Why the Role Should Survive the Individual
Most staffing failures are not hiring failures. They are documentation failures that only become visible in the week someone leaves, and they cost far less to fix before that week than after it.
Every practice I have worked with has told me a version of the same story. They found someone good. That person learned the schedule, learned the doctors, learned which insurer needs the call made twice. For a year, everything ran. Then the person gave two weeks' notice, and within a month the practice was two hundred charts behind and nobody could say exactly why.
It is tempting to call that a retention problem. It is more accurate to call it a design problem, and the design decision was made long before anyone resigned. The practice hired a person and never built a role. When the person left, the role left with them, because it had only ever existed in their head.
The Difference between a Person and a Role
A person is who shows up. A role is what has to happen whether or not they do. The distinction sounds academic until you try to hand one over. If everything you can say about a job is the name of the individual doing it, you do not have an operation. You have an arrangement, and arrangements end.
At Berry Virtual we learned this the expensive way. We bootstrapped the company from nothing to roughly $3.5M in annual recurring revenue, and the accounts that hurt most when we lost them were rarely the ones with a service problem. They were the ones where a client had fallen in love with one specific person on our side.
The obvious fix, trying harder to keep everyone forever, is not a strategy. People change jobs, move cities, have children, get promoted. Designing an operation on the assumption that nobody ever leaves is designing for a world that does not exist.
What a Durable Role Actually Contains
A role that survives its occupant is not a long document. In my experience it fits on two pages, and it answers four questions that most job descriptions never touch.
- What comes out of this seat each week. Not responsibilities, outputs. Claims submitted, calls returned within the day, prior authorizations moved from open to closed.
- Where the inputs come from. Which system, which inbox, which person hands off what, and at what time.
- What to do when something is unusual. The escalation path, written as a sentence a new person can follow on their second day.
- What “good” looks like numerically. Two or three numbers, checked weekly. Not a dashboard.
Written that way, the document is not bureaucracy. It is the only asset that stays behind when a person leaves, and it is worth more than the two weeks' notice you are usually given.
The Test: Could Someone Else Hold This Seat in a Week?
Take any seat in your practice and ask what it would take for a competent stranger to hold it in seven days. Not to be excellent at it, just to hold it. If the honest answer involves shadowing the current occupant for a month, the role is undocumented.
What This Changes about Hiring
Once the role is written, hiring gets easier in a way that surprises people. You stop looking for someone who will figure it out and start looking for someone who can do the four things on the page.
At Staffing For Doctors, the same principle guides how roles are defined before recruiting begins.
“We don't have a staffing problem. We have a Maria problem, and Maria is wonderful, and Maria is moving to Phoenix in April.”A practice manager, describing the situation accurately
Start with the Seat You Are Most Afraid Of
You do not need to document the whole practice. Pick the one seat whose departure would ruin your month, and spend two hours with the person in it writing down the four answers.
Every practice eventually loses the person. The only thing decided in advance is whether it also loses the week.
Danny Nabavi is the Founder & CEO of Staffing For Doctors. He previously co-founded Berry Virtual, bootstrapping it to approximately $3.5M ARR before its acquisition in 2023.
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