Practice Building through Employee Ambassadors
Cyndi Miller
CEO, Miller Medical Marketing
milcyn@sbcglobal.net
What is your current Active Patient Count?
What is your Active Patient Count goal for a year from now? Five years from now? What will it be when you retire and sell your practice? Your annual revenues will directly impact not only your cash flow but also the selling price of your practice – and your Active Patient Count will directly impact those annual revenues.
Your reputation, and that of your practice, depends heavily on much more than just your technical skills as a physician. Referrals for successful practice building will be directly related to your reputation in your community.
Since your practice building will be heavily dependent on your reputation in your community, what can you do today and over the next five years to help build a strong, positive reputation in your community to achieve your goals for your Active Patient Count?
One way your reputation can be enhanced is to make sure that all of your employees are outstanding, well-trained ambassadors for your practice and that they understand the business goals of your practice.
Like it or not, all of your employees represent you.
Everything they do at the office, and a lot of what they do away from the office, reflects on you and has some level of impact on the reputation of your practice. This impact can be positive, neutral or negative and can directly affect your practice building goals.
If all of that is inevitable, what can you do about it? Seize the opportunity to positively capitalize on the inevitable!
It Starts with Hiring
What is your hiring approach for employees of your practice?
• Are costs and direct technical skills the major, or even the only, criteria?
• Do their ambassador skills come into consideration?
• Do you have a company thoroughly check backgrounds to help ensure that the person is who you think they are?
• Do you have a company help you with personality testing to help ensure new employees will mesh well with your company’s culture?
• Is this the person you want representing your practice in the community when they tell folks who they work for?
• Do you only go for the “A” players?
• Is “Good,” good enough for you and your practice?
• Are your employees all heavy hitters, good-looking, high energy, enthusiastic and highly intelligent?
• Are you willing to compensate “A” players accordingly?
How much is all of that worth to you and your practice? Are you being “penny wise and dollar foolish” with your personnel budget when you consider the revenue impact of hiring both the right people and the wrong people?
This is your team that we’re talking about. These are the folks that will let you positively leverage your market presence, customer impact and time efficiencies.
These are your Employee Ambassadors.
Friday, September 24, 2010
Monday, July 12, 2010
To Test or Not to Test?
By Cristina Boggiano
The Ophthalmic Associates
Email: cristina@theophthalmicassociates.com
With all of the elements involved in bringing on a new employee, practice administrators must keep a close eye on selection options. Turnover comes at a high cost and is compounded by the price of productivity loss, training and development, advertising, and recruitment.
Employers should determine the best practices for evaluating candidates and use uniform approach every time. While there are many steps involved in assessing viable candidates, pre-employment testing, when used correctly and in the right situation, can serve as a good predictor of how well a candidate fits the position.
In over a decade of recruiting in ophthalmology, I have seen the use of pre-employment testing of candidates implemented only a handful of times. However, progressive practices are eyeing this procedure more commonly and the popularity of pre-employment testing is gaining ground across many industries.
If used correctly, these tests can objectively measure basic skills, competencies, acquired knowledge and qualifications and gage aptitudes for a given position. These types of assessments give a broader overall picture of a candidate beyond a resume and interview.
There are many reputable testing companies whose services include everything from administration of assessments to a lengthy interpretation of test results.
Testing is a controversial evaluation option because of the potential biases it can create. In order to ensure proper usage, it is important for an administrator to decide early on what they are looking to measure and evaluate. Certainly, any practice considering adoption of pre-employment testing must check the credentials and reputation of test vendors. Ultimately, the hiring party is responsible for any testing that it conducts. The Equal Opportunity Employment Commission sets clear guidelines for employers who are looking to engage in pre-employment testing. In addition, each state has their own set of regulations, so it is important for the practice to seek legal advice to ensure that the proposed policies will not violate any employment laws.
It is always important to proceed cautiously when adding new hiring policies and procedures. Testing elevates the hiring processes and can alert an administrator to attributes and potential problems and subsequently help the practice avoid costly hiring mistakes. Pre-employment testing, when done well, can serve as a key tool in making an effective hiring decision.
The Ophthalmic Associates
Email: cristina@theophthalmicassociates.com
With all of the elements involved in bringing on a new employee, practice administrators must keep a close eye on selection options. Turnover comes at a high cost and is compounded by the price of productivity loss, training and development, advertising, and recruitment.
Employers should determine the best practices for evaluating candidates and use uniform approach every time. While there are many steps involved in assessing viable candidates, pre-employment testing, when used correctly and in the right situation, can serve as a good predictor of how well a candidate fits the position.
In over a decade of recruiting in ophthalmology, I have seen the use of pre-employment testing of candidates implemented only a handful of times. However, progressive practices are eyeing this procedure more commonly and the popularity of pre-employment testing is gaining ground across many industries.
If used correctly, these tests can objectively measure basic skills, competencies, acquired knowledge and qualifications and gage aptitudes for a given position. These types of assessments give a broader overall picture of a candidate beyond a resume and interview.
There are many reputable testing companies whose services include everything from administration of assessments to a lengthy interpretation of test results.
Testing is a controversial evaluation option because of the potential biases it can create. In order to ensure proper usage, it is important for an administrator to decide early on what they are looking to measure and evaluate. Certainly, any practice considering adoption of pre-employment testing must check the credentials and reputation of test vendors. Ultimately, the hiring party is responsible for any testing that it conducts. The Equal Opportunity Employment Commission sets clear guidelines for employers who are looking to engage in pre-employment testing. In addition, each state has their own set of regulations, so it is important for the practice to seek legal advice to ensure that the proposed policies will not violate any employment laws.
It is always important to proceed cautiously when adding new hiring policies and procedures. Testing elevates the hiring processes and can alert an administrator to attributes and potential problems and subsequently help the practice avoid costly hiring mistakes. Pre-employment testing, when done well, can serve as a key tool in making an effective hiring decision.
Sunday, May 30, 2010
Have You Heard?
Have YOU Heard???
Cristina Boggiano, Ophthalmic Staffing Specialist: Cristina@theophthalmicassociates.com
At Boston’s ASCRS/ASOA meeting I heard a lot of buzz regarding both breakthrough surgical technologies, and also pertaining to practice management pearls. Practice members were eager to learn and share survival strategies during this time of economic instability and shrinking reimbursements. At the meeting it was apparent that practices having the most success in these tough times are those that are able to successfully incorporate ancillary services. Expanding your practice by offering a vertical integration of services fills in the gaps in delivery of care and serves to bolster practice profitability.
At the recent meeting, the most popular and practical approach to adding secondary services, by far, was the option of adding a hearing program.
Hearing services are taking the successful integrated practice models one step further. Practices can add a revenue stream without significant increase in overheard due to the straightforward approach used to incorporate these services. I met with companies operating exclusively in ophthalmology to gain a better understanding of the effort involved and potential benefits of adding a hearing program. Many of these companies already have plenty of successful practice models to point to.
“Adding a hearing program increases convenience for a practices’ current patient population while in turn providing a practice with vital ancillary income” shared Brooke Peyton, marketing coordinator for Physician Hearing Services, Inc. “Without daunting financial investment or risk, a hearing program can quickly generate strong additional revenue to add to a practice’s bottom line”.
Practices hoping to increase revenue by adding ancillary services must analyze what equipment and obligations are involved. There are cases where practices find that adding a hearing program is not an option. I have heard practices share concerns about throwing off referral patterns with local ENT’s. The addition of services is just one of the strategies practices are implementing. There are successful practices whose approach it is to work on gaining market share within their specific specialty.
In any case, each physician and staff member must be committed to a new venture to avoid a new program being potentially underused. While survival strategies abound, many practices have successfully capitalized from the addition of complimentary ancillary services, most notably, hearing programs.
Cristina Boggiano, Ophthalmic Staffing Specialist: Cristina@theophthalmicassociates.com
At Boston’s ASCRS/ASOA meeting I heard a lot of buzz regarding both breakthrough surgical technologies, and also pertaining to practice management pearls. Practice members were eager to learn and share survival strategies during this time of economic instability and shrinking reimbursements. At the meeting it was apparent that practices having the most success in these tough times are those that are able to successfully incorporate ancillary services. Expanding your practice by offering a vertical integration of services fills in the gaps in delivery of care and serves to bolster practice profitability.
At the recent meeting, the most popular and practical approach to adding secondary services, by far, was the option of adding a hearing program.
Hearing services are taking the successful integrated practice models one step further. Practices can add a revenue stream without significant increase in overheard due to the straightforward approach used to incorporate these services. I met with companies operating exclusively in ophthalmology to gain a better understanding of the effort involved and potential benefits of adding a hearing program. Many of these companies already have plenty of successful practice models to point to.
“Adding a hearing program increases convenience for a practices’ current patient population while in turn providing a practice with vital ancillary income” shared Brooke Peyton, marketing coordinator for Physician Hearing Services, Inc. “Without daunting financial investment or risk, a hearing program can quickly generate strong additional revenue to add to a practice’s bottom line”.
Practices hoping to increase revenue by adding ancillary services must analyze what equipment and obligations are involved. There are cases where practices find that adding a hearing program is not an option. I have heard practices share concerns about throwing off referral patterns with local ENT’s. The addition of services is just one of the strategies practices are implementing. There are successful practices whose approach it is to work on gaining market share within their specific specialty.
In any case, each physician and staff member must be committed to a new venture to avoid a new program being potentially underused. While survival strategies abound, many practices have successfully capitalized from the addition of complimentary ancillary services, most notably, hearing programs.
Tuesday, December 22, 2009
Feature your practice on Facebook
Feature your practice on Facebook
Cristina Boggiano, Ophthalmic Staffing Specialist: Cristina@theophthalmicassociates.com
The newest forms of marketing and advertizing for your practice are here. If you are not yet using social media sites to market your practice, you may be at a disadvantage. Ophthalmologists and administrators alike have been using social media sites; such as, Facebook, LinkedIn and Twitter increasingly for personal use. Many have now branched out from personal profiles by creating profiles for their practices. While you may not reach everyone you want for your practice through just one platform, the more places you advertise and have practice information readily available, the more likely it is that it will end up in the hands of the patient.
There are advantages to using these social sites to promote your practice. Not only are these sites considered an interactive marketing tool but they also serve as a direct, real time, medium to communicate with patients. Telling your patients about your practice’s services via your Facebook page is a fast and free way to share ever-changing information. Posting your practice as a group on Facebook will give you more opportunities to appear in online searches and let you connect with patients in ways you can't via your practice's web site. Ultimately, you are encouraging visits to your own web site and making it easier for your practice to be found. This gives you increased exposure online with very little effort.
While there are many advantages to using social media sites, there are potential disadvantages as well. First off, your practice Facebook identity must be managed and monitored regularly. Frequent updates will keep information on your practice relevant and current. Additionally, poor comments or ratings could potentially hurt your practice’s reputation. Decide on a strategy early on as far as who will control and respond to any complaints or negative comments. Make sure you have a practice member dedicated to managing these types of situations to maintain a positive reputation. Furthermore it is important to be conscious of the marketing and advertising guidelines imposed by your state licensing boards along with HIPPA regulations as well. Follow these guidelines just as you would with any traditional forms of marketing.
Presenting your practice on Facebook functions to highlight services, put you in close contact with your patients and add to your practice’s market prescence both online and off
Cristina Boggiano, Ophthalmic Staffing Specialist: Cristina@theophthalmicassociates.com
The newest forms of marketing and advertizing for your practice are here. If you are not yet using social media sites to market your practice, you may be at a disadvantage. Ophthalmologists and administrators alike have been using social media sites; such as, Facebook, LinkedIn and Twitter increasingly for personal use. Many have now branched out from personal profiles by creating profiles for their practices. While you may not reach everyone you want for your practice through just one platform, the more places you advertise and have practice information readily available, the more likely it is that it will end up in the hands of the patient.
There are advantages to using these social sites to promote your practice. Not only are these sites considered an interactive marketing tool but they also serve as a direct, real time, medium to communicate with patients. Telling your patients about your practice’s services via your Facebook page is a fast and free way to share ever-changing information. Posting your practice as a group on Facebook will give you more opportunities to appear in online searches and let you connect with patients in ways you can't via your practice's web site. Ultimately, you are encouraging visits to your own web site and making it easier for your practice to be found. This gives you increased exposure online with very little effort.
While there are many advantages to using social media sites, there are potential disadvantages as well. First off, your practice Facebook identity must be managed and monitored regularly. Frequent updates will keep information on your practice relevant and current. Additionally, poor comments or ratings could potentially hurt your practice’s reputation. Decide on a strategy early on as far as who will control and respond to any complaints or negative comments. Make sure you have a practice member dedicated to managing these types of situations to maintain a positive reputation. Furthermore it is important to be conscious of the marketing and advertising guidelines imposed by your state licensing boards along with HIPPA regulations as well. Follow these guidelines just as you would with any traditional forms of marketing.
Presenting your practice on Facebook functions to highlight services, put you in close contact with your patients and add to your practice’s market prescence both online and off
Monday, December 7, 2009
Unconventional Practices for Ophthalmic Job Seekers
Unconventional Practices for Ophthalmic Job Seekers
Cristina Boggiano, Ophthalmic Staffing Specialist: Cristina@theophthalmicassociates.com
In these challenging times both employed ophthalmic professionals and those interested in positions in the industry are using unconventional practices to keep themselves current and essential. Both job seekers and employed professionals know, just as the practices’ ophthalmologists do, that it is important to continue to learn and grow. Now, along with solid education, experience, and proper certifications, professionals in ophthalmology are making a greater effort to add value to the practice and ultimately for themselves.
Ophthalmic professionals seeking a promotion or new position are pursuing unique skills. I have heard of job seekers working with a career coach to provide them with expert advice, guidance, and support. These coaches concentrate on helping the job seeker develop goals, plans, and action steps towards future employment. Additionally, there are those who enroll in intensive Spanish courses, hoping to broaden opportunities within the Hispanic marketplace. Employees who learn Spanish for business can help practices increase their: revenue, markets, patient base, customer service, and overall bottom line.
As more and more practices choose to add EMR, many ophthalmic professionals find that developing IT skills can add both to their own career advancement and marketability. Similarly, adept personnel are sharpening their soft skills. These soft skills are important in any profession or job role, and in this fast changing marketplace, can help you remain an asset.
There are plenty of examples like this and many ophthalmic professionals are choosing to remain prepared and relevant in today’s unpredictable economic cycle. Determine what areas you could improve upon, then sign up for a course, seminar or conference to help you do it.
Cristina Boggiano, Ophthalmic Staffing Specialist: Cristina@theophthalmicassociates.com
In these challenging times both employed ophthalmic professionals and those interested in positions in the industry are using unconventional practices to keep themselves current and essential. Both job seekers and employed professionals know, just as the practices’ ophthalmologists do, that it is important to continue to learn and grow. Now, along with solid education, experience, and proper certifications, professionals in ophthalmology are making a greater effort to add value to the practice and ultimately for themselves.
Ophthalmic professionals seeking a promotion or new position are pursuing unique skills. I have heard of job seekers working with a career coach to provide them with expert advice, guidance, and support. These coaches concentrate on helping the job seeker develop goals, plans, and action steps towards future employment. Additionally, there are those who enroll in intensive Spanish courses, hoping to broaden opportunities within the Hispanic marketplace. Employees who learn Spanish for business can help practices increase their: revenue, markets, patient base, customer service, and overall bottom line.
As more and more practices choose to add EMR, many ophthalmic professionals find that developing IT skills can add both to their own career advancement and marketability. Similarly, adept personnel are sharpening their soft skills. These soft skills are important in any profession or job role, and in this fast changing marketplace, can help you remain an asset.
There are plenty of examples like this and many ophthalmic professionals are choosing to remain prepared and relevant in today’s unpredictable economic cycle. Determine what areas you could improve upon, then sign up for a course, seminar or conference to help you do it.
Wednesday, November 18, 2009
High Demand for Optometrists in the Ophthalmology Practice
High Demand for Optometrists in the Ophthalmology Practice
Cristina Boggiano, Ophthalmic Staffing Specialist: Cristina@theophthalmicassociates.com
The demand for optometrists (ODs) in the ophthalmology office is ever increasing. In his keynote address at a recent industry meeting Harvey V. Fineberg, MD, PhD, President of the Institute of Medicine, comically referred to ophthalmologists who cautioned him not to mention the “O” word. The “O” word meaning optometrists. In view of the current and future challenges in healthcare, he is advocating a more collaborative relationship between ophthalmologists and OD’s than ever before. Practice employment trends are reflecting this sentiment. Over the last 15 years the number of practices employing optometrists and/or embracing co-management has increased drastically. Whereas years ago only about 25% of ophthalmology practices employed optometrists, now about half of all ophthalmology organizations employ OD’s.
The challenge for an administrator is to identify when it is appropriate to add a new optometrist and how they will balance the OD’s role in the practice to continue to provide high quality, high value care. Most ophthalmology practices find that by adding optometrists to their staffs they are offering a more complete vision-care package to their patients, which drives up profits in the process. Overall, successfully integrating optometrists into the practice can dramatically facilitate practice growth within, while providing a professionally stimulating and financially rewarding environment for both the ophthalmologist and optometrist.
Optimal MD-OD relationships are proving to be mutually advantageous to the doctors and practices involved, allowing for increased patient flow and higher revenues while maintaining a high level of patient care. The trend is advancing towards more and more ODs in ophthalmology practices and an increasing alliance between both professions.
Cristina Boggiano, Ophthalmic Staffing Specialist: Cristina@theophthalmicassociates.com
The demand for optometrists (ODs) in the ophthalmology office is ever increasing. In his keynote address at a recent industry meeting Harvey V. Fineberg, MD, PhD, President of the Institute of Medicine, comically referred to ophthalmologists who cautioned him not to mention the “O” word. The “O” word meaning optometrists. In view of the current and future challenges in healthcare, he is advocating a more collaborative relationship between ophthalmologists and OD’s than ever before. Practice employment trends are reflecting this sentiment. Over the last 15 years the number of practices employing optometrists and/or embracing co-management has increased drastically. Whereas years ago only about 25% of ophthalmology practices employed optometrists, now about half of all ophthalmology organizations employ OD’s.
The challenge for an administrator is to identify when it is appropriate to add a new optometrist and how they will balance the OD’s role in the practice to continue to provide high quality, high value care. Most ophthalmology practices find that by adding optometrists to their staffs they are offering a more complete vision-care package to their patients, which drives up profits in the process. Overall, successfully integrating optometrists into the practice can dramatically facilitate practice growth within, while providing a professionally stimulating and financially rewarding environment for both the ophthalmologist and optometrist.
Optimal MD-OD relationships are proving to be mutually advantageous to the doctors and practices involved, allowing for increased patient flow and higher revenues while maintaining a high level of patient care. The trend is advancing towards more and more ODs in ophthalmology practices and an increasing alliance between both professions.
Monday, November 2, 2009
Staffing for EMR
Staffing for EMR
Cristina Boggiano, Ophthalmic Staffing Specialist: Cristina@theophthalmicassociates.com
Upon returning from a recent industry meeting, one of the most common topics of conversation and concern was the adoption of Electronic Medical Records (EMR). While there is much planning and forethought that goes into implementing EMR, once the decision is made concerns about staffing for this project must be confronted.
The first step is to outline what the practice goals are for this process of automation. Meet with your staff and make clear to them what post implementation goals are. Once you have your current staff on board, consider any personnel needs. Be sure not to underestimate your staffing needs, especially in the transitioning process. Despite what some practices might think, EMR does not necessarily enable a work force reduction, especially in the beginning.
A practice or ophthalmic institution has several options for delegation of work. The most straightforward approach would be to invest in your current employees. Once you have discussed the choice to initiate EMR, expand the duties of those staff that are enthusiastic about the change. If your staff is willing to absorb new responsibilities, those ancillary positions such as medical records staff can be gradually phased out over time.
Addition of permanent IT staff is not absolutely necessary and all depends upon the system you choose. Larger practices that choose locally hosted systems are more likely to need a permanent IT employee. Smaller practices that use online systems could be better served by hiring an IT consultant for the initial stages of implementation. Technology consultants come with different skill sets and it is important to have a checklist for your practice. Ask prospective consultants the right questions to determine how they will complete the work.
Taking on EMR can be both an exciting and challenging experience. There are several components that lay the foundation for a smooth transition with staffing and personnel being at the cornerstone. Take time to plan and prepare with every aspect of this investment and the efficiencies and revenue generated should pay off in dividends.
Cristina Boggiano, Ophthalmic Staffing Specialist: Cristina@theophthalmicassociates.com
Upon returning from a recent industry meeting, one of the most common topics of conversation and concern was the adoption of Electronic Medical Records (EMR). While there is much planning and forethought that goes into implementing EMR, once the decision is made concerns about staffing for this project must be confronted.
The first step is to outline what the practice goals are for this process of automation. Meet with your staff and make clear to them what post implementation goals are. Once you have your current staff on board, consider any personnel needs. Be sure not to underestimate your staffing needs, especially in the transitioning process. Despite what some practices might think, EMR does not necessarily enable a work force reduction, especially in the beginning.
A practice or ophthalmic institution has several options for delegation of work. The most straightforward approach would be to invest in your current employees. Once you have discussed the choice to initiate EMR, expand the duties of those staff that are enthusiastic about the change. If your staff is willing to absorb new responsibilities, those ancillary positions such as medical records staff can be gradually phased out over time.
Addition of permanent IT staff is not absolutely necessary and all depends upon the system you choose. Larger practices that choose locally hosted systems are more likely to need a permanent IT employee. Smaller practices that use online systems could be better served by hiring an IT consultant for the initial stages of implementation. Technology consultants come with different skill sets and it is important to have a checklist for your practice. Ask prospective consultants the right questions to determine how they will complete the work.
Taking on EMR can be both an exciting and challenging experience. There are several components that lay the foundation for a smooth transition with staffing and personnel being at the cornerstone. Take time to plan and prepare with every aspect of this investment and the efficiencies and revenue generated should pay off in dividends.
Wednesday, October 21, 2009
Scheduling and Patient Flow
Scheduling and Patient Flow
Polly Neely, pollyd@msn.com
Patient flow and scheduling are vital to your practice. There are numerous methods to evaluate this. One is to take a day where no one in your practice has schedules for the following day. This means no charts are pulled ahead of time, no preparation is done ahead of time, and there is only anticipation no expectations.
You may surprise yourself to find that you stay on task all day, inclusive of a lunch break and ending at the correct time. When we are on ready to perform, we do just that, perform! While this cannot be standard practice, it can let you know if you have the staffing, equipment and process to achieve a successful on time day full of efficiencies and quality patient care. Not to mention happy employees that work a good 8 hour day for 8 hours pay and get lunch and leave without overtime.
Polly Neely, pollyd@msn.com
Patient flow and scheduling are vital to your practice. There are numerous methods to evaluate this. One is to take a day where no one in your practice has schedules for the following day. This means no charts are pulled ahead of time, no preparation is done ahead of time, and there is only anticipation no expectations.
You may surprise yourself to find that you stay on task all day, inclusive of a lunch break and ending at the correct time. When we are on ready to perform, we do just that, perform! While this cannot be standard practice, it can let you know if you have the staffing, equipment and process to achieve a successful on time day full of efficiencies and quality patient care. Not to mention happy employees that work a good 8 hour day for 8 hours pay and get lunch and leave without overtime.
Friday, October 16, 2009
Having a Practice Management Consultant
Having a Practice Management Consultant
Polly Neely, pollyd@msn.com
There are times when you just need that verification that the action you are about to take it the correct one. It is times like these when two heads are better than one. Having access to an on-line practice management consultant could prove to be an economical and advantageous benefit to administrators, managers, employees and physicians.
Polly Neely, pollyd@msn.com
There are times when you just need that verification that the action you are about to take it the correct one. It is times like these when two heads are better than one. Having access to an on-line practice management consultant could prove to be an economical and advantageous benefit to administrators, managers, employees and physicians.
Monday, October 5, 2009
A Note About Job Promotions
A Note About Job Promotions
Polly Neely, pollyd@msn.com
Most job promotions stem from excellent performance. However, are they all good moves for both the employee and/or the practice? Just because someone is good at the job they are performing, doesn't necessarily mean they possess the qualities and abilities to perform effectively in management.
Management qualities should be evaluated prior to promoting. There are times when an employee can be satisfied staying in the same position if they know they command the respect and acknowledgement that their performace is above expectations and they are a valuable player in the team of success at your practice. Consider an increase in benefits and/or salary along with keeping present position to show an employee he or she is doing an excellent job and they are valued vs a managerial promotion.
Polly Neely, pollyd@msn.com
Most job promotions stem from excellent performance. However, are they all good moves for both the employee and/or the practice? Just because someone is good at the job they are performing, doesn't necessarily mean they possess the qualities and abilities to perform effectively in management.
Management qualities should be evaluated prior to promoting. There are times when an employee can be satisfied staying in the same position if they know they command the respect and acknowledgement that their performace is above expectations and they are a valuable player in the team of success at your practice. Consider an increase in benefits and/or salary along with keeping present position to show an employee he or she is doing an excellent job and they are valued vs a managerial promotion.
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