One of the challenges facing many medical practices is how to effectively and uniformly administer the human resources (“HR”) function across a number of offices, oftentimes with a diversity of cultures and historic practices. This article is not going to focus on HR issues unique to a medical workplace, but rather the HR issues unique to multi-location operations and the unique HR opportunities and challenges those pose. As the administrative work historically associated with a large part of the HR function are capable of being performed by computers or entry-level individuals, and the legal mandates in the workplace become greater and more complex, many organizations are wrestling with how to both gear up the strategic and compliance capabilities, while pushing other administrative items down to the appropriate level, or even outsourcing. As employment law advisor to many medical practices, I have seen many examples of what does and does not work in this industry.

There are several benefits to effectively implementing what is sometimes referred to as “shared HR services.” It allows a “total solution” and “total approach” to problems by centralizing the HR function, rather than having it administered in whatever number of offices may be involved in your Practice. On the conceptual level, this approach allows the hiring of a high-level HR professional who has the capacity, and also the work and educational capability, to provide strategic advice at the highest levels of the organization in the administration of the HR function, broadly including recruiting, training, compliance, benefits, and productivity. This person can interface with legal counsel and the Board of Directors of the organization in the strategic function, helping the business to successfully execute strategy. Another component of the centralized office are administrative experts who can improve organizational efficiency by making sure that the HR function and other work processes, including benefits administration and tracking legal compliance item such as use of FMLA leave by employees across the organization, are consistent with the needs of the specific organization and its employees. A third skill set that is required in the multi-office environment are the individuals that interface with the office managers and staff to assure consistent enforcement and administration of HR initiatives and policies among all offices. This position would be responsible for providing or initiating training; being available for daily consultation as workplace issues present themselves to the office managers; and periodic visitation to offices for feedback and understanding. These individuals would be critical to implementing best practices in the HR world, and assuring that staff morale does not diminish through feelings of alienation or distance. With the benefits above, there should be improved career development for all staff development and training, while obtaining efficiencies in the professional provision of HR services.

Critical to the success of a centralized HR function is that the office managers understand the critical need for uniform administration of consistent policies across the organization, by referring HR issues to the appropriate HR professional, rather than handling it themselves (and freeing the Office Manager for other tasks). In any
organization, it is lack of consistency that most often turns workplace decisions into claims that will need to be addressed either in settlement or in litigation, as there is disparate treatment of individuals by managers who may not have known what others were doing and have treated individuals in different classifications differently, even if there is no difference in the demographics of the individuals involved. Hopefully the organization can obtain better management information by consistently gathering information across an organization, rather than the practice management only hearing about HR issues after they have become a problem.

On the other side of the coin, issues that need to be addressed which can undercut a centralized HR function in a multi-office environment is the loss of face-to-face contact; employee involvement with the HR management staff; a lack of ownership of Human Resource problems at the office level; and possible IT problems with an extended network.

Management should also be aware that a smooth transformation to provision of centralized HR services is critical in assuring that the efficiencies and enhanced benefits of a centralized model are not lost. In that regard, management needs to define and achieve business goal as early as possible. The centralized HR group must be extremely diligent initially so as to be taken seriously be other management, particularly office managers. It is important that office managers understand what the process will look like. Initially also, there should be a high visibility of the central HR staff in the offices to help with buy-in and confidence around the new model.

In summary, management needs to consider strategic issues as to why an enhanced, upgraded central HR function is useful; consider how it will affect the business strategy, understand the relationship between the HR professionals, office managers and line managers, and how it will provide both day-to-day administrative support while providing the strategic input at the corporate level. Management will need to be very attentive to managing the change process from the current system, oftentimes one of a laissez-faire management with office managers being relatively empowered versus centralized management. Operational issues will need to be considered with regard to location and access. Finally, there needs to be understanding of what changes and goals are reasonably expected from the process to avoid failure of implementation. And while this model may not work for all, it is one that can provide significant improvement in recruitment, compliance, risk avoidance, and efficient provision of benefits and other employee programs. With a commensurate improvement to the bottom line.

About the Author

Randy’s practice focuses on all aspects of labor relations and employment law. He handles the full spectrum of the employment relationship from pre-hire procedures to post-termination closure, including unemployment compensation and statutory compliance issues such as Title VII, ADA, FLSA, FMLA and OSHA compliance. Randy negotiates, drafts, and enforces contracts protecting client’s rights in all aspects of the employment relationship, including employment and separation, confidentiality and non-competition, intellectual property protection, and independent contractor arrangements.