In the May 2, 2017 Ask The Headhunter Newsletter, a doctor’s small business suffers from hiring the wrong people.


small businessI’m a doctor running a solo medical practice. How do small businesses like mine get good managers and staff? I have two medical assistants I’m dependent on to keep work flow steady.

I caught the new assistant doing something very inappropriate! I was livid, but there were patients waiting and I needed them to get back to work. So, the next morning I had a talk with them. My instincts told me to fire the old assistant on the spot, because she makes a lot of errors and isn’t very conscientious, but I need her until I can hire someone new.

So, I’m scrambling to find someone. I’m too busy running to look up. I may have found a good prospect but she needs to give notice to her current employer. There ought to be some semi-structured ways to find under-employed business managers and great employees. Any suggestions?

Nick’s Reply

I know the fire drill: Small business owner is too busy to hire good help. Meanwhile, the business burns down.

Small business is too busy

Employers kid themselves that they’re too busy to recruit and hire good people. My rule of thumb: If you’re not spending 15% of your time recruiting — even if you’re not ready to hire immediately — then you’re not managing your business. Your business depends on good employees.

It’s clear that the staffing problems you describe are the result of hiring the wrong people to begin with. If you were devoting 15% of your time to recruiting, you’d have good people in your hiring pipeline. Yes — you read that right. Even a business with just two employees needs a candidate pipeline! When you don’t have a short list of very good potential hires in your desk drawer, you’ll wind up hiring the wrong people and pretty soon you’ll need to fire them (if they don’t quit). That’s no way to run a healthy business.

Good sources keep your candidate pipeline full

Small business owners rely too much on a sort of “just in time” hiring strategy — posting ads at the last minute and interviewing random applicants who come in over the transom. That’s no way to hire.

You must maintain a pipeline full of the kinds of people you’d be happy to hire. This means you must go out into your professional community to meet and and recruit them yourself. Posting jobs and waiting for candidates to appear when you need them is a fool’s errand. You already know that. I want you to realize it.

But stop looking for job candidates. The people you need to hire will come to you mostly via trusted referrals — so learn to identify sources of good candidates. One good source will lead you to worthy candidates again and again.

Make sourcing your business

Make it your business to source good managers and employees. I’ll start you off with a few examples.

As part of your 15% recruiting time, you should regularly attend a local chamber of commerce breakfast. Ask the attendees and event coordinators – not for referrals to possible candidates, but for referrals to possible sources of good candidates. A handful of reliable, trusted sources is an absolute must for any small business that can’t afford to be down 50% of its staff. That’s where the best job candidates always come from.

Go to that chamber meeting. Chat up who you meet. These are the movers and shakers in your business community.

How to Say It
“If you were trying to fill a job like this, who would you go to for some good referrals? Who do you know that knows under-employed business managers? Would you be kind enough to introduce us?”

I’m talking about local lawyers, accountants, retailers, building contractors, bankers, technology consultants — all the people who gather to feed one another business. As a group, they know everyone — including people you need to hire. If you feed this channel of referrals regularly, it will be there when you need to hire. By feeding, I mean returning favors: Referrals: How to gift someone a job (and why). Stay in touch with them. They know who’s under-employed, who’s talented, and who may be looking for work.

Recruiting: A small business necessity

You can recruit anywhere, any time. That 15% recruiting-time suggestion isn’t so outlandish if you consider that you can do it while doing other things. You can source potential hires while chatting with a patient who might know local talent. Or in the grocery checkout line. Or while talking with a pharmaceutical sales rep who calls on other medical offices and knows who’s happy at their job and who’s not. (Meet the right people offers tips to help job seekers network. But any employer can use the same tips to recruit.)

Don’t make sourcing and recruiting a last-minute fire drill in your business — especially if it’s a small business. If you think you can post a job ad and wait for instant job applicants, you’re going to hire more wrong people – “because they came along.”

Take the medicine now

I’ll bet you tell your patients, “Take the medicine now. Change your diet and behavior now. Or suddenly it’ll be too late.”

Start devoting 15% of your time to keeping your staff at 100%. If you’re too busy running to look up, you should see what it’s like to wind up flat on your back with no support staff.

For more tips about how to recruit like your business depends on it, see Recruiting: How to get your hands dirty and hire.

Once you find good candidates, know what to do with them! Read Smart Hiring: A manager who respects applicants (Part 1).

Still think you need help to hire good help? Check Talk to Nick. (No, I’m not going to sell you headhunting services. The offer is to teach you the basics of being your own headhunter for your own small business!)

How do you maintain 100% staffing for your small business? Do you rely on job postings and just-in-time hiring? Or do you make recruiting personal?

: :

  1. Back in the day I managed fast food (a regional chain where I learn a great deal).

    One day a kid comes in and asks for a job application. He fills it out, the manager takes me with him, I sit in on the interview, he hires the kid on the spot.

    Afterwards, I asked why, with a full staff, he hired someone else. He asked me what I thought of this kid.

    “He had a shirt and tie, that set him apart. He expressed himself well. He talks about his involvement with school activities. He wrote down all the information for referrals…they appear to be professionals, and it should be easy to contact them.”

    Then my manager dropped the lesson on me, “We always have room for good people. School lets out in two months, we know when that happens, there will be some turnover. Also, that kid is sharp. I want him on my team. I do not want to compete with him.”

    • @Gregoy: Who said fast food doesn’t require smarts? Your manager was smarter than most in ANY business. He was thinking ahead, and he was hiring good people – not filling jobs. Good people always pay off if you know what to do with them.

  2. Nick, what you suggested to this physician seems to be the most logical approach for a small business entrepreneur.

    When Bill Gates was asked many years ago during an interview to discuss one of the things he liked most about his role at Microsoft, he responded succinctly, “Hiring great people.”

    If someone as busy as Mr. Gates made recruitment a key priority, perhaps it is a lesson for us all.

    • @Steve: Have you heard the ZipRecruiter ads? They feature a manager who says, in a cocky sort of way, as if you’re a fool if you don’t agree, “Hiring people is the worst part of my job…”

      • Those ads get worse. The ad copy claims they post the job to hundreds of websites. This is the exact wrong, unfocused approach for so many reasons.

  3. Most managers and CEOs, for that matter are too busy trying to be the smartest guy in the room to be bothered with hiring top quality talent. And even if their second lieutenant is given a little leeway to hire someone, at least temporarily, said manager still micro-manages the hiring system to their “cultural fit.”

    • @Frustrated: The smartest guy in the room is the one who can hire the best talent, and does, and enjoys it. Because job #1 for any manager is hiring.

  4. I don’t have a small business but during my daily routine I notice how people respond to customers in their respective shops. Whenever I see/feel a standout, who behaves “responsibly” toward the customers, I imagine that I would try to recruit this person for a position wherever it is I worked. There aren’t many but you know it when you see it, IMHO.

  5. Being a doctor gives him access to temp help that is actually trained. Nearly every town has a medical temp service that he can use to take some of the pressure off. Yes, it will cost a bit more but gives some breathing room and it’s always possible the temp will be very very good and hireable.
    Whether he ends up hiring the temp or not, at least it will allow him enough time to get that 15% going and get rid of the inappropriate employee (can’t have that in a medical office…ever).
    It also sounds like he either needs more staff, needs better staff, needs to let his staff do their jobs or needs better scheduling. I understand the pressures of the modern medical office, but he is going to get a bunch of time off when he has his first heart attack.
    And, yes, I have been a practice administrator. I understand the constraints. Physicians are not generally the best business people in the world, by personality trait or by training.

    • @Doug: Thanks for the insider’s perspective!

  6. I once read a brilliant man (nod to Nick) express that employment is not an expense, it has an ROI.

    If a small business cannot treat employment as it would any other valuable investment (for example in this week’s instance: wouldn’t the doctor jump on a new medical device?), then is he truly managing a business? Maybe the small business is more of a craft processing center…

    • My friend, your comment sums up 96% of what Nick talks about when discussing head hunters/recruiters.

      If I may add to what you said, after a hire has been made, it is not unusual (in my experience) to have no resources readily available, no OJT (no time for it), and no 30/60/90 day goals of what the new worker should be working one/working towards.

  7. ‘Small business owners rely too much on a sort of “just in time” hiring strategy — posting ads at the last minute and interviewing random applicants who come in over the transom.’

    I’d argue that this same thing is the cause of the so-called talent shortage as well. There’s no thought to hiring before you’re in crisis mode, then you post an ad, and get 200 resumes and claim no one can do the job because no one is “experienced” enough to do the job on day one.

    “You can recruit anywhere, any time. That 15% recruiting-time suggestion isn’t so outlandish if you consider that you can do it while doing other things.”

    The good part of this approach is that you aren’t in the whole stressful and adversarial setting of a job interview. If you’re talking to someone over a few beers, everyone’s going to be a bit more relaxed for starters.

    • @Dave: It isn’t just small business owners who rely upon “just in time” hiring (I need someone two weeks ago but can’t spend time talking to candidates/reading résumés nor do I have time to train them–they need to have done this job before, for years) and figure out the chaos I’ve created because I don’t know what I’m doing without me telling them anything–plenty of bigger businesses (Wal-Mart, for one) rely on “just in time” hiring.

      No one thinks of hiring as important or of employees as an investment anymore. And if the doctor (or lawyer) follows Nick’s advice re the 15% recruiting time, then he’s not hiring when there’s an emergency (then takes anyone with a pulse and half a brain, regardless of experience or brains).

      This is common sense, but sense is no longer common.

  8. Let’s see….the doctor is too busy to hire people, and in the meantime his practice isn’t running as smoothly as it could because he either doesn’t have the right people, hasn’t trained them, or is too hands-off/too much of a micro-manager. Eventually, his practice will suffer.

    I worked for an attorney like this doctor–too busy, needed help because she couldn’t both practice law AND run her office, but was too busy to hire an office manager and train her.

    I think Nick’s advice to the doctor is right–spend the time on hiring the right help, and then the doctor can do what he does best–provide medical care to his patients (instead of dealing with appointments, billing, and more).

    If he lives near a community college, check them out–they might offer a program/certificate in office management, and might be able to recommend soon-to-graduate students and alumni. Ask other doctors who are in private practice for recommendations too, and please, unless you really can’t afford to pay them, don’t be cheap. Having a good office manager will make all the difference to your practice; look at the office manager’s salary as an investment, not an expense.

  9. “Physicians are not generally the best business people in the world, by personality trait or by training.”
    Also applies to any service provider that thinks they can “do it all” themselves. It’s called hubris and it’s not strictly limited to doctors (but I have a close relative who is a surgeon and has closed 2 private practices). If you are running a business (small or otherwise) you are no longer a service provider, you are the CEO, COO, CFO, CIO, etc.

  10. That’s a common problem for small business owners. If you want talent but don’t have time to search you may need to spend some money. Best option is used an agency though it’s costly it’s also worry free. You know you’ll get what your looking for, and they will absorb most of the work load.

    Option 2 is to use a job board. Best option for you is probably indeed or career builder. For a fee you’ll have access to posting a job and searching resumes. But it will require you to take time out of your day to play recruiter. Though it’s cheaper than an agency.

    Best bet, it’s free but takes time, start building a linked in network. Take 1 hour a day to search profiles on linked in. Most real professionals will have a profile available and those are the ones you want. Once you connect with them you will be able to send messages and gain access to their contact info. But again you need to play recruiter. If you do this every day 1-2 hrs a day for a month, you’ll have some solid prospects lined up.

    In the end you have to decide how urgent is your need and how much does good talent worth.

    Hope this helps.