So what does this old saw from Silicon Valley really mean – and how can it help your medical practice?

Just like in Silicon Valley startups, medical practice teams are usually small enough that every person has an important role to play. When a key position in your practice is vacant, near-desperation can set in if the right candidate doesn’t materialize quickly. That can lead to hiring impulsively and compromising too much on important traits, skills, or knowledge.

Because even the best candidates will have a learning curve, you probably won’t realize you’ve made a bad hire for months. Those extra weeks that you “saved” by not extending your search to find a stronger candidate will, in retrospect, seem trivial in comparison to the lost benefits of having the right person in a key position.

When a key role is held by an underperformer, your entire practice is dragged down. But – just like in the tech startup world – the small size of practice organizations can feel family-like. In fact, that’s one of the most appealing aspects of working in an independent practice. However, that close-knit culture can make it hard to confront under-performers, who wind up staying in their jobs longer than they should. Physician owners and practice administrators often move slowly in dealing with performance problems out of compassion for the underperformer – not recognizing that their other employees are picking up the slack and, in effect, being penalized for doing a better job.

Hire slow, fire fast is an important lesson mainly because most people’s natural tendency is to do the opposite – hiring too fast out of urgency, and firing too slow out of misplaced kindness. Both of these can lead to having the wrong employees in place for far too long, dragging down performance and morale in your practice.

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