Hiring post-COVID is a whole different animal. We talk to Dr. Mark Sanna about how to find & keep great chiropractic employees in this new world. And in our Ask NCMIC segment, Mike Whitmer answers a question about standardized informed consent forms.
Links to additional resources can be found below the Transcript.
TRANSCRIPT:
Mike Whitmer:
Hello. Thank you for joining us for NC M I C'S Chiropractic, the podcast that helps doctors do more. I'm Mike Whitmer, NC M I C's, Vice President of Corporate Relations. Do you need to fill an office role? Good luck. Hiring in 2022 isn't the same as it was in 2019. Candidates are hard to find and when you do find someone you want to meet with, the tables are turned. They're going to interview you. Dr. Mark Santa has helped many, many chiropractors with issues around managing their practices of which hiring is a big part.
(00:32) Dr. Santa is CEO of Breakthrough Coaching, an International Healthcare Practice Management consulting firm. Dr. Sanna teaches an outcome based, functionally oriented system of procedures focused on preparing healthcare providers for the prevention and wellness services in high demand in today's healthcare environment. He is a fellow of the International College of Chiropractors, a Foundation for Chiropractic Progress board member, the finance committee chairman for the Chiropractic Summit, and the Future of Chiropractic Strategic Plan Communications committee co-chair. Dr. Sanna, thank you for joining us on Chiropractical.
Dr. Mark Sanna:
Thank you for having me.
Mike Whitmer:
Dr. Sanna, we see the trends. People are quitting their jobs at record levels to seek greener pastures. Why is this happening?
Dr. Mark Sanna:
Mike, I think that the period that we've all gone through just recently with its challenges and the pandemic, really enabled many of us to take a harder look at not only what we do but why we do it. And so we have a period now that folks are referring to as the great resignation. I think maybe it was the great realization that the reason, the why we do what we do, is as important as how we're compensated for what we do.
Mike Whitmer:
Absolutely. I think that a lot of us had time on our hands and a lot of thinking and what kind of fulfillment. And like you say, more than a paycheck. Let's talk about some of the specifics about what's changed and how chiropractors can adapt. Let's start with finding good candidates for positions that you may have open. How has that changed?
Dr. Mark Sanna:
I think to go back to our original premise of why we do what we do, when I first came up in chiropractic practice, the rule was, you hired someone because they made your life easier, and that was the main reason for having an employee. Now we hire someone to compliment our skill sets, to fill in the gaps that we don't have. There's a great book called Traction, the Entrepreneurial Operating System, EOS, by a guy named Geno Wickman. And Geno likes to say it this way, and I think this fits exactly for chiropractors, is that your job in running your business is to be the visionary. You set the vision, you set where we're going, and you need something they call an integrator, somebody to get stuff done.
And so filling in the gaps in your own personal organizational chart in a way that helps your organization move forward, grow, and also benefit not only you as the owner, but the employees as well, I think is really key. And so looking at hiring now is a lot different than just a job description or skill set. If you're hiring for skill set, you're going to be really limiting yourself in terms of the type of employee that you can really have to support you. Before you even think about hiring, take a good look at your core values as an organization, as a practice. What are we here to accomplish? And make sure that we hire folks that are in alignment with that value set.
Mike Whitmer:
So in this new environment, everything has changed, including the interview process. What's changed there? How do we approach interviews in this new environment?
Dr. Mark Sanna:
The internet has totally dramatically changed what the interview process used to be. You'd put an ad in the classifieds and folks would come in, they'd send resumes, et cetera. Now you put something out in Indeed or ZipRecruiter, and you get, no kidding, two, 300 responses. And out of those two, 300 responses, the folks who actually agree to maybe a group Zoom interview might be a third. So we're now down to a hundred or so. The hundred folks who say that they're going to come to that Zoom interview, maybe a half show up from that, maybe. Again, a half, we're down about 25 now, are maybe qualified for the job.
And when you set the in-person interview, if you're lucky, four show up, and the rest just ghost you, they're totally gone. And so you're there, "Is there something wrong with me?" And there's not. It's just the way that the interview process works now, and you're going to have to toughen up to that. That's very disheartening. You're thinking, "Is the posting not correct? What's wrong with what I'm doing?" And the bottom line is people are looking for a job that they can connect with. Making sure that posting really describes not just the hours of the job, full-time job description, et cetera, but why you're there and what they're going to gain and grow from. Being in that position, I think is really key.
Mike Whitmer:
The conversation during an interview has changed. It used to be the employer, the hiring doctor, would go in and ask all the questions, but that's changed too.
Dr. Mark Sanna:
Well, sure. So they've already Googled you, they've checked your LinkedIn profile, they know what your website looks like. When the candidate comes in, and in particular, millennial Gen Z candidates, they're going to be asking you a lot of questions. And that kind of puts some folks who haven't been used to this new process a little bit off. And the idea is they're looking for a match just as much as you are. Gen Z and millennials really want a position that has some social consciousness to it, something that is giving back, that has a higher purpose.
So if you're going to fill a clerical position, you have to connect the dots for the candidate between, how they are going to do their job, whether it's managing patient records or patient files or et cetera, and how in fact, that connects to the bigger place of making a difference in people's lives. And that's where, as chiropractors, we really shine, because we have that tremendous mission as our practices, to make a difference in people's lives. And so being able to verbalize that, make that part of the interview process, make that shine, I think is really important for folks who are going through that process right now.
Mike Whitmer:
Yeah, I think that chiropractors do have kind of a leg up in that they do have this terrific social purpose and place in healthcare. Communicating that is a challenge, I would imagine.
Dr. Mark Sanna:
Very true.
Mike Whitmer:
So once we find a good employee, how do we keep them? What do team members need to stay at their job?
Dr. Mark Sanna:
First of all, some flexibility. If in the past you've been very rigid, as many of us were. From two years ago till today, the whole landscape has changed. We are still in the tail end of this pandemic, and you're going to find maybe your paid time off policy, in which you gave folks a week or maybe two weeks after employment, PTL, the folks are burning through that really quickly. If you think you have to stick to that rigidly and not be flexible in terms of time off, I think that's really key and important to note.
I think what's also really important is to know that a lot of your workforce are parents now, and being rigid in terms of only a full-time position, versus maybe thinking about, could this be two part-time employees who are sharing the duty of that role? And maybe even a step beyond that, thinking about what is actually totally necessary to be onsite in the practice, versus what could possibly be done offsite from home in terms of being able to have childcare and the balance? It's really interesting that 50% now of our chiropractic college students are female. This I think not only holds for the employee, but for the employer as well. Thinking about quality of life balance is super, super important.
Mike Whitmer:
What about benefits as the job market becomes more competitive? Do employers have pressure on benefits offered to employees?
Dr. Mark Sanna:
As chiropractors, we truly do. First of all, when we talk about the starting salary, a couple of years ago, starting salary in a chiropractic practice for a typical chiropractic assistant position might be 11, 12, $13. If you're going to lead with 11, 12, $13, you're going to hear crickets chirping on your Indeed posting. Folks are having to adjust the starting salary up three, four, $5 in some regions, simply to be competitive for that entry level position.
I think the other challenge for us as small business folks is healthcare benefits. Being able to do something toward healthcare. Let's say you're a small chiropractic practice with a doc and a couple of CAs, it's a challenge to be able to pay for a full insurance premium for an employee that could cost seven, eight, nine, a thousand dollars a month. Having some sort of matching fund there, where maybe you pay 30, 40, 50% of their healthcare benefit, and as they gain in longevity in their position, maybe increasing that.
There's an interesting component of the CARES, C-A-R-E-S, CARES Act, and that is a student loan repayment program that a lot of employers don't know about. I think it's $5,250 a year. You can pay an employee and they can receive that tax free, which, if you're talking about an associate or if you're talking about a high level employee, that's a 30% something tax bracket, and you're getting the benefit because it is an actual expense for your practice.
But most importantly, that individual is decreasing their student loan, which now everybody has. Those sorts of creative ways of making the position attractive, lets your potential employee know that you care about them, you care about their future, but it also is a creative way to give you an edge up maybe over some of the other employers that are out there.
Mike Whitmer:
Great point. I've heard it said that people don't quit jobs, they quit their employers, they quit their manager, which really to me comes down to communication. I think many employers, chiropractors included, have always viewed communication as a top down process, which may not be effective in this environment. How has employee communication changed?
Dr. Mark Sanna:
That old authoritarian managerial process where, my way or the highway, here's how we do it, that's no longer going to be successful. By the way, it's just not a great way to run any business. I am a big believer in the motto that there is not one of us who's as smart as all of us together. And when you bring together a team, and you create that free flow of ideas from the bottom up, I like to tease that kind of a glass of champagne, where the bubbles kind of bubble from the bottom up to the top, you want that in your practice.
You don't want folks being on tiptoes or walking on eggshells around the boss, that they can't call us out on what we could do better. Doing things because it's the way we've always done it, simply doesn't work. Being innovative and creative in today's environment is absolutely essential. So letting folks know that we not only honor what it is that they have to say and their opinions, but you can feel free to call me out if I'm not walking my talk as well. Let me know. It's important that we have that type of a relationship.
Mike Whitmer:
Dr. Sanna, thank you so much for helping us with this topic. You've given us some really good things to think about, and some good tips to navigate this challenging employment environment that we're all living through right now.
Dr. Mark Sanna:
Thank you for having me, Mike. I much appreciate you and the team at NCMIC.
Mike Whitmer:
Dr. Sanna gave us a lot to think about. We're putting the transcript of our conversation and links to some articles about hiring in the show notes.
(14:13) Mike Whitmer:
Does NCMIC have an informed consent form for doctors to use in practice? That's the topic of our question this time on Ask NCMIC, where we get quick answers to chiropractic issues. The short answer, doctors, is no. There are a few reasons why. First, the informed consent process is exactly that. It's a process. This is a communication process, a conversation. And while a form is always good to have in the record, the conversation is the most important thing.
Second, rules vary from state to state. What may be required for a form in California may not be required in Ohio. And finally, NCMIC is extremely cautious of setting standards. If we were to publish a form for all our policy holders to use, it would be used against us when defending our doctors. If a doctor doesn't use NCMIC's prescribed language, it could be construed as a breach in the standard. Our top priority is to provide you with the best defense possible, and we don't want to do anything that may compromise our ability to do so.
We do, however, have a sample form available on NCMIC.com. We'll put that link in the show notes. Please understand this is a sample only. We encourage doctors to take the sample, adapt it for their state of practice, and of course, as with any other form you employ in your practice, a review by local legal counsel is a good idea.
Thanks for listening. If you like what you heard, consider giving us a rating on Apple Podcasts. It really does help more people find the podcast. Don't forget to check out the show notes too. Talk again soon.
Other resources of interest:
CARES Act Student Loan Information
A Training Plan Creates a Smooth Transition
How Current is Your Office Policy Manual
Employee Benefits Don't Have to Stress Your Cash Flow
Developing Long-Tern Staff Relationships
Guest:
MARK SANNA, DC, ACRB Level II, FICC
Many people go through life and never experience their true calling. Dr. Mark Sanna is
one of the few to find his absolute life's work. Dr. Sanna the CEO of Breakthrough
Coaching is an international health care practice management consulting firm that
teaches an outcome-based, functionally-oriented system of procedures that focuses on
preparing health care providers to become the providers of the Prevention and Wellness
services driving healthcare reform today. He is a Fellow of the International College of
Chiropractors, a member of the American Chiropractic Association’s Governors’
Advisory Cabinet, a Foundation for Chiropractic Progress board member, the Finance
Committee chairman for the Chiropractic Summit, and a National Chiropractic Legal
Action Fund board member.
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