Industries
Why hospital staff leave and how to understand why
Nurses, doctors, technicians and support staff leave hospitals for different reasons. How to run a respectful exit conversation, spot patterns and act.
7 min readRead article
Healthcare · Private medical practices
HR for Private Medical Practices: Doctors, Clinic Staff and Patient Flow
A private practice is often one doctor or a small group with a handful of staff, where the doctor is also the employer. When the doctor is also the employer, people matters tend to wait behind patients, so small routines made early save the most time.
Not sure what you need? Tell us about your business in six short steps and we will come to the first meeting prepared.
Share your requirementsA private medical practice is usually a general practitioner or specialist working alone or with a few partners, supported by a nurse or assistant, a receptionist and perhaps a compounder or pharmacy attendant. The doctor is the clinician, the owner and the employer, and has little time for staffing matters between patients. Staff are few, so each role carries wide duties: the receptionist books, bills and answers the phone, and the assistant handles dressings, injections and tidying. Hours run in a morning session and an evening session, and a doctor's absence closes the practice. Pay, leave and notice tend to be agreed by word, and staff move on when a better offer appears. See also HR for healthcare.
- Plan
- Hire
- Onboard
- Manage
- Develop
- Perform
- Engage
- Retain
- Exit
- Improve
When HR is weak in private medical practices, you may see
- The doctor is also the HR department
- Everyone does everything
- Terms are verbal
- Split shifts wear people down
- Locum cover is arranged at the last minute
These are the places the people side of this kind of business tends to give way. The rest of this page works through them.
Who does the work in private medical practices
HR here has to work for each of these groups, not only the office. The set-up below is written with all of them in mind.
- Doctor-owners and partners
- Locum and visiting doctors
- Nurses and clinic assistants
- Compounders and pharmacy attendants
- Receptionists and billing staff
- Housekeeping attendants
- Part-time accountants
Where HR strains in private medical practices
The doctor is also the HR department
Hiring, pay and complaints are handled between patients, with no time or system.
Everyone does everything
Roles are not defined, so tasks are missed or duplicated, and nobody can say who owns which duty.
Terms are verbal
Pay, leave and notice are agreed by word and remembered differently, which leads to disputes at exit.
Split shifts wear people down
Morning and evening sessions with a gap between make the day long, with little recognition.
Locum cover is arranged at the last minute
When the doctor is away, the practice closes or a locum arrives with no briefing.
HR topics for private medical practices
Start with the topics that matter most here: Employee Administration; Organisation Design; Retention and Attrition Management. Then work through the rest. Each topic is written for healthcare, not in general.
Employee Administration
Records, attendance, leave and the day-to-day HR that must simply work.
Organisation Design
Structure, reporting lines and who is allowed to decide what.
Retention and Attrition Management
Who leaves, when, why — and which of them mattered.
HR Strategy and Workforce Planning
How many people, in which roles, by when — and what they will cost.
Recruitment and Talent Acquisition
Requisition to joining, the same way every time.
Onboarding and Probation
A first day that is the same for the fifth joiner as the first.
Compensation, Payroll and Benefits
Salary structure, payroll inputs and a month that closes on time.
Performance Management
Goals, reviews and ratings that hold up in a conversation.
Learning and Development
Training planned from need rather than from the calendar.
Career and Succession Management
Named backups for the roles that cannot be vacant.
Employee Engagement and Experience
Communication, recognition and the conditions people actually work in.
Employee Relations
Two routes — one for complaints, one for conduct — kept separate.
Policies, Compliance and Governance
Policies a manager can apply, and obligations with owners and dates.
Health, Safety and Wellbeing
Induction, records, incident reporting and follow-through.
Exit and Alumni Management
Resignation to relieving letter, in a defined order.
HR Technology and Automation
Records that survive people, and approvals that do not queue.
HR Analytics and Management Reporting
A short monthly pack management actually reads.
HR Operations and Governance
An HR function that runs the same way every month.
What a working HR set-up looks like
The pieces a private medical practices business puts in place, in an order that makes each easier. Open any card for the detail.
Write the roles on one page each
A short description of duties for the receptionist, assistant and compounder.
What this coversHide
Write the roles on one page each
A short description of duties for the receptionist, assistant and compounder.
What this coversHideA short description of duties for the receptionist, assistant and compounder. See role design and job descriptions.
Issue a simple appointment letter
Pay, hours, leave and notice in writing, signed by both sides.
What this coversHide
Issue a simple appointment letter
Pay, hours, leave and notice in writing, signed by both sides.
What this coversHidePay, hours, leave and notice in writing, signed by both sides. The HR documentation process shows what to include.
Make the split shift fair
A clear schedule, a weekly off that is honoured and extra pay or time off for the long days.
What this coversHide
Make the split shift fair
A clear schedule, a weekly off that is honoured and extra pay or time off for the long days.
What this coversHideA clear schedule, a weekly off that is honoured and extra pay or time off for the long days.
Prepare a locum brief
A one-page note on routines, records and contacts so cover is ready on short notice.
What this coversHide
Prepare a locum brief
A one-page note on routines, records and contacts so cover is ready on short notice.
What this coversHideA one-page note on routines, records and contacts so cover is ready on short notice.
Set a monthly people routine
One hour a month to check attendance, pay and complaints, so issues do not pile up.
What this coversHide
Set a monthly people routine
One hour a month to check attendance, pay and complaints, so issues do not pile up.
What this coversHideOne hour a month to check attendance, pay and complaints, so issues do not pile up. See fractional HR management.
Start by checking where you stand
Before changing anything, find out what is true today. These checks take an afternoon and tell you which of the topics above to start with.
Share your requirements- Write each person's duties on one page and see if they agree.
- Check that every staff member has terms in writing.
- Count how many days last year the practice closed because of cover gaps.
- Confirm with a qualified professional the registration and employment obligations that apply to your practice.
Confirm with a qualified professional. What applies to you depends on your business, your state and your arrangements, and it changes. This page describes practice. It does not state a legal position.
How GullyHR helps
The services below fit this kind of business best. Each starts by recording where you stand, and every later report compares against that. We do not promise outcomes.
- HR documentation
Appointment letters and written terms for every staff member, so pay, leave and notice are on record.
- Role design and job descriptions
One-page role descriptions that make clear who does what at the desk and in the consulting room.
- Attendance, shift and leave
A fair split-shift schedule with weekly offs and a simple leave record.
- Recruitment process
A route for finding and checking receptionists and assistants, and a locum bench for cover.
Start with a free conversation, or see the paid HR Diagnostic.
Our hospital HR transformation approach
- 1
Assess
Understand the hospital, its workforce, current processes and HR challenges.
- 2
Identify gaps
Find the missing, weak, inconsistent or person-dependent processes.
- 3
Design
Create the structure, processes, policies, SOPs, dashboards and systems needed.
- 4
Implement
Help HR and department managers actually adopt the new system.
- 5
Automate
Digitise repetitive and approval-based workflows where it is worth doing.
- 6
Measure
Track hiring, attendance, employee cost, performance, training and attrition.
- 7
Improve
Strengthen the people-management system continuously, not once.
Blogs worth reading first
From the GullyHR blog: one on HR in healthcare, and one on each of the topics this page points to.
HR Process
One employee, three versions of the record: fixing employee information management
Payroll says one joining date, the personal file says another and the manager remembers a third. How to establish a single trustworthy employee record and keep it that way.
7 min readRead article
HR Management
Everyone reports to the founder: when and how to redesign the structure
A flat structure works until the founder becomes the only route to a decision. How to tell when you have passed that point, and how to redesign without a reorganisation.
8 min readRead article
HR Management
How to recognise and address employee workload problems
How to spot an unmanageable workload before it becomes an exit or an error, what to look at, how to talk about it and what to change, without guessing.
5 min readRead articleMore on the GullyHR blog.
Questions owners ask
Yes. A short appointment letter with pay, hours, leave and notice protects both sides and costs very little.
Write down who handles booking, billing, records, injections and cleaning, and review it after a month.
Give a clear schedule, honour weekly offs and recognise the long day with pay or time off.
A one-page note on routines, records, contacts and any local practices, and a short chat before the first session.
Pay on time, define the role, offer a small step up in duties and pay, and treat the person as part of the team.
Quite practical. We would ask you to describe each person's duties, check whether everyone has terms in writing, and look at how often the practice closed because nobody could cover. A first piece of work might be one-page role descriptions and a simple appointment letter. Nothing starts until the scope is agreed with you in writing.
More on HR for healthcare
All 29 business types in healthcare · Find another business type