Employee Performance Review Mastery in Ophthalmology
Performance reviews should be mainly future oriented.
For many ophthalmology practices, the annual performance review is a necessary evil—a bureaucratic exercise to justify raises and check an HR box. But in a high-stakes clinical environment where healthcare staff retention is critical, treating performance reviews as a backward-looking formality is a costly mistake.
The truth is, your annual review process is one of your most powerful tools for improving employee engagement in clinics and ensuring your team members feel valued, developed, and motivated to stay. It’s time to transform the traditional performance review into a Performance PREview—a forward-focused conversation about growth and potential.
The Strategic Shift: Focusing on the Future, Not the Past
The most critical change you can make to your performance review process is changing the emphasis from looking backward to looking forward. Your goal should be to align the employee's development with the clinic’s strategic needs for the coming year.
Here is how you can implement this forward-looking mindset:
Make it a "Performance PREview." Dedicate the majority of the conversation to the next 12 months. What specific goals will they set? What new skills will they acquire to better support patient flow or advanced procedures? Use the simple framework: What should we start, stop, and continue doing to elevate performance?
Make growth the central focus. Don’t miss the opportunity to discuss your employee’s long-term career aspirations. Ask: "Where do you want to go in your career in the next two to five years, and how can we help you get there?" This demonstrates a commitment to their future, which is a key driver of staff retention among high-potential employees.
Solicit ideas for clinic improvement. Performance reviews are a prime opportunity to leverage your team's on-the-ground knowledge. Ask them for their ideas on improving the department or the clinic as a whole—from optimizing the patient check-in process to streamlining surgical scheduling. This empowers them and boosts employee engagement.
Spend enough time on the past to help you understand and plan for the future.
Ditching Formulas: Making Pay and Feedback Flexible
Many practices try to fit complex human performance into rigid formulas—a strategy that often backfires by frustrating top performers and creating unnecessary HR challenges in healthcare.
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Performance reviews are not chemistry experiments. Having multiple weighted ratings that lead to a single overall score is a recipe for failure because human performance doesn't fit into a tidy formula. My advice:
Focus on narratives, not numbers. Instead of spending time arguing over a 4.2 versus a 4.5 rating, focus on detailed, written feedback that clearly explains the employee's impact and next steps for development.
Allow for documented deviations. While using a guideline for pay raises is helpful, it’s crucial to allow for flexibility. A top performer with high potential is often harder to retain and should receive a higher raise to maximize your ability to keep them. Ask managers to document any requested deviation from the guideline with specific, compelling reasons tied to retention and performance impact.
Merit Pay Is Not a “Reward”
Most clinics view the annual pay raise as a reward for past performance. However, psychology tells us that a reward that arrives just once a year is not a very effective motivator. The annual pay raise should be viewed primarily as a retention tactic.
To truly motivate and reward:
Focus on timely, regular rewards. Implement spot bonuses (even small ones) given immediately after an employee resolves a crisis or goes above and beyond. Consider mid-year promotions or title changes to reward sustained excellence.
Appreciate consistently. Regular verbal expressions of appreciation—specific, sincere, and timely—are far more impactful than waiting for a single, annual conversation.
Use the raise to secure your top talent. Your goal should be to raise the pay of your team in a way that maximizes your ability to retain your best performers. Better performers with high potential tend to be the hardest to replace, so they should be prioritized for higher pay increases.
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Avoid the Whitewash Rating
Never give an employee an overly high or satisfactory rating that doesn’t reflect their true performance. This hurts the employee by giving them a false sense of security, and it severely hurts your clinic. The worst part is that if you ever have to let this person go due to continued poor performance, you will have to defend why you previously gave them an excellent or satisfactory rating. Don't put yourself in that legally vulnerable position.
No Surprises Allowed
The annual review should never be the first time an employee hears about a performance issue. Surprises in a review destroy trust and make the entire process ineffective.
Give feedback during the year. Make consistent, informal one-on-one conversations about performance and progress a standard practice. If you are waiting for the annual review to give direction or praise, you are failing your employee and your clinic.
Delay the review if needed. If you feel you are about to drop a bomb on someone with negative feedback they haven't heard before, delay the review. Explain the situation and give them 60 to 90 days to elevate their performance. This gives them a fair chance and strengthens your position later if they fail to improve.
Navigating the legal, emotional, and financial complexities of annual reviews requires specialized knowledge and consistency. If you're looking for tailored strategies to ensure your performance management process is driving HR compliance for medical practices while boosting staff retention, you don't have to navigate these issues alone.
Ready to transform your annual review from a compliance checkbox into a strategic retention tool? Let’s connect. Visit my services page to learn more about how fractional HR can empower your healthcare practice.
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