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In today’s challenging staffing market, increasing employee retention has become a top concern for practice owners and leaders aiming to reduce costs. An affiliate for the Society of Human Resource Management has calculated that it costs 6 to 9 months of an employee’s salary to hire a replacement.1 For example, if an employee makes $60,000 a year, it will cost $45,000 to recruit, hire, and train a new person! As you can imagine, these costs can quickly accumulate for practices with high turnover rates. The question is: How can your practice improve staff retention?

Although understanding your employee’s emotions and satisfaction levels can be challenging, it should be a priority for those experiencing high turnover rates. Fortunately, you can open the lines of communication and build a better relationship with your team by clearly outlining requirements and expectations, conducting thoughtfully structured performance reviews, and setting schedules for consistent communication.


Consistent performance reviews are essential. They can not only help you gain insight into your staff’s perception of their performance and the overall practice, but these conversations can also allow you to gather the feedback needed to create a more positive work culture. With this in mind, consider implementing the following tips to better connect with your staff, improve morale, and increase employee retention.

Clearly outline job requirements. Accurate job postings are more likely to recruit candidates with the skills and commitment to complete the tasks required by the role. During the interview and onboarding process, clearly outline job duties and discuss expectations. This proactive communication may help prevent confusion later by eliminating any ambiguities. When discussing expectations with newly hired staff, cover principal aspects of the job such as the mission and vision of the practice, team culture, professionalism, attire, attendance, sick days, and vacation allotments.

Establish expectations for performance reviews. Setting and communicating a consistent review timeline for staff performance reviews creates a predictable environment for feedback and recognition. By scheduling specific dates for one-on-one development discussions, you can foster a practice culture where providing and receiving feedback is standard protocol, thereby opening the lines of communication. These actions convey to your staff that consistency and standards are important to the practice’s leadership team.

Incorporate self-evaluations into the review process. It is beneficial to ask employees to complete a self-evaluation before their scheduled one-on-one meeting with leadership. Their scoring and comments provide valuable insights into their perception of their own performance, which can help leadership to effectively prepare for the review. If you have a rating system of one to five, with five being the highest, it is good practice to ask the individual to provide examples if they score themselves higher than a three. These examples may help you better understand what the employee perceives as “going above and beyond” and allow you to adjust expectations as necessary.

Implement quarterly performance reviews. Performing scheduled quarterly reviews demonstrates your dedication to developing and recognizing staff. It also serves as documentation of staff performance, which can be referenced for promotions or terminations. Providing specific examples of good performance, as well as opportunities for improvement, helps establish expectations for the upcoming review period and sets employees on a clear path to success. Providing team members with a copy of their review and a template for the next one can also help them stay aligned with the goals you’ve set, enabling them to better hit their targets between reviews.

Provide precise and timely feedback. Constructive feedback can help employees understand whether they are meeting the practice’s daily standards. When providing feedback in the moment, you can frame it as developmental. For example, you can say, “Thank you for answering the phone so quickly! Next time, be sure to include your name so the patient knows whom they are speaking with.” If you need to provide delayed feedback (eg, during a one-on-one review), be aware that it can sometimes be perceived as unfair criticism, especially if it has never been mentioned before. In these instances, phrases such as “Help me understand why…” or “I appreciate all of your hard work, and I’ve noticed…” and “In the future, could we try…” can serve as helpful segues leading into specific feedback and may help the recipient feel less defensive.

Conduct team meetings with a structured agenda. Consistently planned meetings can positively influence your practice culture by providing team members a structured time to share, ideate, and celebrate together. Including a well-defined agenda allows employees to prepare ideas, share proposals, and offer feedback or suggestions on operational efficiencies. Having a cadence of regular meetings—ie, the first Tuesday of each month—also provides leadership with a platform to connect with staff and reiterate expectations for the upcoming day, week, or month while establishing (and maintaining) expectations for protocols and performance.

Recognize staff throughout the year. Employees seek validation and want to be seen and heard. Recognizing their positive impact on peers and the business throughout the year can encourage and reinforce the standard of excellence as well as empower and engage staff. Praising behaviors that positively impact the patient experience, highlighting positive reviews in team meetings, appointing high-achieving team members to special projects, and encouraging peer-to-peer recognition are just some ways you can recognize and empower staff.

Hold exit interviews. If a team member decides to leave the practice, an exit interview can be an opportunity to learn the departing staff member’s perspective. Often, these employees are more willing to share underlying obstacles to their performance (eg, office bullying, low team morale, vague direction, or lack of leadership) because they are no longer afraid of potential repercussions. Although staff may seek a different opportunity with the simple explanation of higher pay, other factors typically contribute to their decision to leave. Gaining perspective from different angles can help leadership consider new organizational changes or adjust processes to improve efficiencies or culture.


Setting expectations and providing consistent staff feedback does not have to be a negative or uncomfortable process. When leadership clearly and consistently communicates with their team, it helps to build a foundation of trust, recognition, and a culture of excellence. Furthermore, when staff members have a clear understanding of expectations and feel included in the practice’s culture, they often experience increased empowerment and confidence. These positive qualities contribute to a happier team that is intrinsically motivated and committed to the practice for years to come.

1. Essential Elements of Employee Retention. Published October 19, 2017. Accessed June 11, 2023.

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