As a manager, I was never more frustrated than when a great employee decided to move on from the organization. The blood, sweat and tears that I had spent recruiting and developing this employee felt wasted. 

Hiring is really an ongoing process, so continue networking even when you don't have an opening in your office, says Bryan M. Rogoff, OD, MBA, CPHM (above).

The cost of staff turnover is not just the simple price of posting a help wanted ad for a new staff member, but the development and training time of the new associate, as well as lost knowledge and lost productivity of the vacating associate, which adds unrecoverable expenses to your practice. In fact, “turning over” an employee can cost you as much as 150% of that worker’s annual salary!1 

How can we find out what, if anything, went wrong and prevent this from happening with other employees? 

Of course, I conducted exit interviews, which can provide valuable information. But then again, vacating staff members may not disclose all the reasons and details of why they’re leaving your practice. If your practice is losing critical staff members rapidly, chances are other staff members are also in search of better opportunities. 

So, before attempting to recruit new team members, conduct a full analysis of your retention rate and identify opportunities of improvement. (“Acceptable” turnover is subjective. In my experience, a large corporation is happy with a turnover rate under 10%. But private practices should strive for less than 5%.) Plain and simple, if you do not have metrics of your retention, then you cannot make improvements. You then run the risk of newly hired employees leaving for similar reasons, which will cost your practice financially and even cause some patients to seek care elsewhere. 

Having the right team is essential. (As a matter of fact, I prefer the term “team member” or “associate,” instead of “employee.”) It is your team that ensures patient satisfaction and education, optical sales, scheduling, day-to-day operations and overall practice productivity. With that in mind, here are seven solid steps to help improve your employee recruitment and retention.

1. Network to Hire
After filling certain positions, I’d become lax. So if I were caught by surprise with a resignation, I had no network of individuals to contact to discuss possible employment.

Now, when I consult for other practices, I stress the importance of networking. Hiring is really an ongoing process, and it should be a strategy of our everyday operations. So, even when your practice is fully staffed, you should always continue to network. Build rapport with vendors and other small business owners; when at events, take notice of individuals who you respect and trust. 

Network not only within industry, but outside. People who are recruited outside of industry can bring completely fresh perspectives to an organization and practice. Some experience and skillsets outside the optical industry can be easily transferred. For example, a good restaurant manager understands specific costs and revenues associated with the business, yet also has the skills and qualities of a supervisor—such as managing people, providing good customer service and understanding profits and losses—which easily overlaps into the ophthalmic arena. Similarly, nursing assistants have a general knowledge of the human body and disease processes, and can easily transfer these to the role of an ophthalmic assistant with minimal training.

Once you meet such an individual, stay in touch and learn about what they are looking for professionally and personally. Even though your practice may not have a position or the budget to bring these individuals on board, an unpredictable circumstance may occur where you need to add or backfill a position. 

2. Success Through Social Media
Social media has become a vital source of networking and recruiting these days. I’ve had great success finding candidates using the Internet—but also found there are certain sites that were counterproductive and wasted a lot of time. I’ve used free sites like Craigslist and pay-per-posting like, and found you often get what you pay for. That doesn’t mean you may not have success with these posting sites. But, in my experience, lost time and productivity lead to lost revenues. So, it’s important to be as time-efficient as possible.

LinkedIn, deemed the “World’s Largest Professional Network,” has become the website of choice by most hiring managers, and more than 70% of recruiters use it as their only source.2 I’ve used Linked-In to get connected with a number of certified ophthalmic technicians, eyeglass sales associates and office managers. 

Facebook has also become a useful recruiting tool. Although posting opportunities on LinkedIn will likely double your applications, Facebook was the only social network to increase in job applications in 2013-2014.2 To post an opening, you can create a Facebook Ad as easily as you’d submit a classified ad to your local newspaper. But Facebook also allows you to input specific keywords and demographics to target your ad. For example, if I’m looking for an individual in my area who has optical experience, I’d type in such keywords as “optical,” “eyeglasses,” “sales,” “Washington DC,” etc. Facebook then displays the ad only to individuals who might have those keywords in their profile. Another way is to post an opening directly on your practice’s Facebook page. 

These sites are vital tools when filling special voids in your practice where you can view specific educational background, overall experience and endorsements from coworkers right from your computer or mobile device. 

3. Building a Team Takes a Team
Great talent is hard to come by, so be prepared to modify the job description if you’re not attracting the right applicants. Certain candidates may not have the laundry list of education and experience that you desire, but they may show potential with a basic skillset. Some specific skills can be learned through patience and good training, especially with talented individuals. In other words, you can teach optics and selling, but you can’t teach good intuition or the ability to interpret customer needs. 

If you want to find the most qualified, capable candidate with the most potential, and also one who will fit seamlessly with the rest of your team, get your associates involved with the selection process. Analyze traits among your successful staff members and see what’s common—not only which traits make them essential team members, but also which ones match your management style. Long-term employees not only need to be qualified individuals, but also must possess similar traits as current team members in order to build camaraderie. Whether it is customer service or staff management, your current staff will have to work with the new associate, and although personality conflicts are extremely difficult to avoid, this process can help reduce possible tension. Key team members can also reveal different perspectives and opportunities that you, as a supervisor, may not see. 

Be objective about how this employee would be a significant investment—or worse, a significant risk. Due diligence is always necessary when hiring new employees, and this is where a reference check could add value to your decision. A reference check could reveal certain inadequacies or a background history that might not come up during the interview process. (I use the word “could” because reference checks shouldn’t be the final decision when hiring. Many times, I’ve trusted my “gut instincts” even when a candidate’s reference checks were not perfect.)

In addition, consider a criminal background check, particularly for team members who will be managers or in charge of money. Be aware that criminal background checks can be time consuming and costly. Some instances to consider a criminal background check: when a candidate’s resume has significant gaps in employment; when an individual is overly anxious to start a new position; or if a candidate avoids eye contact when asked about past work experience. Again, listen to your gut. 

For your part, always be honest and upfront with candidates about why the position is vacant and discuss how they can be a solution for certain challenges.

In addition to the traditional, sit-down interview, create a half-day or all-day “itinerary” of your office in which the best candidates meet with different team members. With the involvement of your associates, demonstrate a “typical day” of the responsibilities of the position while, at each stage of the process, have your staff evaluate the candidate’s reactions, interactions and applicability of their experience. Later, discuss as a team which candidate seems to be the best fit. 

4. Set Up for Success
After years of improving on approaches to onboarding and training, I found it is important to prepare your practice and team to welcome new members, and the easiest way to set up them for success is thorough development. (The concept of development encompasses more than just employee training. To offer an extreme example: a dog can be trained, but an individual who can make independent decisions and contributions should be developed.) 

This will be your opportunity to mesh the common values of the new team member with your practice. By giving them the tools and proper training to do their job well, you are also demonstrating your support for them to succeed. For example, if you’ve just hired a new optical sales associate, be sure to provide a manual of your office operations, procedures and policies; train them on your point-of-service computer system; have a working pupillometer; show them where extra supplies are located in the office, and how they can order supplies if they’re running low. Such suggestions may seem intuitive, but these details can be overlooked when the associate’s first day is approaching. Empowering the employee from day one will boost their confidence.

Also, just as you involved your staff to be part of the hiring process, use them to develop new associates. The top-down approach can be intimidating for new hires and may not be as welcoming as using an experienced, long-term associate who will be working with them side-by-side every day. This fosters camaraderie and allows easy access for questions of daily operations. 

Have new associates arrive for basic development before your practice is open to give you and other team members the opportunity for undivided and uninterrupted time. Starting a new team member during regular office hours can be overwhelming for your team as they are trying to ensure smooth operations of your practice.

5. Learn About Your Team Members
Small practices have a great advantage of creating a work environment that feels more homey and family-like. Dedicated weekly meetings allow associates to discuss recent issues and accomplishments. This input demonstrates associates’ concern to do their job well and helps them express their frustrations. 

Remember to listen and not have defensive reactions. This gives you and other senior staff an opportunity to make fixes before they escalate into something larger that can lead to turnover. 

The reason why you have an amazing staff is because of their amazing skillsets and talents. Their assets that promote and ensure your practice’s success, and using them to their full potential leads to more job satisfaction. I found focusing on associates’ career goals and making one-on-one appointments every six months allowed me to review opportunities and learn more about them and their ambitions. You may be surprised to find that their experience and skills can be used in other capacities outside their current job description.

6. Customize Your Benefits and Create Opportunity
As you learn more about your employees, discovering their personal needs in terms of benefits can lead to longer employee retention. 

Big corporations have centralized benefit packages that usually have little room for modification, so employees can become frustrated with “benefits” that add little or no value to their lives. Small practices, on the other hand, can match benefits to best fit the staff. This doesn’t mean to keep adding benefits, but creating a package that meets the needs of your team. Not every team member may need a health care or retirement plan, but they may use other benefits such as health club membership or day care. Or, perhaps a flexible schedule allows certain associates to work from home a few hours a week. 

Creating employee satisfaction is crucial for retention, so customizing your benefits can be a critical tool to keep your practice’s work environment competitive. Additionally, it allows employees to balance their personal and professional lives more efficiently.

7. Recognize and Reward
Acknowledging hard work speaks more loudly than recognizing mistakes and shortcomings. 

Employees want to feel rewarded for performing a job well—the key word is not “rewarded,” but “feel.” Validating and recognizing an employee for their efforts goes a long way and is critical for retention. 

Not all rewards have to be monetary raises and bonuses, either. Small practices have a greater ability to reward additional days off and gifts that provide a personal touch than larger organizations. 

Nothing is more gratifying or powerful than saying, “Thank you!”3 Thanking your associates publicly and privately shows your appreciation of the value they provide. Personalizing your “thank you” with a card or a note in their paycheck demonstrates a genuine regard for their service and not just a simple habit. 

With many Americans spending more time at work than at home, making your practice environment fun, social and comfortable creates a place where your team wants to work. 

Dr. Rogoff is a private practice and industry consultant specializing in best practices. He is also the legislative chairperson for the Maryland Optometric Association, and a consultant for the FDA’s Ophthalmic Devices Panel of the Medical Devices Advisory Committee. Email:

1. Bliss WG. Cost of Employee Turnover. Small Business Advisor website. June 17, 2014. Available at: Accessed Sept 15, 2014.
2. Brooks C. Facebook Up, Twitter Down Among Job Recruiters. Business News Daily website. Sept 8, 2014. Available at: Accessed Sept 15, 2014.
3. Kruse K. 25 Low-Cost Ways to Reward Employees. March 1, 2013. Available at: Accessed Sept 15, 2014.