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Dermatologists struggling to staff their practices aren’t imagining a worker shortage. And they are not alone. In a recent analysis of Bureau of Labor Statistics Data, Forbes found that with 47.8 million workers quitting their jobs last year—an average of nearly 4 million each month—2021 has the highest average of resignations on record. Health care is particularly hard-hit. As of this spring, nearly 1.7 million people have quit health care jobs—equivalent to almost 3% of the health care workforce each month.1

Staff shortages aren’t just a hassle for physicians. They represent a top safety concern in the US. Whereas top patient safety concerns in America used to revolve around device malfunctions and medical errors, health care worker shortages and the impact of COVID-19 on health care workers’ mental health now top the list. ECRI ( and its affiliate, the Institute for Safe Medication Practices (ISMP), analyzed a wide variety of data, including scientific literature, patient safety events or concerns reported to or investigated by ECRI or ISMP, client research requests and queries, and other internal and external data sources to show that health care worker shortages have been a simmering concern.

Practices are pressed to attract and retain the best talent. Here’s how.

Reignite Your Passion. Focus on Mission

According to Katherine T. Kelly, PhD, MSPH, in a recent interview for Modern Aesthetics® magazine, “People don’t go to medical school or into other forms of health care unless they have a passion for it. There’s a passion to help. There’s often a passion for precision. The stress of trying to provide care in the middle of this pandemic has taken doctors away from being able to focus on the reason they went into their field.”

Dr. Kelly, a psychologist, consultant, and speaker, is author of The Healer’s Path to Post-Covid Recovery (

“From an emotional standpoint, it hits right at the core of who you are. Part of the physician’s identity is to provide care in a particular way. Across the board, many are finding they can’t do that in the ways that they expect,” she says. “They are forced to focus on a business model or trying to make numbers meet or something other than their passion. That does a number on a health care professional’s identity.”

Dr. Kelly urges physicians and those in health care to make a point to ask themselves, “Did I make a difference today?”

“It’s important, as you’re walking out the work door, to ask yourself, ‘Can I say I made the kind of difference today that I wanted to?’ I do this for myself every day, and I really try to emphasize this with the health care providers I work with,” Dr. Kelly says.

Developing a mission statement, a vision statement, or both, can be beneficial, Dr. Kelly stresses. “When they refocus on their mission statements and their vision statements, practice leaders often recognize that many of the people who are leaving either have not been able to live up to the missions and visions anyway, or they wouldn’t be able to contribute to that vision or mission in the long run.” That doesn’t negate the loss, but it helps to conceptualize that there’s change in everything.

Doctors in practice should “play to your passions,” Dr. Kelly suggests. “We do best at the things we’re good at and we love. A lot of physicians think they should or could do it all. They should really look at the investment of energy they’re taking away from their passion by not letting someone else be in their passion by doing the books or doing the hiring or the managing. It’s actually healthier for a health care business or practice to have people in place who can do the things that the practitioners either aren’t trained for or don’t really like doing. They have to start looking at it as an investment that will pay off, usually in dividends,” she says.

“Whenever I hire someone, the very first thing I ask them is, ‘What do you love to do?’ If they were to start asking those questions, practices could probably filter out many of the people who are not going to be productive for them. And if they ask themselves that question, they might be more able to put themselves in the role in which they would be the most productive and would love the most.”


One of the most significant aspects of any offer letter is a statement that the offer is contingent on a satisfactory licensure, background, and criminal check. Many states prohibit an employer from inquiring into a person’s background or criminal check during the application process. However, once an offer is made, states typically permit the employer to obtain those investigations as well as speak with references.

Make sure the employee knows you are doing it, and do it after you have made an offer of employment—which would be contingent upon the results of the background and criminal check.

The Fair Credit Reporting Act (FCRA) is the national standard for employment background checks. For applicants, it guarantees the right to obtain a copy of the background check. It also allows the applicant to file a dispute if the background check contains inaccurate or incomplete information.

FCRA guidelines apply when a hiring company uses background checks prepared by third-party providers. In these cases, the employer must do the following:

  • Provide the applicant with written notice that a background check and report may be required.
  • Obtain the applicant’s permission to conduct a background check via an authorization form.
  • Obtain specific permission if the job requires the collection of medical information.
  • Provide notice if the employer intends to use the applicant’s neighbors, friends, or associates as character references or if the employer will interview these people about the applicant’s “character, general reputation, personal characteristics, or mode of living.” The FCRA calls this process an “investigative consumer report.”
  • Notify the applicant if the information contained in a background check is used to make an adverse hiring decision.
  • If an employer compiles a background check report on its own, FCRA provisions do not apply. However, an applicant must still provide approval to have a reference, background, and criminal background check performed.

—Allyson Avila, JD

Allyson Avila, JD is a contract attorney and litigator for Gordon & Rees Scully Mansukani, a 50-state law firm.

Ask the Right Questions

Practice Consultant Lindsay Applebaum notes that asking general questions to uncover personality traits, transferable skills, and potential red flags is a common interview method, but it doesn’t always give aesthetic provider candidates the opportunity to showcase their unique skills and abilities. Ms. Applebaum, a management consultant with the Allergan Practice Consulting Group of Allergan, advocates for a richer consultative interview process that “will allow you to more quickly find out who has the skills and characteristics to best contribute to your practice and its patients,” she writes. Those who frame interview questions based on the fundamental job components are, “better equipped to decipher who the best fit for your team and culture is.” These components include:

Patient care ideology. In the role of aesthetic provider, professional experience and training are paramount in influencing patient care. Knowing how a potential provider would approach patient assessment, concerns, care, and treatment is crucial. To uncover if candidates share the same approach to patient care as the practice, you should ask questions related to the qualities you seek.

Practical application. To get a better feel for how candidates would apply their professional knowledge and actually interact with patients, conduct a mock consult. Start by presenting a likely scenario, such as a consult for a woman in her 50s who has never had any aesthetic treatments. Show a picture of the hypothetical patient and ask relevant questions to assess candidates’ approach.

Working style. Bring your promising candidate(s) into the clinic for a day to observe—and possibly perform—regular job duties. Your main provider should oversee these working interviews and observe a full consult led by your top applicants. This is an opportunity to sit-in on treatment (e.g., neurotoxin) and assess their skills with a real patient, as well as gauge their level of training and how they mesh with the existing team. Consider using a staff member or friend of the practice for this treatment/consult.

Professional commitment. Even if there is a candidate who checks all the qualities you are looking for in a provider, there is still a line of inquiry that needs to be addressed before extending an offer of employment: the provider’s future plans. Finding and interviewing eligible providers can take a while, so making sure you are hiring someone who envisions being with the practice for an extended period is prudent. Get more from Ms. Applebaum at

Sign-on Bonuses: What to Consider

Thinking of offering a sign-on bonus to acquire new talent? Proceed with caution, experts say. According to HR specialists at the Society for Human Resource Management, the benefits of sign-on bonuses are sometimes short-lived. However, a key benefit of the sign-on bonus is that it is a one-off, and not an expense the practice will endure for the span of the employee’s service.

To get the most from a bonus, pay it out over time. And consider requiring the new employee to pay back the bonus if they fail to remain in the position for a specified time.


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