How one award-winning medical spa hires, trains, and retains productive, satisfied employees

If you have owned a small business, you already know. If you are starting up your first small-business venture, you are about to find out. Almost invariably, payroll is the biggest line item expense for the small business owner. For many owners, payroll and personnel issues are some of their biggest headaches.

Yet, the successful management of employee hiring, training, and retention can also be extremely rewarding. Some of the rewards are personal, in the sense that you are providing a means for a group of individuals to earn a living and to realize their inherent potentials. The rewards can also be quite significant financially, because the efficient management of employee hiring, training, and retention is the most immediately accessible and effective means of controlling—and even reducing—expenses.

Occasionally, the successful management of human-resources issues can have unexpected benefits. In 2005, our Blue Water Spa was recognized as a “Best Place to Work” by the Triangle Business Journal, a business periodical that serves the communities of Raleigh, Durham, and Chapel Hill, NC. In thinking about how we achieved this honor in our third year of operation, it occurred to us that the efforts that create a positive work environment begin well before each individual employee begins his or her first day on the job.

This article will examine employee hiring, training, and retention issues that have a significant impact on the kind of work environment that a small-business owner creates.

Whom to Hire and How

The kind of work environment you create has everything to do with the kind of employees you hire. If you do not develop a positive, creative, and motivating office culture by virtue of the way you treat and manage your employees, then you are making mistakes in terms of who you are selecting to punch the clock.

Where to look. The first issue to consider in the hiring process is to decide what pond you will be fishing in—this will largely determine the quality of the “fish” you will catch. Ideally, the means by which you collect applicants will help to select individuals who are the most likely to be a good fit for your business.

If you place an ad in your local newspaper to fill an open position, you are casting your net over an extremely broad potential applicant pool, and you may spend quite a bit of time weeding out applicants. Alternatively, placing an ad in a specific trade publication or trade-employment Web site, or going through a local industry-specific staffing agency, may narrow your search to a pool of potential applicants who are most likely to have the qualifications you seek.

Screening applicants. Most job applicants will communicate volumes of information about themselves before they sit in front of you for the initial interview, and it is extremely important that you pay attention to it. If you are looking for employees who are articulate, responsible, motivated, affable, organized, and punctual, it does not make much sense to expect these behaviors from individuals who have not demonstrated them prior to the first date of employment.

If you request in your ad that applicants send you résumés, and one phones your office instead, that individual is not following simple instructions. If an applicant’s demeanor and disposition during the first phone contact do not impress you favorably, don’t expect these behaviors to magically change because of qualifications that look impressive on paper.

The ability to communicate effectively in writing can be a very revealing indicator of how articulate and sophisticated an individual will be in person. Before you commit to spending any face-to-face time with a potential interviewee, conduct a pre-interview by email and request written responses to a variety of questions. You might also have the applicant demonstrate how he or she would communicate via email to other staff members about a hypothetical office issue.

The use of incorrect grammar, run-on sentences, and poor syntax may say a lot more about the applicant’s educational background than the list on the résumé of universities attended and technical training received.

The interview. Once you schedule the interview, observe closely: Is the applicant on time for the interview? If he or she happens to run late, were you given the courtesy of a phone call to let you know? Is the person dressed appropriately? Did the applicant do any research about your business, for example, by visiting your Web site and learning some of its content? If the applicant has not even bothered to visit your Web site before the first interview, it would be a mistake to expect such a person to be a highly motivated employee.

It is important to make the interview a process, not a one-shot “audition.” As a rule, make the first interview somewhat brief and informal. If there is clearly not the fit you are looking for, you have not spent a lot of time with an applicant you will never hire.

If the applicant looks promising, ask him or her to return another day. This will give you an additional opportunity to assess punctuality, attire, and attitude.

Due diligence. Appearances can be deceiving, and it is important to know that there are a lot of good actors out there. It is absolutely imperative to avoid the temptation to simply believe the best about someone who has made a favorable impression. The “con” in “con artist” is short for “confidence,” and that is precisely where successful frauds begin: by gaining the confidence of the intended victim—in this case, the employer.

In this information age, it is extremely easy to run a background check and to search for criminal records on any individual. Several Web sites provide this service online for a relatively small fee, and your state may also make such information available online at no charge. A human-resources consultant can provide this kind of service, but be certain beforehand what the fee will be.

References from previous employers are an absolute must, and they should be thoroughly investigated. If previous employers do not report favorable experiences with an applicant, or if they seem reluctant to say much that is either positive or negative, you run a fairly high risk of receiving a repeated poor performance.

Skills demonstration. This is a very basic concept, but unfortunately, it is often overlooked. The overstatement of skills and qualifications on a résumé is not uncommon, so the statement that an applicant can “type 90 words per minute” or is competent with the use of a particular software program does not necessarily make it so. Have the applicant demonstrate his or her purported skills to you—it’s much better to find out that an individual has presented an embellished résumé before hiring that person.

Question yourself. Maintain a list of questions to review as you make the final hiring decision. Set your standards high, or at least as high as the available applicant pool will allow, and stand by them. A final-decision list of questions might be:

• Does the individual meet the minimum requirements of the position, or am I being lenient because the person is (for example) a friend or relative of a staff member or personal friend?

• Did the initial contacts with this person or the actual interview process raise any red flags?

• Will this person fit into the existing office culture?

• Do I truly want this person as an employee, or am I making the hiring decision because I am desperate to fill the position?

• Will I look forward to seeing this person in the office every day?

Training the New Hire

Here are some tips for molding your new arrival into the kind of employee you want:

Arriving prepared. It is good for the morale of the new hire and that of existing staff members when that person arrives with a working knowledge of at least some of the important aspects of the business. This also saves time, and therefore money, because the new hire is “on the clock” once he or she walks through the door. Provide pre-employment printed materials that give the new hire an adequate working knowledge of the practice and its policies and procedures.

If your practice’s Web site contains a significant amount of information about the business—as it absolutely should—instruct the new hire to know the Web site cold by the first day of employment. Quiz the new hire about the content several times during the first month of employment, and you will rest assured that your new employee is well-informed. If this is not accomplished, it will be clear to everyone involved that the person should seek employment elsewhere.

Learning the ropes. It can be extremely useful to have a new employee spend the first 2 or 3 days learning basic office operations, especially the use of the practice-management software system and even the electronic medical-records platform, if you have one. Be prepared to pay the new hire to do nothing but learn for a couple of days before performing the job duties for which he or she has been hired. It is a sound investment that ensures that every individual is fully up to speed in fairly short order. Ideally, the new hire should spend some of this time “shadowing” an established employee with the same or a similar job description.

Specific job description. There are few things more disruptive to the productivity and overall morale of an office than an employee who does not have a thorough and detailed understanding of what he or she has been hired to do. This is an issue that can be easily overlooked or inadequately attended to in a busy office. The employer and other staff members may brush it off by saying or thinking, “Isn’t it obvious what you should be doing?”

Most people perform their best when they clearly understand what is expected of them. Those expectations should be provided in writing and updated regularly. Clear and detailed job descriptions are also absolutely essential for assessing performance and handling disciplinary issues.

Retaining Good Employees

What is the secret of employee retention? It’s no secret at all, actually: job satisfaction. An employee who is satisfied and personally rewarded by his or her job will drive long distances to work in your practice. Such an employee will work for a lower less money than what may be available at another business that cannot provide the same degree of job satisfaction.

Let us be clear—this is not a suggestion for how to save money on payroll. It is merely a statement about the power and significance of job satisfaction.

Pay good employees at least what they are worth, then add enough perks to keep them around. Give them performance- and responsibility-based raises as you deem appropriate. Remember that people are motivated by different interests and goals.

Whereas some employees are motivated primarily by their compensation, others are motivated by working in an environment that fosters and values a sense of camaraderie. Still others respond the most to being appreciated: for themselves as individuals, for their own personal skills or talents, or for their contributions to the success of the business. Some employees place the greatest value on having the opportunity to perform the specific task or tasks for which they have trained.

Perhaps the most employees are motivated by a varying combination of the above factors. It is therefore very important to make some attempt to recognize individual situations and to determine each employee’s individual needs.

Here are two additional ways to keep employees content:

Cross-train your employees. Why cross-train? Because at the very least it will save you a great deal in payroll expenses over time, and because the cross-trained employee is given at least some protection from workday monotony and long-term burnout. It also promotes a sense of camaraderie among office staff and, in particular, the willingness to help out when needs arise.

In some cases, the exposure to alternate work tasks may even influence an employee’s career goals. All employees should be given the opportunity to identify the type of work for which they are best suited. Their strengths are often not obvious at the outset.

Provide continuing education. If you have managed to hire the kind of individuals who take great pride in their vocation and the quality of their work, you can count on them to value the opportunity to expand their knowledge base and update their skills. Count your blessings, then send these people to courses where they can earn continuing education units—and foot the bill yourself.

It would be difficult to identify a sounder investment for the success and expansion of your small business. The aesthetics business is nothing if not a customer-service industry. If your goal is to provide the best aesthetic services in your locale, then maintain your practitioners at the cutting edge of aesthetic science and technology. You will be amazed at what you can learn from a motivated aesthetician or laser operator. (See the sidebar “Listen to Your Staff,” above.)

Tying It All Together

It all seems fairly simple on paper, doesn’t it? Hire the right people, give them appropriate training and preparation, and figure out exactly what motivates them. As with any other part of managing a small business, handling these issues will be, to some extent, a trial-and-error process. However, with a little planning and attention to the important details we have described, you can be fairly certain that you will be able to get the maximum performance from most of your employees, while fostering a workplace environment that is appealing to your clients and your staff. PSP

Michael Law, MD, is a board-certified plastic surgeon in private practice in Raleigh, NC. He performs a full range of surgical procedures for the body and face, as well as a variety of nonsurgical procedures. His practice features the Blue Water Spa, which was recognized as one of the top four medical spas in America in 2005 by American Spa magazine.

Kile Law is president of Blue Water Spa and has been appointed to the 2005 advisory board of the National Day Spa Association. She is a consultant to physicians who wish to open or expand medical spas. In 2004, she won the ABBIES award for the best editorial feature in a spa publication, and in 2005, she was recognized as the Humanitarian of the Year by the Southern Spa Conference. She can be reached at (919) 870-6066 or [email protected]

Listen to Your Staff

We had worked with lasers for more than 10 years, and we were not convinced that laser hair removal was an effective or profitable service. When we started our business, we did not offer laser hair removal for the entire first year. Our staff encouraged (insisted, really) that we take another look at this service.

We found that today’s lasers can perform full-leg hair removal in less than 30 minutes, and that no topical numbing preparation is required. Once we began to offer laser hair-removal treatments, we have generated more than $25,000 in revenue from it each month. Our staff knew that patients were demanding this treatment and were going elsewhere to receive it. Our only regret is that we didn’t install lasers sooner.

—ML and KL