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How often is enough for discussing performance with medical practice employees?

MGMA Stat - May 9, 2019

Performance Management

The Medical Group Management Association’s most recent MGMA Stat poll asked healthcare leaders how often they meet with their employees to discuss their performance: 45% answered “annually,” while 19% responded “quarterly,” 15% specified “monthly,” 5% reported “weekly” and the remaining 16% stated “other.”

Respondents who answered “other,” elaborating on their response, noted:
  • “A mixture of the above - depends on position and employee"
  • “Annually and as needed”
  • "Performance is a continual conversation"
  • “Biannually”

This poll was conducted on May 7, 2019, with 1,108 applicable responses.

To understand how to better help your employees flourish, MGMA has invited Melissa Phillippi, president & co-founder, Performance Culture to help shed light on this topic:

How often should managers meet with their employees about their performance? How often is enough or too much?

The short answer is it depends on numerous factors, including:
 
  • The individual relationship between the manager and the employee
  • The current workload and any project urgency
  • How concise or comprehensive the conversation needs to be
  • The level of compliance and documentation necessary
  • How much time you want to save prepping for the annual performance review

One-on-ones, pulse checks, stand-ups and check-ins — they all essentially mean the same thing. Check-ins are not a new concept to performance management, but they are a relatively new feature in performance management systems.

Managers often say that they are already checking in with their direct reports on a regular basis. The formats vary based on organizational culture, size and the manager’s preference. Given how generic “check-in” is compared to its more-structured cousin, the performance review, it is open for interpretation.

Check-ins and performance management

The human resource industry has been talking about continuous performance management for years now, and you don’t need a SHRM SCP certification to know that the traditional process of once-a-year performance reviews doesn’t really work. In fact, it’s a detractor from employee engagement.

Personal relationships will suffer with only one meaningful conversation a year, and manager-employee relationships are no exception. Thus, check-ins are a way for managers and employees to hit “pause” multiple times a year to discuss what works well, what doesn’t and assess individual alignment and satisfaction.

Gallup research found more than half (51%) of departing employees say “that in the three months before they left, neither their manager nor any other leader spoke with them about their job satisfaction or future with the organization.”1

Given this insight, managers should recognize that “I’m too busy” is not an excuse to not check-in regularly with their employees. Some fool themselves into thinking the elevator ride-up is enough time and attention to count as a check-in.

Managers are indeed too busy at times on account of organizational design or lack of Lean processes. Sometimes it is a product of turning “doers” into people leaders with little or no time for training them in professional development.

But when the cost of replacing an employee can be upwards of two times salary,2 organizations should implement a simple process that can dramatically decrease this pain point — above all else, it’s the right thing to do.

“People don’t care how much you know until they know how much you care.”

Want your employees to perform at a high level? Treat them with the same respect you would want to be treated with: Listen to them, appreciate them, coach them and help them succeed. If most employees who leave a job cite a lack of managerial concern, they won’t feel appreciated or think anyone cares about their career progression or personal goals.

The next step becomes determining how often to check in with employees. Check-ins could be too infrequent to engage employees, yet going too far with requirements that are overly stringent or complicated can be just as harmful. We suggest the following as a rule of thumb:
 
  • For new-hires:
    • Weekly check-ins at the beginning of each week for up to 90 days.
    • When the employee shows sufficient progress and generally seems to be getting the hang of things, switch to monthly check-ins at the beginning of the month. 
  • For all others:
    • Monthly check-ins at the beginning of each month, culminating with an annual or semi-annual performance review.

Starting a week or month with a check-in proactively produces alignment, leading to a more successful week or month for both the employee and the organization. This should include defining an employees’ performance objectives and workplace behaviors as soon as possible — no more waiting for the year-end review to find out a manager and employee have different perceptions of “excellent” performance.

In addition to the benefits of setting a check-in frequency, documenting these regular meetings provides risk mitigation for the unfortunate times when you may need to part ways with an employee, as past discussions of performance or behavior issues will be at your HR professional’s beck and call.

What does a check-in look like?

Structure of meetings have a number of factors that must be determined: Do we meet in person? How are notes documented? Where does the meeting occur? Most of those questions can be answered based on considering context, privacy and the goal of your meeting. The biggest factor is choosing a time and place that minimize interruptions.

How long should these meetings last? While your goals will dictate that, 10 to 15 minutes is a good limit for more-frequent, in-office check-ins. Managers and employees alike must be disciplined in their conversations, tabling non-agenda item discussions for another time. For the manager who has numerous direct reports, this is particularly important. Setting an agenda in advance is a great start toward this goal.

However, outside-the-office meetings are a great opportunity for more informal or non-documented conversations where the employee is free to discuss his personal vision, career aspirations or ask the manager questions.

What gets said?

There are two key types of feedback that can be addressed in a check-in:

1. Appreciation: What are your biggest accomplishments since our last check-in? What are you most proud of?

2. Coaching: What are your key priorities for this next check-in cycle? How can I best help you?

In either instance, the check-in should be employee driven, not manager driven. Prompting questions for employees to begin processing their performance, where they are succeeding or struggling, what they might need help with and where they should focus their thoughts and energy helps the manager know exactly how to coach the employee for success. This cuts down on bad assumptions.

While it might sound like homework, providing those prompts in a written format for an employee to reply back before the meeting is helpful. Writing forces clarity, and your employee will provide much deeper and accurate responses when he or she has had a few quiet moments to allow their brain to process. Introverts especially hate to be caught off guard with a Q&A session they have not had time to think about. Extroverts can usually wing it, filling in the gaps of silence, but mostly with ridiculous answers that are not well thought out.

Similarly, managers coach better when they’ve had time to process employee’s thoughts and respond with a coaching question about the response, such as, “tell me more about what you believe is getting in the way of you meeting this goal.” Asking coaching questions versus simply telling your employee the answer produces far more effective and lasting results.

By implementing the best practices mentioned above, the once laborious task of the annual performance review is reduced to a light summary of previously documented conversations — with more time allowed to focus on the future. It also gives regular times for the manager to address performance or behavior concerns, which should yield fewer surprises for the employee regarding unclear or unmet expectations.

Remember, healthy organizations have the shortest amount of time between conflict and resolution, and frequent check-ins are one of the best ways to address this.

Notes:
  1. McFeely S, Wigert B. “This fixable problem costs U.S. businesses $1 trillion.” Gallup Workplace. March 13, 2019. Available from: https://www.gallup.com/workplace/247391/fixable-problem-costs-businesses-trillion.aspx.
  2. Ibid.

Additional Resources
MGMA Stat is a national poll that addresses practice management issues, the impact of new legislation and related topics. Participation is open to all healthcare leaders. Results of other polls and information on how to participate in MGMA Stat are available at: http://www.mgma.com/stat

Learn more about MGMA Consulting
Learn more about MGMA Stat
Learn more about Performance Culture and the Performance culture System

About the author:


Melissa Phillippi
President & Co-Founder of Performance Culture,
an organization dedicated to helping leaders build better teams.
 
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