I learned the hard way how valuable a receptionist can be to a practice. They are the first person a patient sees, and often they are the most poorly paid person on staff. A good front desk person will set the tone for your whole practice, while a bad one can make everything more difficult.

A few years ago, I hired a receptionist whom I'll call "Carol." Carol was the nicest person, and at first she seemed like a Godsend. She graciously made coffee every morning (and it was good), and the patients appreciated her kind manner and attention to detail.

But slowly things started to unravel. Every staff employee is on a 60-day probationary period when they first start working at our practice. In Carol's case, those two months were the high water mark of her employment.

At first, she was a little tardy. As most of you know, a receptionist must hit the ground running every morning. They are the frontline and crucial to the start of any business day. Gradually, her tardiness stretched into days where she was sometimes a half hour late.

Eventually, she lost her temper with patients, and the pressure of answering the phones and maintaining a working knowledge of paperwork and scheduling caused her to be rude to the rest of the staff. It was like she'd burned out on the job within the span of four or five months. When she finally didn't show up for work one day, I was relieved.

I also realized that I allowed the situation to get out of hand. I let the employee dictate the terms, instead of taking charge of the situation. One doctor friend later told me that I was like a patient who didn't follow any medical advice, waiting for my condition to worsen past the point where I could no longer ignore it.

A medical office is a fast-paced environment, and the thought of training a new person can seem like an unnecessary distraction. As I've gained more experience, I have gotten a better handle on the various personalities which seem to fit. Carol was a knock-out in her interview, but I do recall that she didn't stay any one place too long on her resume. At the time, her references checked out, and she had a smooth line for why she hopped from job to job. Now when I see that, I view it as a warning sign. I also instituted background checks, and lobbied to make the receptionist position better paying.

Our current receptionist is tremendous. She not only works the phones expertly, and treats every patient with great care, but she also goes the extra mile. When a day is busy (which day isn't?), she will often gauge the mood of the waiting room, and let the staff and doctors know when to tread lightly.

Granted, the quality of medical care is what establishes a practice, but the face and demeanor of the person who greets every incoming patient is what gives it a personality.