Onboard Like You Mean It

Onboarding, or orientation, involves the completion of employment-related paperwork; familiarizing your new staff member with their responsibilities, coworkers, and workspaces; explaining the practice’s policies and benefits; and more. Proper onboarding is essential to the successful integration of a new staff member into their role. However, to their own detriment, many organizations invest more financial resources into hiring new staff than in helping existing staff adjust and become productive.¹

When organizations properly execute onboarding, they can expect to nearly double their revenue growth and profit margins compared with companies that do not pay attention to their onboarding processes.² Additionally, proper onboarding reduces new hire turnover and helps new hires become productive members of the practice more quickly and smoothly. This article provides a rationale and guide for strengthening your onboarding practices using a three-phase socialization method.

WHY SOCIALIZE NEW HIRES

Socialization is a long-term process that involves activities and experiences that help the new doctor or staff member understand the attitudes, behaviors, and knowledge required to be a successful contributing member of the practice.³ When effective, socialization helps the new hire absorb the values, processes, and traditions of the practice, which inevitably allows them to fit in with the organization and establish productive and lasting relationships with colleagues.⁴

While it’s true that proper onboarding requires effort, consider the fact that voluntary turnover of new hires may occur within 45 days of employment due to ineffective onboarding and socialization.⁵ Therefore, in reality, practices can’t afford not to find the time to provide adequate onboarding and socialization for new hires.

An effective socialization plan includes the following three phases:

1. anticipatory socialization, 
2. encounter socialization, and 
3. settling in socialization. 

This process of organizational socialization leads new hires to comprehend the values, norms, and required behaviors expected for successful employees.⁶

Phase No. 1: Anticipatory Socialization

Consider the current workforce. This generation has access to social media, which often provides information about the inside of organizations. What does this mean regarding recruiting, hiring, and onboarding for your practice? The applicant wants access to the day-to-day operations and flow of your practice. Social media may provide insights, but consider offering a realistic job preview (RJP), which will provide the applicant with information regarding the job’s attractive—and potentially less attractive—aspects. The RJP is ideally designed to provide realistic information for the applicant so they can self-select into the organization or, as the case may be, deselect themselves from the organization (Table).¹

In a useful RJP, the applicant should arrive at the same time as a staff member with similar job responsibilities, so the applicant can become familiar with the workspace and shadow the incumbent staff member. Be sure to allow the applicant to speak with the hiring doctor and practice administrator(s) to ask questions about why the position is vacant, etc. The applicant should also be given a chance to speak with other staff members and associate doctors in the practice to learn why they have decided to remain employed at the practice.

Phase No. 2: Encounter Socialization

During this phase, the new hire should go through an official orientation program where they learn about your practice’s policies, culture, and goals, and the role’s salary, benefits, job opportunities, and opportunities for advancement. Several socialization programs exist (too many to discuss within the scope of this article), but consider using a staggered, individual, and serial approach. Presenting the information using a one-time program and expecting the new hire to learn the rest as time passes causes them to be inundated with information and sets them up for failure. A staggered approach provides the new staff member with smaller learning sessions designed to provide pertinent information.¹ Lastly, consider having an experienced, high-performing staff member serve as a role model and mentor for the new hire.

To help your new hire acclimate to their new job and your practice, consider creating an orientation schedule (see Sample Onboarding Schedule for Full-Time Staff for a brief sample template). Please note, the precise timeline and duration of your orientation schedule is entirely dependent on the needs of your practice.

Phase No. 3: Setting in Socialization

At this point, your new hire should be comfortable with their new job and the practice. They should be interested in learning how they can advance in your practice and what development opportunities are available to them. This interest in growing indicates the staff member could become a good contributor in reaching the practice’s goals and objectives.⁶ Engaged staff members also tend to be interested in the practice’s evaluations of their performance and potential opportunities for career advancement.¹ Increased employee engagement provides the opportunity for the practice to enjoy a competitive advantage.¹

Settling in may involve:

• The employing doctor or (preferably) the practice administrator conducting an annual review at the 1-year mark, including discussing performance and highlighting areas of success and areas for improvement.
• Regular discussion of any opportunities for training and development and promotion possibilities in the future.
• Scheduling time to discuss a career development plan, including short- and long-term goals and steps to take to reach each milestone.
• Successful socialization will ideally produce an engaged staff member who contributes to superior practice performance.

ONBOARDING A PER DIEM DOCTOR

The orientation process for hiring part-time staff varies depending on the circumstances. If possible, the managing doctor should be available to give the fill-in doctor a tour of the facilities, introduce them to office staff, and instruct them on office operating procedures (eg, scheduling, patient flow, etc) and referral protocol. If the managing doctor is unavailable, an office manager or office personnel at the practice should provide the per diem doctor with the information listed in the first scenario. The managing doctor should provide per diem staff with information regarding instruction on office operating procedures (ie, patient scheduling and patient flow) and referral protocol before the new hire arrives for work. If possible, the managing doctor should provide a virtual tour with introductions, so the the fill-in doctor has some familiarity with the practice before they arrive.

SET YOUR STAFF UP FOR SUCCESS

Onboarding has many benefits, such as reducing staff turnover and increasing employee performance and organizational productivity. Onboarding also helps the staff member acclimate to their new work environment faster so they can start to show a return on investment in a shorter amount of time. While practices may vary in their operations, ineffective onboarding or failing to onboard altogether can lead to high turnover, poor engagement, and subpar performance, all of which can become costly to a practice.