Before You Hire – Part 1

Ask This One Question Before you Hire in Your Weight Loss Practice 

If you lead a bariatric, medical weight loss, or lifestyle medicine practice, you have probably heard the statement, ‘We need another person.’ You may have said it yourself just this week. The phones keep ringing. Patient follow-up is slipping. Your team is stretched thin, and you are answering questions long after the last patient has left. 

Hiring feels like the obvious next step. You need relief, and another set of hands sounds pretty good. Sometimes, that is exactly what your practice needs. But before you post a job opening, I encourage you to pause and ask: 

Is this a workload problem or a workflow problem? 

The answer can save you from adding an ongoing expense without solving the issue that made everyone feel overwhelmed in the first place. 

When a Busy Team Needs a Better System 

I have encountered this situation in both practice and health system settings: leadership is convinced another care coordinator is needed because the current coordinator is completely swamped. 

Patient calls are not getting returned consistently. Follow-up is falling through the cracks. The coordinator leaves each day feeling behind, exhausted, and frustrated. 

From the outside, it looks like a staffing shortage. 

But when we look more closely, the problem becomes clearer. There is no documented follow-up process. No consistent next step for patients at different stages of their journey. Too many interactions require the coordinator to stop, figure out what should happen, and sometimes track someone down for an answer. 

She is essentially rebuilding the process every day. 

In the situation I discussed on a recent podcast, putting a clear system in place allowed the existing coordinator to manage the volume comfortably. The practice avoided a hire it had been ready to make. 

That does not mean every overwhelmed coordinator can absorb more patients with a checklist. It means we need to understand what is creating the pressure before deciding how to relieve it. 

Hiring into a broken workflow gives you a better-staffed broken workflow. 

And now you have another person to train in a process that still is not clear. 

Listen to Your Team, Then Look at the Work 

When your team says they need help, take it seriously. Asking about workflow should never become a way to dismiss their concerns or ex

pect them to keep doing more. 

Instead, get curious with them. 

Where does the day get backed up? Which tasks require repeated clarification? What information gets entered more than once? Which responsibilities have no clear owner?

For example, “patient follow-up” may sound like one task. In reality, it could include responding to new inquiries, reaching patients who missed consultations, checking on outstanding requirements, and helping patients understand their next step. 

If all of those activities sit on one person's mental to-do list without a system that supports personalized automation, even a capable employee can struggle. 

Before deciding you need another employee, look at the volume of work alongside the time, tools, and decisions required to complete it. You may discover a true capacity gap. You may discover a process that needs improvement. You may discover both. 

That is useful information to have before you add to your payroll. 

Start With the Work Before Choosing the Job Title 

Another issue I see is a mismatch between the position a practice plans to fill and the work it actually needs done. 

A physician may tell me, “I need a medical assistant.” 

Then we talk through the responsibilities, and the biggest needs are managing patient communication, following up after consultations, and keeping patients moving through the program. 

Those needs may point toward a care coordination role, dedicated time for an existing team member, or a position with clearly defined responsibilities across more than one area. 

The same thing can happen when a practice asks for front desk help but describes a need for marketing outreach and lead follow-up. Those activities require different skills, priorities, and measures of success. 

In a small practice, one person may wear several hats. That can work well when the expectations are realistic and the person has the appropriate training and qualifications. Typically, cross training is also needed. 

The difficulty comes when “help wherever needed” becomes the entire job description. 

Write down the work first. Then determine the skills, available hours, and qualifications needed to do it well. Choose the title after that. 

A title matters for recruiting and setting expectations. But the title alone will not tell a candidate (or your team) what this person is expected to accomplish. 

The Cost of an Unsuccessful Hire Goes Beyond Salary 

When you are exhausted, it is easy to focus on how much better things will feel once someone starts. I understand that. But a new employee also needs your time and your team's attention before they can contribute independently. 

Recruiting, interviewing, training, and answering questions all take resources. If the role is unclear or onboarding is rushed, the existing team may end up carrying its usual workload while also trying to figure out what the new person should be doing. 

Patients can feel the inconsistency, too. They may receive different answers, repeat information, or wait while staff members determine who is responsible. 

And when a hire does not work out, the strain can linger after that person leaves. The employees who covered the gaps remember the experience. 

Sometimes the person was not a good fit. Sometimes the practice never gave the person a clear role or a reasonable opportunity to succeed. 

A thoughtful hiring process considers both. 

Four Questions to Answer Before You Post the Position 

You do not need a complicated hiring strategy to make a better decision. Start by answering these four questions in writing. 

1.  What will this person own? 

Be specific about the responsibilities and expected results. “Help with patients” leaves too much room for interpretation. “Manage follow-up for patients after their initial consultation and keep their next steps documented” gives you a clearer starting point. 

Identify what this person will handle independently, when they should ask for help, and how their work connects with the rest of the team. 

2.  Who has time to train them? 

Someone needs to own onboarding. That includes teaching the workflow, providing access to the right tools, explaining expectations, and checking progress. 

If everyone is already at capacity, decide how you will make room for training. A new hire should not have to piece together the job from hurried answers between appointments. 

3.  What process improvements should we make first? 

Consider whether clearer ownership, standard follow-up steps, better scheduling, or more effective use of your existing technology would address part of the problem. 

You do not need every system perfected before hiring. You do need enough clarity to understand the gap you are hiring someone to fill. 

4.  What should success look like after 90 days? 

Define a few realistic outcomes. Depending on the role, these might include independently managing a workflow, completing assigned follow-up within your practice's established time frame, or maintaining accurate patient pathway records. 

Give the person measures they can influence and the support needed to achieve them. “Make my life easier” may describe your hope, but it does not give a new employee a useful target. 

A Simple Exercise for Your Next Team Meeting 

Before opening a position, ask your team to help create a list of work that is not getting done, or is taking longer than it should. 

For each item, identify who currently handles it, how often it occurs, and what gets in the way.

You might find that several people are touching the same task. You might find a recurring question that could be answered with one documented process. Or you might find a substantial amount of necessary work that simply exceeds the hours available. 

Use those findings to decide what to improve now and what a new employee would actually take ownership of. This gives you a more useful hiring conversation than, “Everyone is overwhelmed, so let's add someone.” 

Give Your Next Hire a Clear Path to Success 

My goal is not to talk you out of hiring. The right person in a well-defined role can make an incredible difference for your patients, your team, and your ability to lead. 

I want you to make that decision with clarity. 

Before you hire, understand the work. Address the workflow issues you can identify. Define ownership, make room for training, and decide how you will measure progress. 

Then, when you add someone to your team, you can explain exactly how they will contribute and what success looks like for their position. This gives them a much stronger start. 

Need help getting clear on your next step? Visit Weight Loss Practice Builder's free resources for tools to help you assess and strengthen your practice. If you would like support identifying whether your biggest gap is staffing, systems, or both, reach out to me. We can talk through where you are and what would help you move forward.