Learn strategic solutions to remedy staffing shortages in ophthalmology, build and retain a skilled team, create a steady pipeline of employee candidates, and more.
The staffing shortage in ophthalmology is not new. However, it's become progressively worse in recent years. Today's candidate pool is smaller, and the job market is more competitive than ever. This means our practices must be able to attract high-quality candidates, train them effectively and retain them for the long term.
In this article, you'll learn strategic solutions to remedy your ophthalmology staffing problems (including doctors and other skilled employees, as well as support staff), backed by our experiences dealing with a staffing crisis at a regional eyecare center, and with a particular focus on the following areas:
The staffing shortage problems in ophthalmology are driven by two primary causes: first, a lack of available candidates, and second, the burden that training new staff members places on daily operations.
A shortage of employees disrupts the ratio of support staff to physicians, causing a loss of efficiency in the clinic with far-reaching implications. The optimal ratio of staff to doctors is approximately 3 to 1, but this is difficult to achieve when you're unable to draw from a sufficiently large pool of qualified candidates, or when candidates are looking for jobs in other industries.
Staffing shortages can decrease patient satisfaction and trust in the team, ultimately affecting patient outcomes. Shortages also place more responsibility onto already-overburdened team members, eventually leading to more loss of staff, compounding the problem.
Additionally, requirements like onboarding, entry-level skill development, skill maximization, and growth development needs place additional burdens on the entire team. A lack of proper training increases turnover and perpetuates these problems in a vicious cycle.
Before we cover strategies and solutions to turn the tide, I'll share my practice's personal experience of what these issues have looked like in the vision care industry over the last several years.
Earlier in my career — as a medical administrator and now CEO of EYE-Q, a comprehensive regional eye care provider — ophthalmology and other medical specialties enjoyed long relationships with staff who were loyal to the practice and the providers.
But those relationships were disrupted when the COVID-19 pandemic forced our offices to furlough team members while the offices were closed. After the practice re-opened for business, many team members did not want to come back to work for reasons such as:
The depth of the problem at our practice was significant. COVID left us with 17 open positions in our workforce of 90 employees, resulting in a 19% vacancy rate. Staff were forced to take on much greater workloads, reducing the overall efficiency of the office.
We continued to lose staff due to stress and watched our turnover rate rise to 25%, far above our KPI of 10%. We tried to fill these 17 positions, but could not do so amid the compounding problems of industry-wide staffing shortages. Many other practices across the US faced similar issues, which still continue today.
With an open position rate of 19% and an increasing turnover rate, training was the first thing to fall by the wayside at our practice.
For example, while training as an ophthalmology assistant — the staff member who rooms the patient, collects intake data, and conducts screening tests for the physician — a new employee should have time to absorb new information from trainers. But in a severely understaffed office, new employees are often pulled from training to help complete daily tasks.
New employees frequently left the practice due to a lack of adequate training and increased stress from this situation. Some candidates lasted only a week, while a few walked out during the day, reporting that the job needed to be easier, more relaxed, and slower-paced. In response to new employees exiting the practice, seasoned staff became increasingly overworked and stressed out training new team members while also trying to fill gaps in staff simultaneously.
Unfortunately, seasoned members left the practice as well during this time. As a leadership team, we realized that we had to rethink our approach to our employees and to hiring staff to stop our practice from spiraling. In our search for solutions, we analyzed the successes and challenges of conventional staffing methods combined with innovative automation to remove the workload burden on our current team members.
One solution for these issues is revBot by Revival Health, an innovative automation service that eliminates most repetitive tasks at eye care practices, minimizes mistakes, and helps teams do their best work together.
The traditional recruitment process includes sourcing candidates, screening, selection assistance, and Human Resource (HR) onboarding assistance. In many cases, practices use recruiters or "head-hunting" firms for assistance — either to achieve better results, save time for management personnel, or both.
We have found these conventional ophthalmology staffing resources useful at times for filling professional positions, but with some caveats. While headhunters and recruiting firms can sometimes deliver good results, the process needs a more personal connection to attract the very best candidates. In other words, a cold introduction through a recruiting agency is less effective than a warm introduction to a candidate through a referral.
On the other hand, using a recruiting firm to hire ophthalmology assistants (OA) or front desk positions is costly, and no more effective than the results we've achieved using Indeed and other online job boards. In fact, when our managers were involved in the recruiting process for OAs and front desk positions, our success rates were the same or better than the recruiting firms.
The most effective method for hiring top-tier physician candidates is to reach them in medical school or residency.
Warm introductions are our secret formula for finding and recruiting the best physicians — and unlike hiring recruiting firms, they're free. You can use this method at your practice to take advantage of existing network connections.
The warm introduction method includes:
Similar to recruiting physicians, you can also engage support staff to recruit OAs and front desk associates — which are challenging positions to fill. Ask your teams:
To increase the likelihood that team members would engage in recruitment activities, we find it works well to formally recognize and reward the team members for referrals that resulted in a new hire.
Finally, we've also found that local outreach for public awareness helps to further boost the effectiveness of these methods. Examples include volunteering or working together with local charitable organizations.
While participating in these activities, our team members wear a company t-shirt and are encouraged to discuss the practice when appropriate. We get positive press coverage and local awareness, and our employees take pride in helping others out in the local area.
In the wake of staffing challenges, our company culture has shifted to emphasize team member satisfaction in a more focused way than in the past. This includes attracting the best candidates with good benefits, competitive wages, and forward-thinking policies, and retaining them by making the job itself attractive and appealing to their sense of purpose.
Here's what that looks like:
Physician candidates, whether seasoned or fresh out of residency, are drawn to positions with adequate compensation, great benefits, and flexibility. But it's not uncommon for a physician to be recruited for a position and forgo an income until the practice employs them. Instead, to get the best candidates, we take a different approach.
You can achieve superior results with physician recruitment by offering:
Combined with the networking recruitment approach covered in previous sections, these incentives create a powerful advantage in a competitive job market with a limited labor pool.
Just like physicians, support staff candidates are looking for competitive salaries, good benefits, flexibility, and recognition of their contributions to the business. Staff members want meaningful work where they can feel good about what they do each day. With this in mind, consider offering the following incentives:
The point here is to create win-win scenarios to attract and retain entry-level staff, and to develop them into more senior roles over time. Frankly, if you don't comprehensively address compensation, benefits, flexibility, and advancement opportunities, entry-level employees will instead be drawn to roles at national retail and fast-food chains.
Another out-of-the-box method we used to create a pipeline of potential candidates was to start our EYE-Q Visionary Student Internship Program. During COVID, we found ourselves with lots of work and very few hands. We talked to our teams and learned about an untapped resource for the workforce: students looking for paid internships.
Our physicians, staff, and neighbors had high school and college-aged family members who could not go to school or work due to COVID. We brought in and trained entry-level interns aged 16 and older who provided us with these basic, but essential, services:
At one point during the height of the pandemic, we had 35 internship students helping us in three locations throughout our practice. This not only helped our patients and permanent staff during this difficult time, but also helped form invaluable, long-lasting relationships with interns, many of whom would later become employees, helping to fill vacant positions.
The feedback we received about this program has been exceptional. Not only did the students love the work, but we fostered an interest in careers and vision care, resulting in a pipeline of potential employees for our practice.
As a result, several of our interns changed majors to medicine or ophthalmology and have gone on to become successful physicians. One intern graduated medical school, continued to work with us through residency and fellowship, joined our practice as an ophthalmologist, and now serves on our board of directors. With a paid student internship program, you can achieve similar results and build a pipeline of physicians and other essential staff.
Networking and making positions attractive to prospective support staff members are essential steps for acquiring great candidates, but if you can't retain your employees, you'll still end up with a staffing shortage.
One of the best ways to increase your staff retention is to look at problems employees deal with and discuss ways to ease their burdens. For example, attendance is sometimes an issue for team members due to the sickness of children and a lack of affordable childcare.
Use your powers of observation to make note of issues like this, then discuss them with your practice managers and employees to offer solutions. You'll find plenty of opportunities to build loyalty and support your staff's work performance.
These are simple, yet impactful, options you can consider to help your staff and build long-lasting relationships:
The ultimate goal for retention is to create a win-win company culture and keep staff members for decades. While these perks must be balanced with the organization's bottom line, in general, you'll discover that resources for helping your employees feel supported are money well spent.
We have an employee-led charity committee called EYE-Q Cares that decides the monthly community charity activities for the year.
The committee has organized blood drives, volunteered at food banks, and helped out at a pet rescue. The committee also implemented "Jeans Friday," where any team member who donates $7.50 from their paycheck to the current cause can wear jeans on the next Friday. The team raised $15,000, and with a generous donation from our board of directors, the total amount presented to the charity was $20,000.
Community participation in social responsibility programs can be beneficial for the staff and physicians, the practice, and the community at large.
Ineffective or outdated training methods and staff overwhelm due to repetitive tasks are major stumbling blocks to employee satisfaction.
Beyond simply addressing staffing shortages, providing best-in-class training and management practices are essential considerations to help your staff do their best, as well as keep them fulfilled and engaged at your practice.
Having a training process that can be effectively implemented in a busy office is vital from both the hiring and retention perspectives. But creating a training system that works well can be incredibly challenging. Disruptions to training include:
You can support your staff best by offering them standardized, automated, self-directed training that can be completed during the onboarding period of a new employee. The most successful programs will:
Luckily, you don’t need to reinvent the wheel. There are existing electronic training resources that you can consider implementing in your ophthalmology practice, including the following:
You could also consider developing your own training program, though this is critical to consider who is writing and delivering the training. While a team member may be a great at-the-elbow teacher, he or she may not have the acumen to write or deliver a curriculum. Be sure to weigh the pros and cons of in-house training programs against proven resources like those covered above.
The word "automation" is weighty and comes with a myriad of reactions from staff. Even raising the topic with your team may prompt worry about job losses. But automation doesn’t mean that human beings are no longer needed. In fact, the opposite is true: an automated program, like a bot, can only do so much, and lacks the insights a person would have when interacting with others.
The benefits of automation include:
One proven automation solution is revBot by Revival Health. Ophthalmology assistants and front desk associates would rather spend time with patients than areas like:
Help your staff understand the benefits of automation and they’ll quickly realize a bot will not be replacing them in the clinic. They may even be excited to hand off the repetitive, mundane processes they dislike.
Not only do staff appreciate the benefits of automation, but your patients will, too. Any function that makes the wait time to see the doctor shorter and increases the speed and accuracy of a visit increases patient satisfaction. Consider utilizing the patient engagement functions of your EHR, such as a patient portal that can:
Your patients would rather spend time speaking with staff than watching them bury their heads in the computer to document data or complete financial tasks.
To ensure your ophthalmology practice is poised to survive and thrive amidst the staffing shortages and training challenges of today's landscape, your leadership team must focus on strategic solutions aimed at staff recruitment, retention, and repetitive task automation.
Traditional recruitment methods are not as effective in our post-pandemic job market. To be more attractive to candidates:
Also consider deploying innovative solutions in staff retention and training by:
Next-generation automation solutions offered by revBot by Revival Health can increase productivity and staff, patient, and physician satisfaction by freeing up your team members to do what they do best.
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