Listen to the podcast here: How to Train Support Staff
Episode summary: In this podcast episode of DPC Pediatricians, Phil and Marina discuss the importance of effectively training support staff as a DPC practice grows. They share practical insights on onboarding new team members, clearly communicating expectations, delegating responsibilities, and giving employees the tools and confidence they need to succeed. They also explore how investing time in training and building a strong team can help physicians step away from administrative tasks, create a smoother practice, and focus more of their energy on patient care.
Welcome to DPC Pediatrician. We’re Dr. Phil Boucher and Dr. Marina Capella, two DPC Pediatricians who are on a mission to share our love of direct primary care with you.
Welcome everyone to another episode of the DPC Pediatricians podcast. Today, Phil and I are going to help answer a question that came through from one of the registrants to our upcoming virtual summit. If you have not heard about it yet and would like details, would like to learn more, Check out summit.dpcpediatrician.com.
We have early bird pricing available until the end of August, but if you’re hearing this a little after, it’s okay. Registration is available up to the event and we would love to see you there. Recordings are also available for those of you who maybe can’t carve out the time, but would like to access the recordings after the event.
So the question that came through from one of our registrants was regarding how to train staff. Now, I’m not sure I forget exactly Where they are on their journey, but obviously they’re thinking about this issue of, you know, if I hire someone, if I hire a virtual assistant, if I hire a medical assistant, if I hire someone to help with social media or marketing, how do I actually train that person?
And Phil and I have now been in this world for about five years and we both have hired and maybe fired some people and we have some experience with that.
So Phil, I’m curious, start us off. What comes to mind when you think of how you have trained the people that you have hired?
So I think in the big picture, we’re not used to this as physicians to have to like train people ourselves, because usually we work for a big organization that trains all the nurses, that trains those receptionists, that trains the support staff, and you kind of just show up and you do your thing.
And I feel really lucky that when I was starting my career in the practice that I was in and was a partner in, I had the best office administrator and he said, you need to learn what everyone else in this practice does. Me, brand new physician out of residency, sitting with the triage nurses for half a day,
learning not just what they say, but what sort of questions come in and then how they like document to that and send that. And then sitting with the billing department and seeing how bills come in and then sitting with the receptionist and getting to hear the different questions.
We sat and learned all those different roles so that we would know how the organization worked. Beautiful. He suddenly passed away and it was a huge loss for our practicing community. But I feel really lucky that I got to have that as like my first entry into private practices.
Like you need to learn what all the different people in your organization are doing and how they’re supporting you and how you can support them. And so having said all that, I think when it comes to support staff, I look at three big areas when it comes to the different kind of training
that we need to do for them. First and easiest, in my opinion, especially for most of our support staff are going to be young in Texas. So I’m thinking about starting a new note. I’m thinking about billing a patient or starting a new membership. All of those kind of like technical click here, click here,
click here sorts of pieces that we just have to show somebody how to do a couple of times so that then that can be off of our plate. I love using screen recording tools to do that so that one, I don’t have to hover over somebody and be like, no, click there, no click there.
Or they don’t have to stand behind me and they’d be like, wow, you have a lot of different folders on your desktop and files on your desktop. You’re not as organized as it seems. And then I’m trying to be like, okay, click here and then you click here and click here. Which is free is called Loom, L-O-O-M.
And it makes it really easy to just turn it on and grab a screen recording and say, okay, if I’m starting a new patient visit, here’s how I do it. If I’m scheduling a new patient, here’s what it looks like. You can kind of dictate into it. Like, okay, you click here.
And then you type in this and then you click here. And then that becomes a library that goes beyond the training. The one person that you’re hiring is if you, if they leave, or if you hire a new person, you just send them back to that library and you say, here’s the videos that you need to watch.
And if it’s messed up, here’s how to do it again. I’ve even used it. You can use Loom on your phone to record like how to run a strep test because we have an ID now machine that is not complex, but you do have to push some specific buttons. You have to open the thing.
You can record yourself doing it on your phone and then put that on there and be like, hey, this is how to do a strep swab. This is how to run a strep test. Those sorts of things are all very possible and doable. I like having a video library.
People like that because they can consume it on their own time. They can say, yes, I’ve watched this. Yes, I get this. They can also refer back to it if in the future they’re struggling or can’t remember how to do something or it’s been a while since they got all
the equipment out for A laceration repair or something along those lines. So I like not having to remind people and also not having to do it on the spot, using the technical aspects of it, using some sort of screen recording, and then just going through all of those sorts of things. Marina,
when it comes to like training up somebody new from the perspective of like the EMR, the texting, those sorts of things, what have you found that’s helpful?
Yeah. Well, I’m recalling my experience with my very first employee. She’s wonderful. Her name is Erica. She’s now my office manager, but she started out basically as my front desk receptionist. I need help with the phone because I’m starting to get too many phone calls kind of person with the paperwork.
And I don’t like scanning things and uploading them to a folder. And I don’t like faxing things. And that just started to become really annoying and burdensome. It’s like, I want to spend my time doing other things that interest me. So she was lovely and she already came with a lot of customer service experience.
She had worked with scheduling people for surgeries and procedures in the hospital
and also at a
call center with the hospital system. So look for, first of all, be careful who you choose because can you train someone who is completely brand new? Yes. And I’ve done that in my practice before. But when you’re hiring your very first person, you might want to be more strategic about, okay,
do they have at least some experience or do they have natural skill sets in the things that I value? But anyway, she came with a lot of experience. I really believed she had the skills that I needed, but she was really shy in the beginning. She was like, well, I don’t want to mess up.
Tell me exactly how to do it. Can you write me an outline? Can you give me a script for how to answer these messages? And I internally was a little annoyed because I was like, wait, I don’t want more work for myself. I don’t want to do that.
But I realized that’s what she needed in order to step up and feel confident. And now she bosses me around and she tells me how to do things. But in the beginning, it was this like, okay, you have to read where the person is, where their confidence level is.
And if they need very specific instructions, it is going to be your responsibility. To give them those specific instructions. And then what tends to happen over time is that as they do the work, she’s answering phone calls 99% of the time now. And now she knows better how to answer phone calls than I do in certain respects.
And she knows what people need more than I do. And so that’s why she bosses me around now. And she’s sometimes like, I know this better than you do because I’m doing it on a daily basis. And this is my suggestion for how to make it better.
So she’ll run things by me of like, I want to switch this SOP, the standard operating procedure. I want to switch this process that we have. And I said, well, as long as you have a good reason for it, let’s do it. All right. My medical assistant, she was my second hire and she already also came.
I needed someone who had experience because I didn’t know how to be an MA. I’ve never been a medical assistant. I’ve never… Done VFC paperwork and I’ve never done a ton of blood draws. And so she was my second hire. The experience was also really important. She came highly recommended.
She was ready for a job change from a really overly busy toxic work environment. And this was great, but she also was a little shy of like, okay, I know how I did it in this other place, but how do you want it done? Because I don’t want to disappoint you. Right.
And once again, I had to just give her permission slowly over time and run things through. So just know that in the beginning, when you’re training someone, it’s not going to actually take work off your plate. There’s going to be a little bit of a hump in terms of like your work is going
to increase before it decreases. There’s a little bit of that activation energy required for that, but it’s worth it because now. My lead MA, my office manager, they have trained every subsequent employee that we have had come through the clinic. And I, I asked them to kind of help me create an operating manual so
that everybody’s responsibilities are clear and we have checklists and things like that. But I didn’t create it. I said, Hey, your job best. If you were to suddenly leave tomorrow for whatever reason, can you create a list of everything you do so that we have something right?
So that was a long winded answer to your question, but that’s what comes to mind.
I think that makes perfect sense. And I think that that’s what people need to hear of, okay, here’s how we actually do that. And here’s how we empower people and what an amazing place to get to of. Yes, it took longer to train them on how I want things done. I have some things that I’m particular about,
and I have a lot of things that I’m not particular about. I’ll show you what I want you to be particular about. And then here’s the goal with these things you figured out, you come up with what you think is best. And then if you want to change it, let me know.
And I’m at the same place as you are, is there’s lots of things where I actually don’t really care how this or that gets done at this point, as long as it gets done. And we have the same kind of values and priorities and culture as a group.
So I think that it’s a great place to get to of like people do things the way that they should without having to be constantly directed or redirected.
Yeah. One more thing to add, Phil. I think it’s also important to realize that when you are hiring help, there is some degree to which you will have to let go of control, right? For sure. You can’t just duplicate yourself and say, do things exactly as I would do them, right? And I am astrologically a Virgo.
I’m a perfectionist. I am a bit of a micromanager in some domains, and I have had to soften myself in terms of that. In fact, just recently, we have these French doors near the reception area. And the sun this summer has just been so bright.
And so my two front desk people were like, can we please get something? And I said, well, yes, I’m going to give you permission, call this blinds place, get the little remote controlled blinds so that you’re not getting sunburned during the day. But I’m really particular because this was like over
a thousand dollars we were spending on these like remote controlled blinds. And so I wanted to approve them. I wanted to make sure that the aesthetics were right if I was spending that much money on them. Well, they didn’t check with me. They just chose. And then suddenly I get a text message yesterday. Oh, they’ve been installed.
And I had a little moment of panic. This is my micromanaging self of like, wait, but I didn’t approve the color or the texture or the sheerness. And like, what if I just spent $1,500 on this thing that I don’t like for my clinic? Right. And she talked to me and I said,
okay, Just tell me more about what you got and then tomorrow I’ll see them. And they made a lovely choice and it was perfect. And I didn’t have to waste any time being involved. But I think that that’s an example of how some of us as physicians can be
a little micromanaging and want to be in control when we don’t actually need to be in control of everything. So it’s going to be a practice when you hire employees, you have to let go Of being in control of everything. And you have to also communicate very clearly of like, look,
these are the things that are non-negotiable that have to be done in a certain way. And then with other things, there is some flexibility and also understanding that people will make mistakes. And all of my employees have made mistakes because we’re all human, right?
And so when they make mistakes, I say, okay, this is just a learning opportunity. What did we learn? How can we improve the process so that this doesn’t happen again?
Oh, yes, totally. I think physicians have it trained into them for so long that you have to micromanage everything because the attending that said like, well, who’s going to push them down to x-ray? And then you as the resident are like pushing this kid down to x-ray when you could be doing something much better with your time.
You learn that like, okay, I have to take care of everything and I have to do everything perfectly and everyone else will mess it up if I don’t do it. And it takes a long time and a lot of practice and experience with things not going quite right,
but being quite Quite fine enough to get to the point of being like, okay, I might’ve picked something different, but if it were me in that circumstance, it would have taken six months to get this project done because I would have got held up on one little thing and they were able to do it.
And it is perfectly fine. And at the end of the day, literally no one is going to notice that it’s at me. So even if it’s not exactly as I chose, it’s not something that was blatantly terrible because I hire people. We talk these through things. They know what I think. They have good opinions themselves.
But that does take some practice. So good for you for getting…
It’s harder for some people than others. Others are like, just get it done. I don’t care how it gets done. And some of us are like, wait, but I want it a specific way.
Yeah. Example in our practice is we have some glass out in front and I have the traumatic memory of it was a big glass thing in front of the like alcove. And my daughter ran full speed into it because it is perfectly clear glass and left a forehead oil imprint on it.
And so I am very particular about there needs to be something here. And then my staff pick out seasonal decorations. Like right now it has these little like hanging things that are like pencils and chalkboards for back to school. And so I don’t know, nor do I care what they put up there,
but the day that they switch it, I go out there and I put sticky notes all over it. And I’m like, you guys, we have to have this covered at all times. Because Gloria ran full speed into this once. And so I don’t care what you cover it with, but please cover it.
So yes, there’s things that are important. There’s things that can be decided by somebody else and that takes practice.
Well, I’m glad it was just a forehead imprint and not like a broken nose or something like that.
It could have been. So that’s the technical and businessy decisions sorts of things. I think there’s something to be said for the support staff when it comes to the sales side of things. This is a different type of practice. And so we need somebody that is going to support us by helping to Teach people
about our practice and our practice model and those sorts of things. And so that is something that, that now I don’t have to do, but at the start we were in a smaller area and I could like hear them on the phone talking with people that were calling in to learn about the practice.
And it was a really good opportunity. One to hear the things that they were saying in the way that they were saying it and the questions that they were getting asked, but then an opportunity for us to work on our sales pitch together. And so that is something that I think it’s really helpful,
especially if you’re bringing somebody on that doesn’t know a fraction of what you know about DPC and doesn’t know a fraction about how you envision your clinic to really Practice and let them hear you talking with potential patients about it on the phone in real life
or also otherwise simulated so that they know and have a script with the bullet points of why this patient might prefer this practice or how you envision those phone calls going and that that’s a really important thing to give them as much information. As you can,
so that they can make a good pitch for you when they’re calling in and they’re taking that phone call. And so for us, that looked like, okay, somebody calls in and they say, I heard about your practice. Are you taking new patients?
Well, the first thing that we try and do with them is find out what they’re looking for. Oh yeah, what are you looking for in a pediatric practice? Because then the patients will tell you what they’re looking for in the pediatric practice. My current practice doesn’t do this. My current practice makes us do that.
And that’s what we’re looking for. Oh, well, that is a good fit for us. So our practice is blah, blah, blah, blah, and go from there. But you have to really help them to figure out how to make those conversations flow, get across the things that you want to make sure they get across,
and then empower them to ask or do those conversations and then seek, hey, this question came up and I wasn’t sure how to address this. How would you say this? How has that been in your practice?
I like what you said. And what comes to mind is actually that those people skills, interpersonal skills, the customer service skills are so important because if you were to look up the Google reviews of any medical office or dental office in your area,
you’d be surprised how many of the bad reviews are not because of the dentist or the doctor or the service provider themselves. They’re actually about the front desk or the person who answered the phone. Like, oh, the receptionist was rude. And that can really tank your whole perception and reputation in the community
if you don’t have someone that is communicating appropriately as a frontline person, right? So even like role playing with them, okay, I’m going to play the part of a parent and like how would you respond and like training them a little bit in that way. I think super,
super important and super important to empower them and how to how to really sell your services, how to talk about them joyfully without feeling like a slimy salesperson. Right. But also empower them on how to have hard conversations. So I have a virtual assistant who I am.
I think I need to empower a little more because she helps with my billing management. So I didn’t want to be like having to look in my system and like, OK, who hasn’t paid their membership this month? So I uploaded it to her. But I could do a better job empowering her of like, hey, Tiffany,
if if this person has not paid by the middle of the month, you send them a concrete email or text saying you have until the 30th of the month to catch up on your payment or you will automatically be discharged from the practice. Right now, obviously, if they respond with some sort of unique situation,
she knows that she can reach out to me and say, hey, This person just lost their job. Is there any flexibility here? Right. But I think she’s a little too nice. And so I have noticed that I need to do a better job. And it’s just a learning process, right?
We are not going to be able to anticipate every single problem or every single thing that a person needs to know from the beginning. You’re going to do your best to try to anticipate all of the things that you need to teach them. But sometimes you just don’t know until an issue arises.
And then you just pivot and you just Reconnect and you retrain and you say, let’s come up with something together, a strategy together that feels good for both of us, right? Also read the people that you’re training. How do they do? Do they feel comfortable with something that you’re asking them to do?
If you get a vibe of like, I’ll ask you to do something, but I don’t know if it’s really landing or if there’s resistance that I’m sensing, ask them and just be able to try to have those transparent communication relationships with them.
Makes a huge difference. And I think that that’s something that again, we have to practice to get good at giving up that control and saying, Hey, I built this, please keep it going by having these good conversations on the phone and getting feedback from people. I think that that is a really important part of it too.
Absolutely.
What about clinically, when we’re talking about the clinical side of things? Now, this can be very variable depending on the licensure or lack thereof of the person that is going to be supporting you. But at some point, most practices will want to hire somebody to help them clinically,
whether it’s an MA, an LPN, an RN, something along those lines. And so from my perspective, when it comes to the clinical training, it’s a lot of shadowing. It’s a lot of hearing my perspective and it’s a lot of auditing. Like we do a lot over text message.
We spend a lot of time texting patients and that makes for a really easy way to communicate. Hey, here’s how I would approach this or here’s how I typically do this or here’s my typical approach when it comes to constipation or things along those lines.
Those are really good opportunities to teach them as you kind of just do your day to day. Mm-hmm.
That’s where, you know, I’m really grateful that my first MA that I hired already had a lot of experience because I taught her. I mean, by the time I hired her, I was like a year in to practice and I had already established my lab core account
and I had already figured out how to use that centrifuge and how to order things and how to call the lab for pickup and how to. We didn’t have vaccines then though. I hired her partly because we were beginning to give vaccines and I needed her help learning how to properly administer and store and all that stuff.
So there were some expertise that she brought with her that was actually a gap in my own experience and knowledge. And we worked together. Like obviously I’m the one ultimately responsible for everything. And so there were some times when we were first signing up for VFC vaccines
where it’s like, okay, we had the, The VFC person come and talk to us together. And we talked through everything together. We decided, okay, how are we going to do this? And what vaccine fridge do we like? And what freezer and, and all of that stuff. And we, there were,
there was a lot of cooperation in the decision-making because I recognize that she brought a skillset that I didn’t have, but I also had a perspective that she didn’t have kind of as the, the owner and the one who knows how I want. Things to go in my practice. Right.
But that communication was, and she is interesting because with her, I love her. She’s been with us now for four years and she’s just fantastic. But she came from a setting where it was very controlling. And those MA’s like went to work terrified every day because it was like horrible manager.
And if you make even a little mistake, you’re going to get just slammed and, and She just worked in fear, constant fear for like 10 years of her career. And so it was time for a change. And I’m so glad she came over to us. There was some deprogramming of that fear that had to happen.
I had to reassure her a lot in the beginning. Hey, Diana, I want your ideas, please tell me how to do it. I give you permission. This is a safe space. And there was the first few times the little mistakes happen.
I could tell she was like terrified coming to me to tell me it was just written all over her face and body language. And I said, Hey, it’s okay. Like, and after a couple of times she really did let down her guard and start to Feel comfortable.
Just recognize I say that because people are coming with their own baggage sometimes from other places. And it’s not just about teaching the clinical skills. Those are really important. You’re going to teach them everything that you’ve learned to that point. But then also be open to, you know,
learning from them and recognize maybe some of the baggage that they’re coming with and do your best to work around that. Now, if you get someone, please don’t hire someone who is not open to growing or to
learning, right?
Because that’s a bad hire. But in her case, there was some of that deprogramming that needed to happen, but she was open to it.
What a way to totally change her career and life trajectory too, to go from that like constant fear state. Cause I know so many people that I used to work with that like lived in constant fear that they would make the wrong decision because somebody is so particular or you can’t do anything right.
And so I’m glad to be at a place and point in my practice where our team, we’ve had the same team for five years. We’ve never had to fire anybody. And it’s just been great to continue to grow in that way rather than to constantly have people that are worried about their job or worried
about they’re going to offend. Like it’s just a lovely way to practice.
Yeah. Yeah. That’s impressive. You haven’t lost. Has anyone left?
One of our nurses left because her daycare closed and she lived out of town and then couldn’t commute in the way that she did. But otherwise, no.
Yeah. Interesting. I have had… Three people leave, so maybe I’ll talk really briefly about that. One, because she was moving out of state, even though she loved it. And she was a medical assistant. She wants to become a physician. So it was time for her to go back to school and start that path and everything.
Two others that were just younger people. And it’s hard because with younger people, it comes with pros and cons. They’re very teachable. They haven’t had any experience. They’re enthusiastic. They want to learn. They bring that young energy, right? At the same time, that comes with the downside of like,
they really don’t know where they want to go in life. And this very much may be just a temporary while I figure out my life and what I actually want kind of position. Right. And so the, those two that I’ve lost that were younger, it was, it, there were pros and cons to having them.
One of them was causing some interpersonal issues in the clinic. And I think it was just a personality thing. They had a little bit of trouble. Taking responsibility when they made mistakes and owning up to it. And then just interpersonal skills with patients sometimes were lacking. There was a lack of self-awareness in this younger person.
And I don’t think it really had to do with the fact that they were young, although that influenced it a little bit, but it was just their personality too, right? And so they ended up finding a job that was closer to where they live. And so I didn’t have to do the firing.
Although I was getting close to doing that. So I thought, thank you. Thank you, angels, for helping them find another job that’s a better fit, right? And I didn’t have to do that. And then the other younger person, she just really didn’t want, I mean, she did a lovely job when she was with us,
but she was kind of directionless and aimless in life and wanted to go back to school. So the pain point there when you hire younger people that don’t really know what they want to do with their lives is that You may lose them after only a year and you invested all of this time
and energy into training them and to developing systems and everything. And so it’s painful when you have to hire someone else and then retrain them. So when we did, I lost those three employees within the span of like six months. We downsized a little bit in terms of our clinic needs.
And then I hired someone who was older because I thought I want someone who has staying power, someone who has experienced the world outside and how much other jobs kind of suck. And they’re going to appreciate what they have here because that’s the other thing about younger people that they have not necessarily had those other work experiences
that will enable them to appreciate the setting that you have created. So that’s all I have to say about losing people and young people as well.
Well, hopefully this has been helpful. And if you’re thinking about how do I learn more about growing my team, growing my practice, those sorts of things, we have the virtual summit coming up September 24th and 25th. And if you are looking for community, if you’re looking to get more questions answered,
if you’re looking for support as you start or grow your practice, come join us. It’s summit.dpcpediatrician.com. And we will have so many great speakers and so much great information, great chance to build community. To learn from others that have been doing this as well,
we would love to have you and recordings are available if you’re not able to attend the entire summit.
We hope to see you there until next time.
