Home Forums Discussions General Discussion Staff leaving- attention Walter!

Hi everyone (Walter especially),

This is in response to "Walters blog" last entry, but I thought a separate topic would be appropriate. Walter mentioned 3 full time staffers were planning to leave their practice.

I can sympathize. Over the last few years we have dealt with quite a bit of staff turnover. Various reasons, one of the real good ones went to nursing school, a few left for more $, one moved away, etc. (I don't think I'm that hard to work for- I have been with our PA and part time RN for 24 1/2 years.)

Two observations.

1) Three years seems to be when MAs start to tire, and think about other plans. Not always, but this seems to be "the wall."

2) It's really hard to judge how well someone will do in their job. Interview/resume/references etc may not be helpful, twice in the last few years we have hired someone, only to have to fire them in the first week. These were people with excellent recommendations, who interviewed very well.

Keep us posted. Good luck!

Gene

That's good to know! My current MA is over a year, but we have had a bit of turnover. One demanded a huge raise or she was leaving (we let her go) and another had to be let go for incompetence.

About Staff we have quite a lot

What is the average pay scale for:

MA's
RN's
PA's

Also our doc is very generous and we have Health ($1000/$2000), dental, 401K. Also he gives 2 weeks vacation right away for full timers. (I mean I am very grateful, but I also have the responsibility to see where we can save money).

Is this standard for other practices?

Thanks!

Ben

Staff salaries vary widely by regions, or even within regions between urban and suburban practices. We check salary.com periodically, which seems to be accurate for our area. Here's an example for different areas in the state of Florida.

Gene, oop I almost missed this post.

My optometrist gave me an order for three different pairs of eye glasses, but I refused to be that seasoned looking and still want to go with single focal instead of trifocals. Thanks Gene and John to inform multiple turn over and leaving reasons same. One of our MAs graduated from nursing school, our receptionist was accepted to medicine school and our under office manager who been with us since beginning because of her husband loosing his job to start their own business

We are trying to control expenses but with high turn over rate means overlapped staff training salaries. Training time is much longer per EMR and insurance mazes, hard for doc to generate more revenues to cover extra expenses.

I mentioned stories of docs going solo without any staff, strictly on cash or health membership fee to my doc just to make her feel better and she was not amused. She doesn't like the vision of herself talking to 100 different carriers, solving patient complaints about office visit bills, referrals or accepting cash directly... charting by itself more than enough for her.

Changing times indeed. Working less but demanding more and internet based,self inflated values. I looked at John's examples and we are here in North TX paying less but not that much. How we do about this?

I have a CMA, who, if she asked for a $3.00 raise I would have to give it. She is a CMA who practically practices at the level of a FNP. Obviously, she is not. She refuses MaineCare, so I try to help with insurance, but it is tough.

I think the only reason she doesn't ask for more money is 1) she gets the largest raise, 2) she gets a much higher bonues, and 3) she knows I couldn't afford it.

She thinks outside the box, inside the box and on the lines. Half of our patients come here because of her, well maybe the combination. I seriously don't know what I would do if she moved on. She is just that good.
________________________

Speaking of all your employees leaving at one time. My last job where I worked with another pediatrician who was the owner and his wife was the office manager (Peer to Peer using server but no active director), all of the MAs, billers, receptionists, etc., looked up to me and considered me their boss. This, of course, unless there were a major issue. So, one day there was a huge fight over the fact that I was bothering an MA while she vacuumed. It kinda blew up from there. To be honest, I was over it in 15 minutes, but everyone else was overwhelmed by it. So, that night the office manager kept emailing me about what we were going to do. I kept saying just let things go on and maybe we could all sit down with the MA and the owner/office manager and me.

That night, the triage nurse, biller, two MAs, two receptionist called the office manager and told her it was either they or me. If I came into work, they would all quite. So, my colleague of six years told me he couldn't work with no staff and told me if I came to work, he would fire me. So, I came to work and police cars were in the parking lot, and I was unceremoniously dismissed. My stuff was packed on Friday, and I was given until Saturday to pick it up. When I got home I noticed my hard drive had been completely wiped clean by our real IT guy. Really wiped clean. Fortunately, I had a backup, as files from way back were on there.

No wonder you left!

Keeping high quality staff is difficult. The problem is that those of us who are high quality tend to know it because, well, it takes work to be high quality and we know we do that work.

Like everyone else, including all of you on this forum, those of us who are high quality often want the most we can get for the work we do. We know who much money we are saving our "masters" and we want a piece of it.

This, of course, is where the Economic Principles of supply and demand, the marginal principle, and the principle of dimishing returns all kick in. As the employer, you have to decide if the person asking for the raise is really worth it. Do they make you that much money? Do they save you that much money? How easy, or hard, would it be to replace this person should you say no and they leave?

I know many doctors who fail horribly to understand why their front desk clerk left for a job that paid 50 cents more an hour. I tried to explain to them that to someone who makes $9.00 an hour, a 50 cent raise is big money, but either they didn't want to understand or were just to bone-headed. Those docs I know with great practices have a great staff that is loyal to them. Surely, having a great staff is expensive, but there seems to be all kinds of problems these docs just don't have. Office drama, employees that are disrespectful to patients, employees with poor work ethic, and so forth are all on the list of issues they don't have.

In the world of economics, suppliers who need skills seek those skills from the public and those in the public who have skills seek employement from suppliers. The supply of those with skills contrasted against the demand of those who require skills is what determines wage, and who will survive.

JamesNT

Oh, Bert. Your story is so horrible it is hilarious. Police cars? Really? You mean the most mild-mannered poster on this board was nearly led off in shackles? Too bad my daughter wasn't there... she would have loved it. Even better if it was me.

I'll bet a bunch of us here owe our presence on this board to some version of "the partnership from hell." Yours was possibly worse than most, but the drama made for a great story.

@John, that is too funny.

@David I will tell some more when I get a chance. I worked for him six years which was two years longer than the last person. He still emails me as if nothing ever happened. It was the classic pay your lawyer $200 to tell you, it's probably better if you stay on his good side. And, of course, he was right. Faked it all the way, and it made getting records easier and the rumors that I just up and left for Belgium stop a little sooner.

And, yes, police cars. Two. I recall his wife, the office manager, standing at the door telling me I couldn't go in. So, I said, I'm going in, and when she said no you are not, I said then you'll have to fire me. Word to the wise: Never tell your boss "You'll have to fire me."

Put me on that list. No police cars involved though...just lawyers.
Soon after was when I started telling people, ?sometimes what seems like the lowest point in your career turns out to be the best thing that could have happened to you?. I am guessing there are others here who know what I mean.

Add me to the list, my departure from a Community Health Center 7 years ago involved the police as well. I guess that I did not realize what an evil person I am....

Gene

Wow, all of the above stories make my office troubles seem so trivial. I lost my biller (and friend and traveling partner) 6 weeks ago when Ford starting rehiring everybody they had ever previously laid off. She had worked there maybe 8 years ago. How could she resist the money, the benefits and the security? As a small business there is simply no way we can compete. So, I am now doing my billing...bad thing. But, I have also learned a whole lot about insurance companies and patients...good thing. I do hope to hire a new biller in a week or so.

Gee Bert, what did you say to her??? Uh. "Do the things you are supposed to?" Maybe things are different up in Maine, but I have yet to see the MA here in NYC that would have me agree to get rid of , well, anyone else. Granted, if the whole staff threatens to walk out that's a different story. But with my temper wrt people who don't perform, I can guaruntee that if I had to for the short term, over the next few months we'd have a total staff turnover.