Limit the impact of staff turnover

Even if your practice is a “revolving door,” these six recommendations can help ensure continuity.

Practice Management

Limit the impact of staff turnover

Even if your practice is a “revolving door,” these six recommendations can help ensure continuity.


Staff turnover is as inevitable as death and taxes, though it is particularly high in health care. In fact, health care is in the top three for both voluntary and total turnover, behind banking and finance and hospitality, according to recent data from Compdata Surveys, a company that amasses compensation data from more than 50,000 organizations in 13 U.S. industries. Specifically, the voluntary turnover rate (11% across all industries) is 13% for health care. Meanwhile, the total turnover rate (15.7% in all industries) is 17.5% for health care.

Given the inevitability and high rate of staff turnover in health care, staffing experts offer the following recommendations to ensure day-to-day duties get completed.

1. Create job manuals

Corinne Wohl, MHSA, COE, administrator for Delaware Ophthalmology Consultants in Wilmington, says having comprehensive operations manuals with job-specific duties included is critical, as they ensure that alternate staff members can perform their co-workers’ job functions as needed. She adds that, in the clinic area, daily protocols for doctors are best kept as consistent as possible, so tech staff can work efficiently with a doctor they may not normally work with.

Louis Pennow, financial and operations officer at Hollingshead Eye Center, PC, in Boise, Idaho, says the practice’s job manuals include daily, weekly, and periodically performed tasks.

“Any loss of an employee leads to a loss in productivity and possibly income,” he says. “By understanding the duties of each employee type if or when the termination of employment is immediate, the human capital loss should be minimized.”

Krishna Morar, OD, managing director of 5th Avenue Eye Center in New York City, says he requires staff to read through their personal job manuals and update any changes.

“This way, I not only have the most current list of duties and how to perform them, but should any staff member leave, I don’t have to say to another staff member, “Do you know how he or she performed this test or used this software?” he explains.

A bonus of job manuals: They facilitate the training of a new employee, says Ms. Wohl. “[Operations job manuals] provide for a faster orientation and onboarding process, which allows practices to maintain smoother operations. Fellow staff members can deviate less from their own duties when answering questions or showing the new employee how to do something,” she says.

2. “Connect” the entire staff

Use software that provides staff access to needed documents and resources, such as a practice calendar, from any computer in the practice, says Dr. Morar. Having a centralized database of information that all staff members can access prevents a lot of questions and traveling throughout the practice, which can really add up time-wise and hurt practice flow.

“The calendar is especially helpful because, if someone should suddenly leave, the person who steps into that role will know exactly what needs to be done and when,” Dr. Morar says.

3. Cross train

Training staff in areas other than their own is a great way to keep a practice running the way it should, says Mr. Pennow.

“In the practice I work at, if push comes to shove, the scribes could be techs and vice versa,” he says. “In addition, all practice managers should know how to perform each employee’s position in case of an emergency. And this way you always have coverage if someone is gone.”

Ms. Wohl says that cross training is accepted and most successful when practice owners and administrators set the expectation that all staff members, regardless of their department, are expected to lend a hand when needed.

“If some department managers are super protective of their turf, the sense of overall practice team spirit and aiding each other for the common cause isn’t going to happen,” she says. “When practice leaders promote the reality that we are all on one team and not a collection of independent departments, the result is a positive one for patients, employees, and the practice.”

4. Treat employees well

As the old adage goes, “You can catch more flies with honey than with vinegar.” So, treating your staff members with kindness and respect can go a long way, says Ms. Wohl.

“When staff is treated consistently well, they appreciate their managers and doctors,” she says. “Happy staff is generally more productive and willing to step up and get whatever needs doing done. And that’s best for our patients.”

“Consider surprising staff with a reward for lending a hand or creating a staff incentive program for their willingness to step up to the plate when needed,” adds Mr. Pennow. “When the staff in the practice I run accomplish a specific goal, we have a ‘burgers and brews’ night where we go to Red Robin on the company’s dime. I also give my managers a slush fund to buy little knick-knacks, such as coffee mugs, for staff members who go above and beyond their normal duties.”

5. Operate “fat”

Mr. Pennow suggests you employ a little more staff than needed, if possible.

“I’m lucky,” he says. “Wages in Idaho are low, so I can run at 110%. If I know I’m going to need six technicians in a clinic on a certain day, I make sure I have seven.”

In addition to keeping the practice running the way it needs to, having some extra staff increases employee satisfaction and morale, making them less likely to leave or, for that matter, retire early, he says.

6. Have a recruitment plan in place

When an employee resigns, he or she typically provides two weeks notice, which often isn’t enough time to complete the recruitment process. To save time, keep all job descriptions up-to-date in the operations manual and have job advertisements at the ready, says Ms. Wohl. This can save you precious time to recruit the replacement.

A successful recruitment plan often enables the person who is leaving to spend a few days with the new hire to educate him or her about the job, Dr. Morar says.

Or, have employee replacements at the ready, says Mr. Pennow.

“Every time you receive a viable resume, interview that potential employee with the thought that he or she could replace an existing employee, if needed,” he explains. “Be upfront and honest with [the job candidates] by telling them you currently don’t have a job specifically for them at this time, but you would really like to get to know them just in case an opening arises,” he explains. “Then, keep in touch with the ones who impress you.”


It’s not a question of “if,” but “when” an employee leaves, be it by his or her own volition or a firing. To avoid a situation in which you and your staff are scrambling to keep operations running smoothly, prepare for these inevitable departures by using the aforementioned tips. OP