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In a perfect world, the people you hire emulate the drive and ambition you have working in a fast-paced medical practice. However, the reality is that most hires view working in a practice simply as a job and not a career. While mid-levels and aestheticians are incentivized for the work they do, often times other staff members are not. This can create a great — and (negatively) impactful — divide. The big question is how practice leaders can change the level of staff engagement and keep everyone happy, while focusing on building the business at the same time. In my experience, this can be accomplished by taking the following steps:

1. Ask everyone how they like to be recognized
2. Recognize and reward rather than admonish
3. Incentivize team members for incremental revenue gains
4. Offer professional development

In covering the four points listed above, I recommend you remove the words “I can’t” from your vocabulary. If you continue to say I can’t, you won’t. Over time, too many practices create a culture that perpetuates turnover and a lack of training through complacency. In the end, the practice loses.

Turnover costs more money than providing meaningful incentives to a productive staff. There are intrinsic costs to recruiting, interviewing, and training new employees. Practices also lose the knowledge gained by employees upon their departure.

Redefine Your Culture

Now comes the fun part. Here are the steps to take to redefine the culture in your practice:

Relay the basics by holding regular staff meetings. In your first meeting have all staff members complete a survey about how they like to be managed and recognized for a job well done. Let them know you can’t run a successful practice without a highly productive team where everyone has accountability. At the same time, make it clear that you’re willing to compensate them for achieved goals. These meetings should take place at least quarterly to provide updates on practice achievements and recognition to team members for accomplishments. Keep these meetings positive. Meanwhile, keep individual issues to one-off meetings away from other team members.


Hold regular (at least quarterly) staff meetings to provide updates on practice achievements and recognition to team members for accomplishments. Keep these meetings positive—focus on what’s working. Keep individual issues to one-off meetings away from other team members.

Take a positive approach. Nobody likes to sit in meetings to hear what they’ve done wrong. Recently, I worked with a practice that had nearly 100 percent turnover year over year. In an effort to find out why, I sat in on one of the practice’s weekly staff meetings. The meeting consisted of a long laundry list of things that went wrong the prior week. As I scanned the room, all I saw were defeated looks, eye rolling, and frustration. Ten minutes into the meeting I doubt anyone was listening or even cared what was being said. Later, I had an opportunity to ask a staff member if this was how all the meetings went. Her response was insightful:

• Every meeting is negative.
• We are really busy during the week, so we only find out what we did wrong at our next meeting.
• There are always new people, so there’s always something to complain about.

Based on those responses, it was no surprise that there was so much turnover in that practice. If there are opportunities for general improvement, they should be addressed in a positive manner with proper training. If there are individual improvements to be made, manage them in a manner that’s more private. Also, waiting a week only to list issues one by one reduces the level of engagement. When building an agenda for staff meetings, highlight some outstanding individual and team performances.

Measure and incentivize. Consider a team-based incentive plan if you can directly track revenue improvement through the actions of your staff. Employees leave jobs for two reasons — money or their manager. Most hourly wage employees lack opportunity to make more money in their current role until a yearly performance review. Providing measurable, attainable goals that include a moderate incentive show staff that what they do on a daily basis really matters. For example, distributing a portion of retail revenue back to employees when a sales goal is exceeded serves as incentive, especially to those not already incentivized in another manner. This tactic promotes team-building and individual accountability. Be sure to regularly monitor performance to keep staff on track to achieve or exceed their goals.

Invest in professional development. Let your team know that you are willing to invest in them. If there is a course or meeting that staff members would like to attend that will help them become more proficient in their current roles (or prepare them for other roles in your organization), it should be open for consideration. Also, schedule regular trainings to keep staff abreast of changes in the marketplace. Most vendors provide ongoing staff training for products. In addition, there are vendors who provide non-product related distance learning courses covering a wide array of topics related to the aesthetics industry. Most of these are online courses that can be downloaded and reviewed at staff’s convenience. I highly recommend guiding staff members to topics that are most directly related to practice growth. Most large organizations provide ongoing staff training because it leads to higher performance.

Best of Intentions

If you have reached this part of the article, it means you have the best of intentions. You want more out of your staff, and you are willing to invest in them. Culture starts at the top and permeates down. If you embrace a culture model that is built on empowerment, teamwork, and recognition, your staff will respond in kind. Ultimately, they will care as much as you do about the practice and its success.

Bernie Magrino is a management consultant with the Allergan Practice Consulting Group of Allergan, PLC, a global pharmaceutical company headquartered in Dublin, Ireland. Mr. Magrino consults with medical aesthetic practices in the areas of financial analysis, practice valuations, human resource issues, internal and external marketing, leadership training and team building, sales training, compensation, and cosmetic practice development. Mr. Magrino has more than 20 years of consulting, training, sales, and sales management experience. Prior to joining the Allergan Practice Consulting Group, he served in a number of sales and management positions in both the pharmaceutical and aesthetic industry, including business development manager, training manager, and regional sales manager. He also participated in corporate marketing initiatives that included planning and strategizing the launch of several new products and indications. Previously, Mr. Magrino was a corporate area consultant, supervisor, national sales manager, and marketing account executive charged with turning around low-volume stores to make them profitable for sale to franchisees. In those roles, he conducted market research, developed promotional marketing and pricing strategies, and performed customer needs analysis. Also, he was a founding partner of a successful internet startup company that sold products in more than 20 countries. His strengths include selling, business management, hiring top talent, leadership development, coaching teams for top performance, and presentation skills. Mr. Magrino is a frequent speaker at various health care organizations and hospitals. He earned his bachelor’s degree in information technology from American InterContinental University.

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