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J Oncol Pract. 2010 March; 6(2): 104–106.
PMCID: PMC2835475

Essentials of Staff Development and Why You Should Care

Dean H. Gesme, MD, FACP, FACPE, Elaine L. Towle, CMPE, and Marian Wiseman, MA


Physicians may reason that their energy, education, and training should be focused on patient care and research, whereas staff education should be the responsibility of practice managers. But physicians have an important role in staff development.

Many corporate business owners and managers give little thought to staff education. They do not think it is part of their role, or if they do, they never have time to get around to it. For physicians in practice, another factor may contribute to a lack of involvement in staff development. Physicians may reason that their energy, not to mention their years of education and training, should be focused on patient care, research, and staying abreast of clinical advancements, whereas staff education should fall under the category of personnel and be the responsibility of practice managers.

If you have not given staff development much thought or think it does not affect your practice or patients, this article is for you. You have an important role in staff development: establishing its priority, encouraging it by example, and supporting it in your attitude and budget. The truth is that if staff education and development are not a priority for the physicians who own the practice, they will not be a priority for anyone under them.

What Is the Return on Investment?

Staff education should include a formal orientation program, cross-functional training, maintenance of professional skills, coaching, career development, and personal development. The pay-off for your practice is as follows:

  • Employee retention: Staff members develop loyalty to a practice because they feel you care about them as individuals. They benefit from personal and professional growth and do not feel their career has stalled out.
  • Staff morale: A practice culture that encourages learning and fosters education creates a positive, motivated, and committed workforce.
  • Practice efficiency: Orientation and cross training are essential for a smoothly running office. The stability and tenure that result from low staff turnover also contribute to efficiency.
  • Job competency: Employees who have received job-specific training are more productive and confident. Both clinical and administrative staff need ongoing education to stay current regarding the constantly changing aspects of oncology practice.
  • Patient satisfaction: Yes, staff education affects your patients, who benefit from your employees' skills, positive attitude, and efficiency. Employees who feel they make a difference in the mission do better work.

Practice management consultant Kenneth T. Hertz, CMPE, points out that supporting staff education also affects the profitability of the practice. “It all goes to the bottom line,” he says. “By promoting staff development, physicians create an environment where they say ‘you're important to us. We respect you and value you more than just the person that answers the phone.’ When they create that kind of environment, they set things in motion that produce improved employee attitude, patient satisfaction, and physician satisfaction.”

Your attitude—the emphasis you place on staff development—is the critical element. Not every practice can include tuition reimbursement as part of its benefit package, and covering expenses for travel to out-of-town conferences may not always be feasible. But many essential aspects of training have no direct expenses. Let your staff know that you consider their development important.

Management Training for First-Line Supervisors

Many managers have never had any formal management training. They became managers because they excelled in their work, but the skills that made them the best nurses, the most efficient coders, or top-notch office organizers do not necessarily make them first-rate managers. In addition, supervisory responsibilities such as coaching and team development may get short shrift because clinical or administrative productivity remains an important part of their job.

But good management skills are critical, because employees often decide to stay in jobs or leave them depending on how their bosses treat them, not because of the organization for which they work. Set an expectation that all managers in your practice receive management training. Many educational opportunities in basic management can be found through their own professional organizations, local universities, and professional training organizations.


Traditional orientation—providing basic information about the practice, a tour, and face-to-face meetings with other staff—should be expanded to incorporate a longer process with a broader goal. The term onboarding (also known as assimilation) is now being used for an orientation process that has the goal of decreasing the time for a new employee to become productive.

An effective onboarding program starts before the employee's first day and continues for several months. The new employee's workspace, phone, e-mail account, and name badge should all be in place before he or she starts the job. Most important, there should be work for the new hire to perform during part of the first day. Your practice should have an established training program for relevant office procedures, and the employee's supervisor or an experienced staff member should have explicit training and coaching responsibilities.

Improve the onboarding process by making sure information flows two ways. When employees start work, ask them about their own concerns, whom they wish to meet, what they wish to learn, and what motivates them. After a few weeks, ask for feedback about the onboarding process and what other information or approaches might be incorporated to improve the ability of new employees to do their jobs well.

Effective Job Training

Employees, particularly front-office staff, typically receive on-the-job training for their positions. This training is highly variable because it depends on the knowledge and proficiency of the trainers. To reduce the variability, training should follow a structured list of tasks and subjects to be covered, the estimated time needed for training in each area, and performance standards to be achieved.

Continue training for employees throughout their tenure. A misguided belief shared by many managers is that if you hire competent people and pay them competitive wages, they will perform well indefinitely. Managers often do not understand the connection between performance and personal development. Do not limit training to new employees. Provide ongoing training programs in areas such as customer service, conflict resolution, and effective communication. Make cross-function training a standard part of your practice. In addition to the obvious advantages of providing leave-time coverage and continuity in case of abrupt departures, cross-training offers employees a chance to see what others do and gain a greater understanding of the overall practice.

Keep Up With the Legal Aspects of Practice

Just as the billing staff must receive regular updates in coding changes, and changes in the Clinical Laboratory Improvement Amendments are critical to the laboratory, it is essential that managers keep abreast of the constantly changing field of employment regulations. Too often, physicians and managers rely on common sense or what they learned about the Consolidated Omnibus Budget Reconciliation Act, the Occupational Safety and Health Administration, and equal employment law in seminars they took 10 years ago to guide them in human resources practice.

Employment law is constantly changing, and small missteps can have grave ramifications in the areas of hiring, firing, performance evaluations, and documentation. Be sure that the senior management in your practice participates regularly in education in workforce regulations and that both physicians and employees are kept informed about current requirements and best practices.

Staff Development Without Expenses

Many educational opportunities that can benefit your staff are free. The following are a few examples:

  • Journal clubs: A staff development option that incurs no cost is a journal club, which can include both books and journals. Consultant Hertz encourages medical practices to include books and journals outside of the health care industry, noting that publications like Business Week and Harvard Business Review can offer provocative topics for discussion. Examples of books are Hardwiring Excellence and “I Love You More Than My Dog,” both of which deal with customer service. Assign specific chapters or articles, and meet weekly or biweekly for discussion at a lunchtime event or right after work.
  • Hospital programs: Local hospitals may offer free seminars, workshops, or Webinars on topics of interest to your staff.
  • Vendor-sponsored education: Sometimes vendors offer workshops on topics such as customer service or dealing with generational differences, in addition to their product-related training sessions. For example, a group of four companies in the Kansas City area created an innovative consortium that has been offering educational programs for medical office staff for 5 years. The consortium, MidwestMedTrust (Kansas City, MO), offers a series of “lunch and learn” workshops on topics such as work-life balance, dealing with difficult patients, hiring and retention, and embracing change. For the price of lunch, employees from medical practices gain insights and perspectives they can apply on the job. The consortium also works with practice administrators to present in-service sessions on topics of special interest to practices.
  • Government-supported programs: Government grants may also be available for staff education. The Piedmont Health Group (Greenwood, SC), a multispecialty group with a staff of 100, received a $10,500 grant for education under the Incumbent Worker Program of the Upper Savannah Council of Governments. The grant supported a 16-hour customer service training class presented over 8 weeks. Presented at one of the group's facilities, the interactive class included opportunities for employees to talk about issues they encounter at work. “It helped the staff understand how to handle different behavior types, to realize that not only are the patients their customers but so are their coworkers, and they need to listen to each other as well as the patients,” notes the group's administrator, Kim Bradberry. The grant also paid for a 12-week conversational Spanish class offered once a week after hours. To find out about education or grants that may be available to your practice, look for state and county programs funded by the federal Workforce Investment Act.
  • In-house education: Providing regular in-office educational programs offers a way to improve efficiency and remediate problems. One example is a 1-hour educational session held by the Piedmont Health Group every Thursday at two different times. Taught by staff from the billing office and presented at the corporate office, these educational sessions focus on problem areas the collections staff have noticed in the patient registration process. The participants learn shortcuts and receive retraining on correct procedures. Another benefit, notes practice manager Bradberry, is that the employees appreciate the opportunity to get out of their own offices and meet staff from other offices.

Professional Association Membership

Paying the annual dues for membership in professional associations is an excellent way to support staff development. The benefits of membership in a professional society—such as free publications and education, access to industry surveys, and, perhaps most important, networking opportunities—will accrue to their performance and the success of your practice. Membership in the Medical Group Management Association (MGMA) has specific benefits for oncology practice mangers. At no additional charge, MGMA members can belong to the subgroup Administrators in Oncology/Hematology Assembly, an active group that holds its own annual educational conference and has an online forum.

Paying for dues in professional organizations such as the MGMA or Oncology Nursing Society is one of numerous benefits provided by the Kansas City Cancer Center (Overland Park, KS), an organization with approximately 350 staff members and five comprehensive cancer centers. “The physician leadership definitely consider staff education and professional development an investment in the practice,” says Mindy Swayne, CMPE, practice manager of one of the group's centers. The group also promotes certification and pays for education needed to attain and maintain it. For example, all nurses are required to be certified in oncology, the billing department has certified coders, and the practice manager at each location is certified by the American College of Medical Practice Executives. Swayne notes that support of education is not reserved just for professional staff. “If I have a receptionist who is interested in taking a workshop on customer service or how to deal with angry patients, she can receive paid time to attend, and the registration fee will be covered.”

Coaching and Mentoring

Training and coaching are distinct, although, certainly, there is some overlap. Training involves imparting knowledge and skills about processes, equipment, or services the employee will use on the job. Coaching is providing advice, recommendations, and guidance for the employees to perform well.

No formula can be applied to when, how, and by whom coaching should be done. Managers, team leaders, and coworkers may each fill the role of coach at various times. For new employees, a coach should be specifically assigned.

Mentoring is also an important part of employee development. Although coaching is largely task related and focused on performance, a mentor guides the employee as an individual. A mentor is typically selected by the employee rather than being assigned and is usually a role model. The mentor advises, shares experiences, and guides the employee in self-discovery and career development.

Leadership Development

Leadership training for both staff and physicians will pay off in many ways. Effective communication, development of a team culture, and conflict resolution are just a few of the many aspects of leadership training that can make a big difference in the practice. Do not limit leadership development to supervisors and executives. For example, any employee at the Kansas City Cancer Center can apply for the leadership development program offered by the practice. The structured 8-week leadership development program includes 2-hour classes in the evening and is offered three times a year. As practice manager Swayne comments, “Leadership is essential at all levels.”

Staff Education and Development Resources


  • American College of Physician Executives,
  • American Society for Training and Development,
  • Medical Group Management Association,
  • Professional Association of Healthcare Office Managers, Books
  • Levoy B: 222 Secrets of Hiring, Managing, and Retaining Great Employees in Healthcare Practices. Sudbury, MA, Jones and Bartlett, 2006
  • Spath PL (ed): Guide to Effective Staff Development in Health Care Organizations: A Systems Approach to Successful Training. San Francisco, CA, Jossey-Bass, 2002
  • Murphy S: Leading, Coaching, and Mentoring the Team: A How-to Guide for Medical Practices. Denver, CA, MGMA, 2009

Authors' Disclosures of Potential Conflicts of Interest

The authors indicated no potential conflicts of interest.

Author Contributions

Conception and design: Dean H. Gesme, Elaine L. Towle, Marian Wiseman

Administrative support: Marian Wiseman

Data analysis and interpretation: Dean H. Gesme, Marian Wiseman

Manuscript writing: Marian Wiseman

Final approval of manuscript: Dean H. Gesme, Elaine L. Towle, Marian Wiseman

Articles from Journal of Oncology Practice are provided here courtesy of American Society of Clinical Oncology