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Let’s be real: when you first open your doors, you’re wearing every hat. Receptionist. Technician. Biller. Janitor. Doctor. CEO. I was trying to stay LEAN. HIRING is important but it wasn’t a major priority week 1.
So naturally, the moment things get busy, your first instinct is to hire fast — just get someone in to help and breathe again.
But if there’s one decision that can make or break your culture, it’s this one.
I waited four months before hiring my first employee. Not because I didn’t need help (trust me, I did), but because I had two clear priorities:
- I wanted to learn the entire operation inside and out — from insurance verification and billing to answering phones and checking in patients.
- I didn’t want to hire someone just to survive. I wanted to hire someone who would grow with me.
That patience paid off.
1. Your First Hire Sets the Tone for Everything
A lot of doctors hire based on experience — who’s worked in a clinic before, who knows the EMR, who can “hit the ground running.”
I took the opposite approach.
I wasn’t looking for someone with ophthalmology experience. I was looking for someone with the right values:
- Someone who was kind to patients
- Willing to work hard
- Able to adapt to a lean, startup-style clinic
- And who believed in what we were building
Experience is teachable. But culture? That’s foundational.
2. Hiring Luck: Meet “Sarah” — My First and Best Hire
For anonymity, we’ll call her Sarah. But she knows who she is.
When I hired Sarah, she didn’t have a stacked resume in eye care. But what she did have was:
- Hustle
- Emotional intelligence
- A deep sense of ownership
She cared about patients. She learned fast. She never said, “That’s not my job.”
Since then, she’s taken on more responsibility than I ever imagined. I’ve given her several raises and promotions, and my plan is for her to become our future practice manager across multiple locations.
It wasn’t luck. It was the result of being deliberate and patient in who I hired.
3. Where to Find the Right People
This is a question I get all the time: Where do I actually find people like Sarah?
Here’s what I’ve learned:
🔍 Online job boards are hit-or-miss
You can try Indeed, ZipRecruiter, even LinkedIn — but the truth is, you’ll get a wide range of candidates, and many of them will ghost you, apply without reading the job, or be totally unqualified.
📱 Local Facebook groups can work
Posting in neighborhood “jobs” or “community” groups can surface people nearby — especially if you’re offering part-time or entry-level roles. Just be ready to filter.
💬 Ask your friends
One of the most underrated hiring sources is your own circle. Ask:
“Do you know someone who’s great with people, looking for a job, and hungry to grow?”
You’ll be surprised at how often this works — and they’re already partially vetted.
🔁 Word-of-mouth is gold
Referrals from friends, staff, or even patients have the highest hit rate in my experience. When someone puts their name behind a candidate, it means something. Those hires are usually more committed, more coachable, and longer-lasting.
Bottom line? Culture fits are rarely found in a cold resume pile. They’re discovered through conversations and relationships.
4. Who to Hire First (and When to Do It)
Here’s the typical order for most solo practice owners:
- First Hire: Receptionist — the face and voice of your brand
- Second Hire: Tech/Assistant — doubles your clinic efficiency
- Third Hire: Biller/Office Support (can be remote or part-time)
And don’t wait until you’re drowning. Hire before you’re desperate so you can train with intention.
5. Hire for Culture — Not Just Capability
Here are the traits I prioritize:
- Positive attitude
- Accountability
- Curiosity
- Empathy for patients
- Willingness to learn
Skills can be taught. Culture cannot.
And when you’re small, every hire makes a huge cultural impact — good or bad.
6. Set the Foundation for Growth
From Day 1, I told Sarah, “This is not just a job. It’s a business we’re building together.”
She knew I planned to grow. She knew I wanted her to grow with me. And she showed up every day with that mindset.
That’s what turns a hire into a leader.
Final Thoughts
When you’re small, every person you bring in either adds horsepower — or friction.
Don’t hire just to plug a hole. Hire to build a foundation. Ask your network. Be patient. Prioritize people who care about the mission more than their resume.
Because if you get this right? You won’t just survive.
You’ll scale with people you trust.
Next Up: Can You Afford to Pay Yourself?
We’ll dive into how to pay yourself in the early years while balancing growth, taxes, and lifestyle goals.
