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What’s the best way to fill a critical role at your practice?


Whether a position opens up at your practice because of an unexpected departure or practice growth, deciding how to fill it can present a dilemma.

Whether a position opens up at your practice because of an unexpected departure or practice growth, deciding how to fill it can present a dilemma. Instinct usually says “let’s post the job description and try to find someone who’s had a similar title.” That can be a way to find the best local candidate available – sometimes, you’ll even get an even stronger candidate than you expected.

But what if a close match can’t easily be found in your local market? Should you consider bringing in a person with less experience – perhaps someone from a different specialty or even a different industry? And what about the value of promoting from within?

The answers to these questions may depend on the role itself. Some positions more naturally lend themselves to more creative or expansive recruiting than others. If you need a physician, for example, nothing but a physician in your specialty will do. But in many other hiring situations, there is more flexibility than may be obvious at first.

For example, we’ve worked with practices that have needed clinical support staff or technicians with specialized training or certifications. What if someone on your team would like to become certified or learn a new skill? Helping your employee earn the credential may benefit your practice much more than hiring an outsider who already has it.

We once worked with a practice that offered clinical trials that required regular bone density scans. When their DXA tech left the area, the practice did not find many experienced local candidates to replace her. The ones they did find were available only for part-time work, expected much higher hourly rates, or both. The practice now faced a hit to the profitability of their trials, simply because DXA scanning would suddenly be more costly.

Luckily, the practice learned of a weekend bone densitometry training course. One of their medical assistants (MAs) was quite interested in adding this credential. By funding this course for the MA and then offering her an increase in salary once certified, the practice was able to make a valued employee much happier. The net cost was much less than hiring an experienced tech from outside. The practice got exactly what it needed. And the icing on the cake was that this approach also signaled to other staff that the practice was willing to invest in their skills.

There are many other ways practices can invest in affordable training to tap into skills they need while boosting employee morale and reducing turnover. For example, many practices can benefit from having a certified coder on staff – why not reimburse a motivated biller for this training? Certification for MAs is becoming increasingly valuable as more practices seek to participate in quality programs. It’s often possible for the certification process to be overseen by a physician in your practice, so why not do it in-house? This not only saves money, it ensures that the MAs’ training is aligned with practice standards.

The strategy of “growing your own” can also apply to non-physician providers. When your practice needs a new nurse practitioner (NP) or physician assistant (PA), hiring for experience may be a faster path to productivity – but not always. Sometimes, your protocols or approach to integrating non-physician providers may differ so much from the clinician’s prior experience that there will still be a learning curve to scale. Hiring a new graduate may mean you’ll spend still more time training, but you’ll also be assured that the NP or PA learns your preferred methods right from the start.

The idea of growing the skills and credentials of your team doesn’t have to be just a “when-needed” strategy – nor should it be. Thinking about paths for your employees can help ensure you’re not left with critical vacancies in the first place. If employees know they can continue to build their careers in your practice, they’ll feel less of a need to change jobs to pursue advancement. And when key people do move on, continuously cultivating your team ensures someone else in the practice will be ready to grow into the open job.

In many business organizations, the concepts of succession planning and “the bus test” are considered core manager priorities. Ensuring the business can function even if they’re hit by a bus should be a key priority for managers. But in our consulting work, we’ve encountered few practices who take the idea of developing bench strength seriously – and we think all practices should. If you haven’t done so already, it’s a good idea for owners and management to sit down and work through how your practice will respond if key positions unexpectedly become vacant – and develop a plan for grooming your strongest employees if you don’t have one in place already.


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