PHOTOGRAPHY BY MIKE HALLER, HALLER CONCEPTS, INC.

It’s no secret that retaining allied staff in an ophthalmology practice is challenging today, due to factors including the widely-reported shortage of qualified health-care workers and COVID-19-related issues, such as increased needs for childcare services.

Yet Pepose Vision Institute, a two-location practice that is recognized as a leader in cataract and refractive surgery in the St. Louis area, has largely been able to surmount this problem. How? The practice, with six doctors and 32 allied staff members, provides an environment that builds teamwork and job satisfaction.

“Satisfied staff don’t job search,” says Susan Feigenbaum, PhD, the practice administrator, who has been associated with the practice for 23 years and is married to practice founder Jay Pepose, MD, PhD. “Additionally, they contribute to a productive, interactive work environment where colleagues and patients feel they are treated like family. At Pepose Vision, relationships matter.”

Here, members of the Pepose Vision Institute team share the qualities of the practice that create loyalty.

Career advancement and professional growth

For those ophthalmic professionals committed to their careers, Pepose Vision Institute provides advancement opportunities. For example, Elena LaPlante, director of practice development, initially accepted a job as an optician and worked her way up in the practice.

“The investment they make in us is huge!” she explains. “The practice truly is an institute of learning for staff. In addition to the initial training, we are sent to conferences where we can obtain continuing education credits, and there is tuition reimbursement — $400 a semester — after we’ve worked at Pepose Vision Institute for a year.”

When retina technician Charlotte Kelly started working at the practice, she expressed an interest in learning how to do fluorescein angiography (FA). When she became certified in FA, she was rewarded with a promotion and pay increase. In her 10 years at the practice, Ms. Kelly has achieved additional pay raises for earning her COA and learning fundus photography, clinical study protocols, and how to be a scrub tech.

Ms. Feigenbaum says she encourages staff to grow professionally, so they can also grow personally and financially.

“At their annual reviews, for example, we ask staff what skillset they have that they think would be beneficial in another position in the practice,” she offers. “I think that promoting from within has been a great means of retention. So many staff want to keep learning and growing.”

Christine Guccione, a patient account representative with the practice for 16 years, says that one staff member who started in the billing department with her is now a surgery scheduler because managers recognized her ability to work one-on-one with patients to get their surgeries scheduled and obtain their benefit information prior to procedures.

Empowerment

Pepose Vision Institute empowers staff to make their own decisions regarding how to carry out their responsibilities — another reason to stay with the practice.

“In the medical records department, I can handle the things the way that I want to, which is a big thing for me because there may be an approach that works better for me and the practice,” says Mollie Kaltenbach, Pepose Vision’s head of medical records, who has worked for the practice for four years.

For example, Ms. Kaltenbach recently combined a front desk duty with a medical records duty. As a result, staff prepare patient charts the day before appointments rather than gathering the medical record when the patient approaches the front desk for their appointment.

Staff input

By actively soliciting the staff’s input, Pepose Vision Institute helps decrease employee turnover, allied staff say.

An example: A patient was recently referred to the practice for central serous retinopathy, though scans didn’t appear to reveal this to Ms. Kelly. When she mentioned this to Nancy Holekamp, MD, the doctor not only informed Ms. Kelly that she was correct, but also explained the diagnosis of myopic degeneration.

“At Pepose Vision Institute, we encourage all staff to ask questions because we want them to know they are valued members of the practice who need to be informed, so they can provide the high-caliber patient care we and our patients expect,” explains Dr. Pepose.

Ms. Guccione notes that the practice has monthly staff meetings where input is invited, so everyone is on the same page and any issues get resolved.

“The point of the meeting is to review what are we doing right, what are we doing wrong, and how can we fix it,” adds Dr. Pepose.

Ms. Kelly says that when job openings become available, staff members are invited to recommend candidates and enjoy a referral fee if the candidate is hired. Staff members are also asked to review and provide input on the resumes submitted by job applicants. (See “A new approach to recruiting,” p. 15)

“I really appreciate that they want to know what we think, and they want us to ask job candidates questions to find out whether we think they’re going to be a good fit, because it makes us feel that our opinions matter,” she offers. “And our thoughts are definitely taken into account.”

Cross-training

Pepose Vision Institute places a premium on cross-training, which provides several advantages, say the staff.

“We learn about various related positions within the practice, so we can step in and help each other. This helps with managing stress and preventing burnout while also giving us additional skills,” explains Ms. Guccione. “Last April, I lost my sister, and someone stepped in for me, no questions asked. I was able to take the time I needed while not having to worry about my job getting done.”

Ms. Kelly points out that the practice encourages its techs to be cross-trained as scribes and skilled in diagnostic testing, including topography, biometry, keratometry, OCT, meibography, tear osmolarity, fundus photography, FA, and ultra-widefield retinal imaging.

“It’s fabulous because if one person is in an exam room scribing but a retinal scan is needed on the patient, someone is available to do it,” she notes.

Ms. LaPlante explains that front desk personnel are trained to work in the optical; surgery schedulers work the front desk and more.

“This has been particularly beneficial since the COVID-19 pandemic started, as some staff have had, and continue to have, limited work schedules due to childcare, among other related issues,” she adds.

Acts of care

Allied staff cite many other examples of the care and interest demonstrated by the practice as reasons for loyalty, such as:

• The doctors and managers are approachable. “I don’t feel intimidated to ask them questions, and they always take the time to answer me,” says Ms. Kelly.
• The doctors inform staff of changes — and the reasons behind them. “In some other practices, it’s ‘this is what you do,’ with little or no explanation,” says Ms. LaPlante. “That doesn’t feel good, which hampers a staff’s buy-in to a change and, ultimately, can hurt the practice and patient care.”
• The doctors “have the staff’s backs.” During those infrequent instances when patients are particularly surly, Ms. Kaltenbach says, “it means a lot when the doctors and Ms. Feigenbaum step in to diffuse the situation.”
• The doctors demonstrate an interest in staff and their families. Ms. Guccione noted that when her mother passed away last April, Dr. Pepose attended the wake and paid his respects to her and her family. “That meant the world to me!” she says.Ms. LaPlante adds that when some staff were furloughed at the height of the pandemic last year, Dr. Pepose and Ms. Feigenbaum personally purchased and sent grocery store gift cards, acknowledging times were tough.
• The practice demonstrates gratitude. For example, as a thank you for working at the practice for five years, Ms. LaPlante says the staff member and guest receive a week’s expense-paid trip to Hawaii.

Not just a number

“We are not just a number at Pepose Vision Institute,” explains Ms. Guccione. “They truly care about their employees, and I think all our reasons for staying revolve around that genuine caring.” OP