Chapter 06
Staffing a small team
In a small practice every person is a single point of failure, and the only question is whether that has been planned for.
06.1The spare-capacity problem
A large organisation absorbs an absence. A practice of four does not: one person away is a quarter of the capacity gone, and the work does not shrink to match. This is not a management failing, it is arithmetic, and it means small teams have to plan cover in a way larger ones never do.
Planning cover means knowing, before it is needed, who does what when each person is out. Written down, it takes a page. Improvised on the morning, it takes the day.
06.2Cross-training as insurance
Cross-training is usually described as development. In a small practice it is insurance. The specific goal is that no routine task — opening, booking, filing, the billing run — can only be done by one person.
The cheapest version is rotation: the second person does the task occasionally while the first is still there to be asked. Training that only happens in an emergency is not training; it is a handover under the worst possible conditions.
06.3Handover notes
Most small-team failures are handover failures. A conversation was had at the counter, an arrangement was made, and it existed only in the memory of someone who is now not here.
A single shared place for anything that outlives the shift — an arrangement, a promise to call back, a thing to watch for tomorrow — removes most of that category. It works only if it is one place. Two places is the same as none.
06.4What turnover costs at the desk
The visible cost of replacing a front-desk role is recruitment. The larger cost is the period on either side of it: the weeks before, when the departing person is disengaged, and the months after, when the practice is answering its own questions more slowly.
This is the strongest practical argument for written procedures. They do not prevent turnover, but they change what leaves with the person.
06.5Meeting without meetings
Small teams see each other constantly and communicate badly, because everything is discussed in passing and nothing is decided. A short fixed slot — fifteen minutes, weekly, with someone writing down what was agreed — is usually the entire fix.
The written part is what makes it worth the time. A decision that is not recorded will be relitigated, generally at the counter, generally in front of someone waiting.