Common CA Issues That Can Be Avoided

Dr. Tory Robson

Dr. Tory Robson

Chiropractic Practice Success Consultant

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Dealing with employees is usually the most complex and variable component of running a business.

It’s also the one that carries the most risk and where people have the most significant problems, short of not paying your taxes and getting into trouble at the IRS.

Getting behind on taxes and having problems with staff are really the biggest problems that chiropractors have. Or occasionally a Board complaint.

Employee problems can arise because the doctor did not have an office policy in place that laid out the details of how the clinic works. All employees sign it ahead of time.

Pay, vacation, holidays, all of these things should be defined ahead of time so it’s very clear what’s expected from all parties. We also recommend having a new hire probationary period of 30 to 90 days. It gives the employer and the employee a chance to see if it’s a good fit.

We recommend every chiropractor have an employment attorney to ask questions of before they say or do anything that may be sensitive with any employee.

We also recommend every chiropractor check with their malpractice carrier and see how employee related issues are handled should there be an issue. We have certain recommendations for malpractice insurance and direct contacts to make sure that all of our clients are well taken care of for any malpractice needs, especially as it relates to employees.

A few key points are: Employees see every single thing you do and hear everything you say. They know more about you than you probably do about yourself, because they’re able to see it from the outside, day in and day out.

You have to be at your absolute best around every employee at all times because they are seeing, watching, and downloading everything.

You must do everything right at all times, by the book, straight down the rails, perfectly. Everything from billing, to the codes you use, to interacting with patients, to what you say about patients behind their back must be done right.

You have people around you that are hearing and seeing everything you do. You think they’ve become your friend and that they care about you, but then one week later you find out they’re not. So we hire good people, train them well, and then we don’t trust anybody. EXPECT the unexpected.

You have to be very careful and very smart. You don’t expect people to trust you. You realize you have to earn it day in and day out, with our thoughts and our actions.

If an employee is getting off track we have a “keeping employees on track” procedure that we engage to give the person and the doctor a chance to see if the relationship can continue.

If it cannot, it is best for all parties to end the working relationship in an amicable way and allow people to move on and become more successful elsewhere.

CA issues: They want to change their hours with no real regard for what the clinic needs. They have a new expense come into their life so they ask you for a raise (basically asking you to pay for their new expense). They start missing too many days. (Missing one day a year is normal.) Asking for a raise for being there longer despite their work performance being the same and the clinic production being the same. Letting their kids go behind the front desk and make a mess. Coming to work and smelling. Missing trainings. Stealing. Forgetting how to do basic things. Making computer or money errors. Forgetting to do or follow-up on things. Giving medical advice despite being told to refer all such questions to the doctor.

There are a thousand things. The key is to have a good Office Policy in place, train well, use our systems, and keep the place as tight as you can! Saying: Hire slowly…fire quickly if there is an issue. And, if you think you have a problem with a CA, you do. Normally it is irrecoverable at that point.

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