Hiring, Retaining, and Engaging Staff Post COVID

The Goal Driven Practice by Gallup

I remember listening to Bruce Lipton talking in San Francisco at a Life West seminar about how chiropractic was so advanced that cellular biology, specifically epigenetics, was just starting to catch up. My thought listening to him was that, while chiropractic was perhaps ahead of its time, its management was still in the Industrial Age.

Michael Gerber of E-Myth fame and many other consultants emphasize the importance of procedures. Procedures, systems, and routine methods that bring about consistent results are the “best practices” businesses strive to achieve. This is the basis of the franchise model.

But while procedures are important, people are more important.

Therefore, the most vital procedures are those that you use to help your people become more competent and motivated. These are leadership and management procedures.

Leadership and management have always been important. But we are in the 2020’s now, long past the Industrial model of assembly-line procedural work. We are past the Information Age. And now, past COVID.

The world has changed, and how we run our practices must also change. The old model of the dominating doctor and his secretary, or “girls,” hasn’t worked well over the last 20 years. And now, we have seen many offices struggling to find, retain, and engage qualified employees and doctors.

Just as my book, The Goal Driven Business, was being published, I became aware of another book that Gallup just recently published called It’s the Manager. Not to brag, but much of what they explain is also covered in my book, especially for practices. What I like about Gallup, aside from validating my information, is the stats from the hundreds of studies they have completed.

It is now vital that you take on the role of Clinic Director or senior manager, which is different from doctor or business owner, and develop your leadership and management skills.

In short, you need to create a Goal Driven team of employees, doctors, and patients – all working together to achieve positive goals. This is a holistic, even futuristic, model of business.

We have been building new courses to train doctors and their managers in leadership, management, and marketing principles which we will pilot later this summer. (Replying to this email lets me know if you might be interested. I will keep you in the loop.)

But let’s start creating your Goal Driven Dream Team now.

Let’s begin with a recommendation from Gallup:

“Gallup recommends that organizations immediately change their culture from old will to new will. These are the six biggest changes that we discovered: [I only include the first change below.]

“Millennials and Generations Z don’t just work for a paycheck — they want a purpose. Their work must have a meaning. In the past, baby boomers and other generations didn’t necessarily need meaning in their jobs. They just wanted a paycheck. Their mission and purpose were their families and communities. For millennials and Generation Z, compensation is important and must be fair, but it’s no longer their primary motivation. The emphasis for these generations has switched from paycheck to purpose – and so should your culture.”

Seize your future,

Ed

Onboarding for New and Veteran Employees

Just Focus on Goals and Expectations

The way you set up the initial relationship with your new employee will directly determine how well they perform in the first year of employment.

I don’t think that this is given enough consideration. You are in a rush to fill a position, and once you have done so, you are now just happy that it is done so you can get back to seeing your patients.

The new employee is given some training, but since everyone is busy, it is very brief and short-lived. As a result, the productivity of the new hire is held back.

New employees are not like plug-and-play appliances. Everything is new to them. The staff, the patients, the jargon, the flow of traffic, the procedures — all these which you take for granted, are to them, new.

The prospective new staff member never really knows what they are walking into. Is this going to be their best or their worst work experience? So, despite their smiling cooperation for the first few weeks, underneath, they may be worried that your business is not for them.

It can take 8 to 12 months for a new staff member to gear up to full capacity and performance. But the critical period in my observation is the first three months.

Orienting, training, and acclimating the new employee to their new job, new team, and new business is called onboarding.

Onboarding – the First 3 Months

You want each team member to be happy working with you and operating at close to their full capacity. This is what you want for yourself, right?

Once you make the decision and the new person is hired, your management work just begins.

A systematized onboarding procedure helps the new employee feel safe, that this is where they belong, and that they are important to you and your office.

As a result, a deliberate onboarding process will “increase new hire retention by 82% and improve the productivity by 70%.” (zippia.com)

I have seen this in action – both the right way and the wrong way!

We provide an onboarding checklist for our clients (which we are updating), but here are some fast tips:

1. Checklist. Assign the new employee a list of actions to be completed over the first 3 months that include orientation, study, and training. The checklist should also be assigned to a veteran staff member to help the new employee get through the checklist.
2. Ongoing meetings with the owner/doctor. You want to have the new employee have a good understanding of you and your history, goals, and plans to achieve them. Do this over lunch or coffee.
3. Relationship with goals. You want the new employee to have a relationship with the goals of the office. Go over:

a. The mission of the clinic and why this is the mission.
b. The clinic and team’s values. Who we are and how we are. (For example, we are care-aholics!)
c. The outcome of the clinic’s services. For example: happy, healthy patients.
d. Mission and outcome of their specific role.

4. Expectancy. They need to know that achieving the goals for their specialized role is what is expected. How they do it is important, but that they achieve them is most important.
5. Regular (weekly or biweekly) coaching reviews.

Re-boarding

You can do a version of this every 12 months with your key veteran staff. Why not?

Next to your skills, your reputation, and your patients, YOUR PEOPLE are your most valuable asset in your practice. Take care of them, especially when they begin, and they will help you take care of the practice.

Ed

 

How to Hire the Best in 2022

Again, its all about the goals.

On occasion, you may need to hire a new team member. We always help our clients with hiring and “onboarding” new employees on our major consulting programs.

We have been hearing a lot about millennials not wanting to work, people don’t want to work, and it’s hard to find good employees.

I don’t buy it. We have been hiring great employees.

You must understand and appreciate the seismic changes that have been occurring in society. The workplace is not what it used to be.

The Assembly Line

I discuss this a great deal in my book, The Goal Driven Business.

The Industrial Age needed an industrial mindset for a workforce. As a worker, you were a cog on the assembly line. You checked out of your life when you punched in and checked back in when you punched out. Not much was required from you…except your brawn and obedience. It was a machine world and required mechanist minds and behavior. The employee worked just as hard so they wouldn’t get fired, and the employer would pay just as little so that the employee wouldn’t quit.

We have long since passed the Industrial Age, but our work culture hasn’t changed that much. The worker at the sandwich shop asks you what you want on your lunch sandwich, the cashier totals your groceries, and the therapy tech at the hospital follows their checklist.

But a reckoning has been on its way for some time.

And that time is now.

Many factors have culminated in today’s “hiring crisis.” It is a perfect wave, of sorts.

OK Boomers

But let’s first dismiss the judgments from the “OK Boomers.”(“OK boomer” is a catchphrase and Internet meme often used by Gen Z to dismiss or mock attitudes typically associated with baby boomers.” Wiki.)

Older generations have always viewed younger generations as flighty, fickle, and poorly motivated workers. I am one of the hardest workers I know, but my dad didn’t think so when I was stumbling around after college trying to find something to sink my teeth in.

While the youthful uncertainties of work may not have changed, there has still been a dramatic shift in our culture.

Financial Changes

Millennials are in debt the way no other generation ever considered. Today’s average college tuition is 31x more than it was in 1969. (1. Yahoo) Total student loan debt is 1.75 trillion. (For comparison, the U.S. Budget in 2020 was 6.6 trillion) with the average borrower owing $29,000.

We have been in an inflationary spiral, with housing leading the way. Generally, the cost of living is rising. The increase in the Consumer Price Index for March is equivalent to an annualized rate of 15.4%, the largest 12-month increase in 40 years. (2)

So, finance is a factor—a big one.

Goals, Values, and Meaningful Work

In 2015 Gallup, surveyed over 80,000 working adults. The majority (51 percent) of employees were unengaged at work, while another 17 percent were actively disengaged, for a total of 68 percent not engaged. That means that nearly 2/3rds of the workforce were dissatisfied with their jobs and ready to make a change.(3)

COVID 19 sent a shockwave throughout the work-a-day world. It jarred employees out of their jobs and they were now free to pursue something more in line with their new values and purposes.

One office we work with recently hired a C.N.A. who had quit their prior employment because they did not want to get the COVID jab. They felt that the medical approach they were forced to follow was not aligned with their own values and goals. As a result, they took a new position at a chiropractic office we work with and now happily feel part of their new family.

Indeed, a hiring company, states:

“A work environment that possesses organizational culture is driven by purpose and clear expectations. This motivates and inspires employees to be more engaged in their work duties and interactions with others.”

One of the major processes we work with the business owners is helping them and their teams delineate their own values that they aspire to each day. Positive team culture can be better created and maintained by regularly reviewing these values.

One very competent employee we recently helped hire for an office was so impressed with the Core Values on the office website that she knew this was her place. She has since joined the team and is a high producer.

Emphasize Your Goals and Mission

Employees want security. They are not necessarily looking to become wealthy, at least in the short term. You may need to review your pay scale for your team and make gradual adjustments in these inflationary times.

But we all have intrinsic goals, which include our values, and these take precedence. Work these out for your business and nurture them often. Stay true to them. In promoting for new staff, communicate your values and just how rewarding it is to work with your practice.

Become Stronger to Withstand Future Reckonings

I anticipate more “reckonings” and seismic shifts in the not-too-distant future that your business will have to weather and overcome. The world is changing quickly. The stronger you are, the better your chances of surviving and thriving.

  1. Read and apply my book, The Goal-Driven Business.
  2. You can also set up a no charge appointment to discuss how we can help strengthen your business and make it more profitable. Make an appointment for a no-charge call consultation here. LINK
  1. https://finance.yahoo.com/news/average-cost-college-jumped-incredible-122000732.html
  2. https://www.investopedia.com/inflation-jumps-again-in-march-2022-5225599
  3. https://news.gallup.com/poll/188144/employee-engagement-stagnant-2015.aspx

The 3 Key Ingredients to Motivating Your Chiropractic Team

Most of your staff are not engaged in the success of your office.  Most of them JUST DON’T CARE. 

At least that is according to a 2015 Gallup report that interviewed over 80,000 working adults.

The report showed that there are twice as many “actively disengaged” workers in the workplace as there are “engaged” workers who like their jobs.   The percentage of U.S. workers in 2015 considered engaged in their jobs averaged 32%. The majority (51%) of employees were “not engaged,” while another 17% were “actively disengaged.” (“Actively disengaged” means that they are actively sabotaging their work.)

But let’s say your office is different, which I am sure it is.  You are motivated enough to read this article and I am sure that is reflected by your team as well. But all the same, take a look with me at the level of motivation of your office.

How was your last team meeting?  Were you there? Was everyone sitting on the edge of their seat and contributing new ideas and plans on how to reach new goals in the office? Or, were most everyone pretty silent?

Sure, your employees smile and look busy when you are around, and often work hard and they do care.  But really, how much?

What would your office be like if the motivation, creativity, and level of pro-activity was always very high at “10,” or even ranged from 7-10?  If they felt that it was “their” business, where they took responsibility for the quality and quantity of outcomes, and regularly worked to improve the business – and themselves?

I have been reviewing the subject of motivation for some time, from my own experience over the years and from what social scientists have reported.

I have incorporated certain principles into a new system of business management that are specifically designed to unleash everyone’s innate motivation – including business owners like you!

Motivation is the foundational in a chiropractic office, or dental office, acupuncture – even with therapists and other service firms. It is a bedrock for any healthy practice and business.

Here is one very useful principle specifically about motivation and how you can use it to generate more engagement – and productivity — with your team.

3 Goals System of Business Management: Principle #5

Self-Determination and Motivation

Everyone wants their own sandbox to play in.

You do. This is one of the reasons you went to school – and why you started your business.

We all want to have something that we can call our own where we can create and demonstrate our competence. What we get in return is feedback that we can do something good, that we have power, that we can make something beneficial happen, that we can … make a positive difference.   If only to ourselves, we can say: “Look what I did. I did this. This is my creation.”

You can see it in children, for example, when they bring you their colored scribbles on crumpled pieces of paper to proudly show you their great work of art.  This is their sandbox.

Of course, we all work for money. But we also have deeper motivations that if tapped into and nurtured, can be very powerful.  By harnessing these motivations, and then linking them with others who have a shared goal, we can create a dynamic team driven business that is very profitable.

This has been explored by social scientists who have studied what has come to be called Self-Determinism Theory.  I have also seen it in action. Essentially, it states that we all have innate drives and inherent needs that motivate us to be more self-determined rather than determined, or controlled by, outside forces.

External motivation, like the fear of being fired, can only motivate us so far. Threats, criticisms, negative reinforcement may produce short term action, but in the end, they demotivate, or worse.

The level of employee motivation has a tremendous influence over the success of your business. 

An unmotivated staff, one that only becomes engaged to the level of “I will perform just good enough so that I don’t get fired or criticized,” will weigh the office down.

Self-Determinism Theory (STD) has three components, all of which easily apply to your business. These are:

  • Autonomy
  • Competence
  • Relatedness.

And by the way, while reading this, consider how this also applies to you as well!

Autonomy

You do not want your treatment plans second-guessed by a clerk in an insurance company. Neither does your front desk want you breathing down their necks about where all the patients or practice members are, or why they used the blue pen.  You should train and educate your team, but then get out of their way and let them succeed or fail.

Think of helping a child ride a bicycle. Sure, they will need your help for a while. A push now and then. Perhaps some training wheels. But you will have to let them fall down a few times and allow them to get the courage to get back on the bike and succeed. You can continue coaching them to improve, but you must let them go.

Even if you see employees appearing idle, or having brief personal discussion with another employee, back off. Tolerate minor errors. Give your team some rein.  Come back around later to coach them and train them to improve. Mostly educate them on the mission of the office and of their roles, and get them to understand what outcomes they are supposed to be producing. Once they see that the statistics measure their performance, they will be more self-directed and want to do all they can to win the game!

We all want to be free to create our own enterprises, even if we work for someone else. As long as what we do is in line with the purpose or mission of the business and our role, there should be no problem.  This helps us demonstrate our competence, which is the next element of Self-Determined Theory.

Competence

Doing a good job, all by itself, is its own reward. It pushes away self-doubts and shows us, and others, how good we really are. It is positive reinforcement.

And the better we can do a good job, the better the results will be, which demonstrates to us just how awesome we truly are!  Plus, as we increase our skills, we also will find that our duties are easier to perform.

Your team wants to improve their skills. Help them do so.

Sign them up for seminars, webinars, give them monthly reading assignments, and give them a coach or three of them.  But this has to be done in conjunction with your supervision. You will need to guide them through the training so that they see how it applies to their roles and the business as a whole. Quiz them on what they are learning and have them give presentations to the team on what they are learning.  The old maxim applies: “to teach is to learn twice.”

And where possible, make sure they earn certificates and can wear pins or insignia that testify to their competence. This goes along with Game Theory – people win at one level and then want to go to the next level. They want their “badges.”

Business owners throw staff into their jobs and expect them to produce with little or no training. Without exception, the offices I have seen that provide more training and coaching for their team — do better.  Companies spend an enormous amount on employee training. $161 Billion in the U.S. last year (trainingindustry.com). And, it pays off.

One study showed a comparison between car companies and how many hours they trained their new employees: Japan spends an average of 364, Europe averages 178, and the United States – 21 (Pfeffer –The Human Connection).

And you can guess which country has cars with the best frequency of repair record.

Children want to be super heroes and wear their capes.

Don’t we all!

Relatedness.

This is the feeling of being connected – and there are two aspects to this.

Family. First, “relatedness” is the feeling of not being left out of the “loop” and of being included. Staff meetings help with this as does the general work environment. This is the sense that we are in this venture, job, and profession together. That we are part of a family.

Keep your team involved with your decision making. Give them some of the issues you are dealing with and encourage their input. They are stakeholders – it is their office too!

Greater Purpose. The other aspect of relatedness is that people generally want to be associated with a greater purpose. The more that each member can connect to the greater purpose of the group and make it their own, the more motivated they will be. Taking it a step further, if employees have higher goals of their own that coincide with the organization’s and they are allowed to pursue them within the organization, there would be no reason for employees to work anywhere else.

Train your team, let them own and creatively improve their own areas – and help to do the same for the entire office. Nurture camaraderie and a spirit of family – and always remind them – and yourself — why we are doing what we are doing.

Do this, and not only will your business be more successful, but you too will be more motivated and have more fun in the bargain.

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Self-Determination Theory: Basic Psychological Needs in Motivation, Development, and Wellness. Ryan, R. M. & Deci, E. L. (2017) and Why We Do What We Do: Understanding Self-Motivation Paperback – August 1, 1996
© Edward W. Petty,    From the upcoming book: “Three Goals:  A New Practice and Business Building Methodology That Is Simpler, Faster, And More Effective and Fun than What You Are Doing Now.”  By Edward Petty, due to be published sometime before the Singularity. © May, 2017