The Best Fit

The skilled labor shortage is impacting nearly every business in one form or another. Every employer is fiercely competing for productive, dependable and honest employees. With a dramatic shift to a service-based economy, a burgeoning mature population, and a shrinking pool of young people moving into the labor force, dentists will need to create strategies to fend off the flight of employees to other practices and other industries.

A recruiting plan identifies the job candidates who are a good match.

Dr. Ira Wolfe

The skilled labor shortage is impacting nearly every business in one form or another. Every employer is fiercely competing for productive, dependable and honest employees. With a dramatic shift to a service-based economy, a burgeoning mature population, and a shrinking pool of young people moving into the labor force, dentists will need to create strategies to fend off the flight of employees to other practices and other industries.

The demand for skilled employees is expected to increase for the next 20 years. The supply of skilled workers is expected to fall. Dentists will need to remove the blinders of complacency to recognize their biggest challenge in the first 10 years of the 21st century will not be managed care or technology, but a lack of employees.

Problems in a tight labor market

In a recent confidential conversation, a dentist - whom we will call Dr. C - seemed to echo the words of dentists from Pennsylvania to California. Dr. C`s story is becoming the rule rather than the exception. Managing employees has always ranked high on the list of challenges and frustrations for dentists. Now, it is an emotional mine field and many dentists are getting blown up!

"In 1997, I noticed the quality and quantity of people applying for dental positions was very disappointing," confided Dr. C. "The people who did apply didn`t have the skills I needed. What was also scary was there were very few people interested! I made a host of hiring mistakes over this time, but, in most cases, I felt I didn`t have a choice. I had to hire people that I was totally uncomfortable with. I won`t even go into my situation with hygienists!"

Problem No. 1: The cost of turnover and lack of retention of qualified people is frankly unaffordable with current dental-practice overheads. The cost of a "mishire" not only adds to the payroll, but it costs as much as 100 percent of the exiting employee`s annual salary to replace that individual. In today`s highly competitive health-care market, hiring the wrong employee can devastate practice morale and the bottom line.

"Financially, the last two years have been a nightmare," Dr. C continued. "Our collections have been flat for nearly three years. My patients have almost quit referring because of constant turnover. Over the past two years, I have had 10 different people work at two positions up front. Back in 1996, things looked good. That year, the practice grew by over 20 percent. I was expecting another 15 to 20 percent growth in 1997. But in the spring of 1997, my scheduling coordinator`s husband was transferred to another city."

Problem No. 2: Employers make the hiring decisions based on the wrong factors. Dr. C . continues: "We hired someone who had no dental experience, but seemed qualified. We spent two months training her. Then, I had to terminate the employment of my financial coordinator. We couldn`t find anyone to cover the position on short notice, so my inexperienced scheduling coordinator now became my inexperienced financial coordinator."

Problem No. 3: Employers have difficulty matching the right person to the right job. Hiring the right employee for your practice requires more than a well-written resume, a casual interview, and intuition. The best employee for one position may be a nightmare for another.

In Dr. C`s case, one good employee quit because of her inability to get along with another employee. He eventually had to fire the "not-so-good employee." That`s when he came to us and began using employee testing.

"What started out as a tool [employee testing] to see if an employee would be compatible, resulted in me looking at staffing in a whole new light," Dr. C commented. It makes sense: why not work with people whose personalities fit each staff position and who share similar interests and values?"

Successful selection requires an understanding of the dynamics of the position that is open. It also calls for a vision of how the employee filling it will interact with other employees and patients, and how he or she will perform the necessary tasks. A successful selection process must look not only at the job skills, but which performance factors may influence how well an employee will perform the job.

The purpose of evaluating a job, according to Dr. Chuck Coker, founder of LifeThrive Performance Systems in Jacksonville, Fla., is to predict - or forecast - how potential employees will perform on the job before they are added to the payroll.

Getting off on the wrong foot

Interviewing is the most widely used method for evaluating job candidates. Unfortunately, hiring people usually is not a core skill of the doctor or practice manager. It also is frequently done in a crisis mode. The result is hiring the first "warm body," resulting in mediocrity not meritocracy.

Even for those with the expertise and skills in hiring, interviewing alone is a proven poor predictor of selecting the right person for the job.

A Michigan State University study validated that interviewing is only 14 percent accurate in predicting performance on the job. Comparable studies shared similar results for interviewing and identified reference checks as only 26 percent accurate.

Harris Plotkin, author of Building a Winning Team, notes that interviewers make 90 percent of all hiring decisions and that most selection decisions are made in less than an hour. That means selections made by the interview alone are impacted by interviewer bias and emotions, Plotkin says. The problem with this technique is that it is likely that the interviewer`s decision may have nothing to do with performance. This not only leads to a bad choice, but also places the doctor at risk from a legal perspective.

Tools in your hiring toolbox

According to the Guidelines on Employee Selection Procedures - used by the Equal Employment Opportunity Commission and the courts to evaluate hiring procedures - all selection procedures are considered tests, including interviews, reference checks, and work samples.

From this legal perspective, interviews are "tests." In general, applicants either "pass or fail" an interview. Like all tests, employer interviews must only ask job-related questions that help demonstrate whether the prospective employee can or cannot do the job. Asking nonjob-related questions exposes the dentist unnecessarily to labor and discrimination law violations and adds little to predicting how well the candidate might work out.

How do your "hiring" tests stand up? Legally permitted employee-screening methods have four characteristics in common:

- They must be job related.

- They must be valid.

- They must be reliable.

- They cannot discriminate.

The interview, the telephone screen, the reference check, even the application, must meet each and every one of these criteria.

Many dentists want to delegate interviewing responsibilities to their staff. The assumption is that the employees will get more information from the prospective employee. This might be true. However, as representatives of the dentist, the employees are an extension of the dentist and the dentist still is liable for any indiscretions or discriminatory questions asked by his employees. The law is loud and clear. If it`s not job-related, don`t ask it.

Avoiding the crap shoot

An article in the Spring 1988 issue of Personnel Psychology, titled "Structured Interviewing: Raising the Psychometric Properties of the Employment Interview," notes that researchers have found that highly structured interviews - supported by employee testing - can lead to quite accurate predictions of job performance.

Structured interviews provide a planned approach to interview questions, which helps ensure consistency and effectiveness in determining a candidate`s qualifications. Such interviews also allow the interviewer(s) to compare natural talents and motivations of each candidate with the core competencies required for successful job performance.

The structured interview helps the interviewer maintain a focus on getting job-related information and, at the same time, avoiding the subjective, which only exposes the doctor to the threat of discrimination suits. A structured interview is simply the right way to screen and evaluate candidates.

What type of questions should a doctor ask in a structured interview?

The questions should be based on between five and 10 of the most important job-related competencies identified in the job analysis. Examples of the most identified competencies directly related to success in dental offices are:

* Friendliness

* Good customer-service skills

* Listening skills

* Verbal skills

* Multi-tasking

* Working independently

* Team player

* Tactful

* Persistent

* Follows rules and procedures

* Handles conflict well

* Energetic

* Desires to help people

Examples of good questions are:

Friendliness: Describe the biggest problem you ever had working with other people?

Tact: How did you handle an unfounded complaint about something you did?

Desire to help people: What most inspires you to do a good job?

During each interview, it is imperative that you ask each job candidate the same questions. The interviewer(s) then rates each candidate on how well he or she demonstrated competence by his or her responses to the questions. The scores are then totaled and placed on a summary sheet. The candidate with the most points wins!

A minimum hiring score should be set for each position. The goal of a successful hiring process is not to select the best of the candidates, but the best employee for the job. If no candidate meets or exceeds the minimum level, keep looking!

Accepting the challenge

Placing people with the right skills and potential in the right position, and sharing or blending them with the attitudes and values of the other employees, doctors, and patients is not as easy as it sounds. To have a distinctive competitive advantage in the next decade, hard evidence says fee-for-service dentists must have good employees. The best-trained, patient-focused, motivated practices will thrive. That means to remain competitive and profitable, dentists must be prepared to overcome or neutralize the current and increasing labor challenge.

The challenge is to select the right people for the right positions in your practices the first time. Currently, however, most dentists are woefully inept at predicting how well a job candidate will perform on the job. A combination of employee testing, interviewing, and reference-checking will increase the probability of selecting and retaining the dream team for your practice.

Fortunately, employee testing is readily available and interviewing skills can be easily learned. The selection process can be made accurate and predictable.

Successful selection starts with attracting the right people. Attracting the right people starts with a recruiting plan that clearly identifies and promotes the performance qualities you are looking for, represents the job accurately, and targets your recruiting toward candidates who will be a good match for the job and the practice.

Prepare for the search!

The first step begins with knowing who you want and why. Before you can place a classified ad to attract the right prospects or prepare an interview guide to select the right employee for the job, you must answer questions like:

(1) What am I really looking for in a new employee?

(2) What are the make or break job-related competencies needed to succeed in this position?

(3) What questions should I ask in an interview?

(4) How can I accurately evaluate and use the information we get from job applicants?

A systematic process for knowing who you are looking for begins with a clearly defined job analysis. The job analysis must include:

(1) All the educational, technical, and licensure requirements of the job

(2) All the job-related performance competencies (such as interpersonal skills, customer-service skills, behavioral styles, attitudes and values, and motivations) an applicant must meet to succeed in the job.

Identifying the educational, technical, and licensure requirements is straightforward. Positions, however, are very difficult to analyze because different people performing the job see the job differently. Three ways people view the same position differently are:

(1) How would I like to perform the job?

(2) How is the job actually performed?

(3) How should the job be performed?

An excellent job-analysis tool is TTI Performance Systems Ltd.`s "Work Environment Analysis™." It helps employers and employees answer these questions and identifies and compares people`s perceptions and attitudes toward the job

The products of an accurate job analysis are a job description (a guide to what to look for during the interview), what information to place in a recruitment ad, and the questions to ask during the first contact and subsequent interviews. Using the performance competencies discovered during the job-analysis process, a structured interview guide can be developed.

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