs). It serves two vital, interconnected functions: clarifying your job descriptions so you hire better candidates, and accurately tracking — and improving — the performance of those candidates once they’re hired.
Job Scorecards Improve Your Job Descriptions
Let’s be honest… in the history of job descriptions, very few good ones have ever been penned. Traditional job descriptions usually sketch broad responsibilities and requirements that make it difficult to filter out bad matches and zero in on the people that best fit the role.
They do nothing to mitigate your risk of hiring someone who doesn’t fit your company culture or your medical philosophy. Their filter is too broad. They can only tell you whether someone has the necessary training, degrees, and licenses, not whether they can apply those qualifications successfully within your practice.
Without a clear job scorecard to back up your job description, you won’t have a way to objectively grade candidates against each other or to evaluate their performance once they start.
Scorecards Improve Team Member Performance
Maintaining a job scorecard for each of your team members allows them to keep track of their key metrics and know where they stand at any given time.
If there is an aspect of their performance that needs improvement, they don’t have to wait for a nail-biting quarterly or annual review to find out. They can take the initiative to hone in on specific metrics and self-direct their growth.
Job scorecards can provide each of your employees the chance to sit down at dinner with their family and confidently and objectively answer whether they had a good day or not.
Job scorecards also let team members know where they stand. Whether it’s a physician, a nurse, or an office administrator, letting a team member go should never come as a surprise to them. Having a scorecard to set expectations provides an early indicator if someone is off track from their KPIs and gives them a chance to course correct.
The job scorecard is like a bridge that leads from the recruiting stage all the way through to a team member’s full tenure with your business. It creates a self-managing feedback loop that improves both the performance of your current team and the process you use to vet future employees.
Key Pieces of a Job Scorecard
The ease of assembling effective job scorecards depends on having a clear business strategy, and then clearly communicating it.
It’s important to note that the content of a scorecard will vary dramatically based on the specifics of your practice. We can’t cover this whole topic in the space of one blog post, but we’ll look at a few of the key pieces of a job scorecard.
Summary:
The job scorecard starts with a 1-2 sentence, high-level summary of the job. This will define why the role exists and what its purpose is. Because the aim is to set clear expectations, the summary itself should be crystal clear.
Core Areas:
Every role has different facets. Job scorecards should define two to three core areas of the role and include the following for each area:
Outcomes
Outcomes show how this particular role will advance the company’s overall objectives. Each outcome is a high-level result you’re expecting over the next 12-18 months.
Accountabilities (Key Responsibilities)
These are the outputs that will generate the above outcomes. Each accountability item serves as part of a roadmap toward a positive result for the business. Underneath each accountability, you can further flesh out the job by describing the individual responsibilities that belong to the role.
Top KPIs
There are dozens of potential performance metrics, which is why it’s important for the job scorecard to designate which ones you’ll be measuring and rating in the hiring process and beyond. Each KPI should have a clear connection to achieving the role’s outcomes.
Competencies:
The competencies section outlines the qualities, experience, and abilities required for a job candidate to achieve the outcomes you listed for each role. Use extra caution when stating years of experience required. For example, are you willing to (unknowingly) pass on the otherwise ideal candidate who only has 8.5 years of experience and therefore won’t apply because you’re seeking 10?
How To Use the Scorecard
An effective job scorecard strips a job down to its essence so employees can see how their role’s strategic objectives align with your practice’s overall objectives.
Perhaps one of the best assets of a job scorecard is converting soft skills — behavioral characteristics like “time management,” which can be toothless on paper — into actionable job duties. Vague descriptions such as “team player” and “communication” turn into measurable expectations for which team members are accountable.
Your overall set of scorecards should fit together like puzzle pieces, starting at the top with you as CEO and cascading down into the roles of your CFO, CMO, Operations Manager, HR, etc. Eventually, designated department heads can create job scorecards for the roles they oversee.
Moving forward, you can consider integrating the core features of the job scorecard into your hiring process in various ways:
- You can still start with and post a regular job listing. But include the outcomes, accountabilities, and KPIs in the description.
- When vetting candidates, score them on each of the details in the core areas and competency section.
- You can also use scorecards to create the job assessments (questionnaire) the candidate will answer in your hiring process.
Find the Best Fit Through Scorecards
When developed with care and precision, scorecards become visual maps of a business’s operations and how they fit together.
High-performing companies in every major industry use this tool for transparency, organization, and achieving their bottom lines. Does your current hiring process provide enough certainty that new physicians and team members will match your concierge practice? Do your team members know exactly which performance metrics you’re evaluating them by?
If the answer is “no,” then consider creating and integrating job scorecards into your private practice.
The concept of a job scorecard originated in the books WHO: The A Method for Hiring and Topgrading. If you want to really dig into this topic at a granular level, we recommend these resources as a next stop.