Over the last two weeks I have been interviewing candidates, and I asked every one of them the same question: why are you leaving? The top answer was not money, PTO or benefits. It was career growth. In this episode I share what that means for your practice and how we run our own hiring process. Build a career ladder for every role. Growth does not have to mean management. Front Desk Coordinator I, II and Lead Front Desk give people a next step. The same works for MAs, NPs moving toward partnership, and physicians on a partner track. Map year one, two and three. Start people where they are, then add skills like eligibility, prior auths and patient workflow so year three still feels challenging. Often those tasks come off your plate or your office manager’s. Tie raises to responsibility. Instead of an automatic 2% raise every year, attach a small raise to mastering the next level. Culture matters too: trust, autonomy and input keep people. Give tech-savvy staff a real project. Evaluating AI vendors or automation, or running HIPAA-compliant social media and website updates. Carve out the time so it is real. Hire in two interviews. We use an Indeed automation, a short VideoAsk screen with four or five questions to see presence and communication style, then the top three meet me and our leadership panel. Three actions this week: • List every role in your practice and write the next level for each one • Pick one tech-savvy team member and give them one defined project with protected time • Add a short video screening step before your first live interview Episode breakdown: • 0:00 Why we are talking about hiring • 0:32 The number one reason candidates leave • 1:25 What career growth really means • 1:54 Building a career ladder for front desk and MAs • 2:51 Mapping year one, two and three • 3:21 Tie raises to mastery, not the calendar • 3:47 Culture: trust, autonomy and input • 4:46 Give tech-savvy staff an AI project • 5:40 Leveraging social media skills (HIPAA-safe) • 6:06 Our hiring process: Indeed automation • 6:34 Screening with VideoAsk • 7:31 Two interviews and a panel • 8:00 Wrap up