Human Resources for the Small Practice: An Overview of Common Challenges and How to Address Them

By Dee Brown, HR Advisor, HR|Experts

2018 NCMGMA Alliance feature article courtesy of Medical Mutual

Most small businesses, including small medical practices, assign human resources responsibilities to a cross-functional manager or to a single, in-house HR administrator. In either scenario, a single person generally has to focus on tactical HR-related tasks, such as payroll and benefits, time tracking, employee complaints, disciplinary action, hiring, and promotions. As a result, there’s little to no time for more strategic HR initiatives, and a lack of time and resources can also translate to costly HR-related mistakes.

Here are some of the most important HR tactics that smaller practices should be sure to follow:

  1. Hire the Right People for the Job: There are no shortcuts when it comes to hiring the right people. Regardless of the reasons, hiring the wrong person can be costly. Not only may the individual not be qualified for the job, but they will eventually need to be replaced, which creates another expense. In addition, smaller practices cannot afford to have any “seats” occupied by poor performers.
  2. Create Clear Job Descriptions: Taking time to create clear job descriptions is important for attracting the right people for the organization. Job descriptions should include the skills, training, and education that an ideal candidate should possess, and practices should only accept interviews with candidates that meet those basic requirements. Sound job descriptions also help to protect the organization from possible legal implications.
  3. Address and Document Performance Issues: Because small employers do not always have formal performance management processes in place, there’s a tendency to “work around” performance issues. Practices should never ignore concerns around employee performance. Instead, they should utilize performance improvement plans (PIPs) for anyone underperforming, so that employee knows how to improve and understands the consequences for not doing so. By having all of the issues in writing, practices can also back up their decision if they ever need to terminate that employee due to his or her performance.
  4. Gain an Understanding of Basic Employment Laws: There are numerous HR management laws that many small business leaders simply are not aware of, or don’t have time to review in detail. However, ignoring these laws could be detrimental to a practice. HR|Experts can provide information and guidance on a variety of laws, including those related to discrimination, overtime and minimum wage requirement (FLSA), family leave (FMLA), disability (ADA), immigration, and more.
  5. Classify Employees Correctly: It is important to know the difference between contract workers, full-time employees, and part-time employees. Some small practices will classify employees as “contract workers” to save money or to appease the worker. However, the U.S. Department of Labor has strict guidelines on different types of employees, as does the Internal Revenue Service. The duties and pay of the employee determines whether or not they are an actual employee or not.
  6. Develop Staff: Another critical mistake is allowing employees to fend for themselves when it comes to professional development. Leaders at smaller practices sometimes believe that because there’s limited upward mobility, they just need to keep people “happy” in their current role. The truth is that employees want to feel as though they are learning and growing. Once that stops, team members tend to become stagnant and disengaged. To combat those feelings, HR leaders should invest in developing staff and consider creative ways to inject new challenges into employee roles.

For more information on this topic, including more ideas for addressing common challenges and enhancing the strategic capabilities of HR, Medical Mutual members may listen to our webinar on HR for the Small Business, or contact Dee Brown at or 919-431-6096.

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