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Planting the Seeds for Growth

In today’s market, practice managers need to ensure they are well-prepared for growth, which includes being realistic about expectations.  The recruitment process for providers can take several months (from identification of a qualified candidate through the interview process and up to the provider beginning to see patients); understanding your projected growth rate, well in advance, will ensure that you allow sufficient time to begin recruiting your next provider.

To calculate this, you should know your current provider pool and the number of patients they are seeing.  You will also need to analyze the number of referrals you are receiving on a monthly basis, as well as your historical monthly referrals, in order to calculate your average monthly growth rate and predict that trend forward.  Always make sure your current providers have the capacity to take on new patients while you work to recruit another provider.  If your existing providers’ patient bases are full and you are unable to see new patients in a timely manner, you will not only miss out on revenue opportunities, but also risk creating a bad name for yourself in the market due to patients and referral sources being unhappy with your turnaround time.  If you look at your growth rate and predict you will be needing another provider in three months … then it’s time to start recruiting, because you’re already behind the curve!  Ideally, you want 4-6 months to find a provider, which will allow time for possible relocation, separation from a previous practice, unexpected hiccups, etc.        

Additionally, every practice pays their providers differently and this will come into play while recruiting.  In my experience, the issue of provider reimbursement can play a significant factor in how quickly a new hire is onboarded - because, for the provider, it's not as simple as looking at the compensation number by itself; there are many other factors to consider and questions about compensation to be answered.  Due to the competitive nature of the house call space, many practices are moving away from independent contractors (1099 employees) to hiring providers on a salary (straightforward base with or without a bonus potential) or salary variation (lower base with additional compensation opportunities) model.  Practices need to be careful with salary models, though, as they can have a strong correlation with higher visit cancellation rates on the provider side (i.e., lack of motivation to wait those extra minutes for a patient to get to the door, unwillingness to return to a home to make up a missed visit, etc.).  Structuring a salary around a patient minimum has proven effective for house call practices, and providers seem agreeable with that compromise, too.  I have worked with clients who paid salaries, paid based upon activity, and some that set up systems similar to a draw upon commission structure.  With any of these, you need to ensure you will have enough patients to meet the financial needs of both the provider and your practice.  If you are paying a base salary, it’s possible to run into the issue of paying out more than the provider is bringing in.  For example, if you haven’t read your numbers correctly, you could wind up paying a full-time salary to a provider who is only working part-time for the first several months.  On the flip side, if you are compensating your providers based upon activity, you run the risk of not fulfilling your providers’ compensation needs.  This could occur if your current providers are seeing 12-15 patients a day and you hired a new provider with this same expectation … but only have 6-10 patients per day for this individual.  Miscalculations lead to quick turnover and a high attrition rate for providers, who may seek other organizations that will meet their financial needs.

As you can see, when it comes to provider recruitment, it’s crucial to look not only at the “people” aspect, but also at the “numbers”.  Personally, I have made it a point of pride to not only work with my clients on identifying potential providers, but also to help them in quantifying their growth trends and planning accordingly.

Now that you have these helpful tips, I recommend that you look at your referral numbers and plan your recruiting strategy for 2014!