My nephew is a gourmet chef. When he became an executive chef at a fine restaurant in Miami, he invited me to dinner. I enjoyed an exquisite meal with fine wine and impeccable service.

After dinner I asked the waiter if I might see the kitchen. He promptly whisked me off to a small, hot, aromatic area where wonderful cuisine was being created. As we stepped into the kitchen, I heard my nephew expressing his opinion on the preparation of the meal, while peppering his comments with expletives and salting the air with rude gestures. I was pretty shocked and told my nephew so. "That's how it's done," he informed me. "My first chef threw a knife at me and fired me four times."

Ten years later, I mentioned the incident to my nephew and asked if kitchens in fine restaurants were still run in that way. "Nope," he replied. "Times have changed—human resources, you know. Frankly, I miss the drama, but I probably get more productive work from everyone when I mentor instead of yelling."

Then and Now

At my first job, my boss made it quite clear that he owned me from nine to five. Whatever he asked me to do, I did, because he signed the checks. The expectation was that I would take pride in the accomplishment of whatever tasks my boss threw my way. There were no hints of performance or salary reviews. If the boss remembered that you hadn't had a raise in a while, you got one.

In the early days of our practice, we hired smart people with good skills. We gave them an hour of orientation and turned them loose to figure out things on their own or, perhaps, with help from fellow staff members. If they worked out, we promoted them, so they'd learn more at what we hoped would be a higher level.

We were happy to have people to do the work; they were happy to have a job. Nobody ever asked us about career paths, benefit packages or profit-sharing plans. Job descriptions and operations manuals were for employees of IBM or Ma Bell. We all worked the hours necessary to get the job done, and no one ever used the phrase "balanced life."

A strange thing happened as this industry made the journey to professionalism: We started to move our practices toward professionally managed businesses. Almost overnight, new hires were asking us for offer letters, exploring our benefits and inquiring about career paths. While we felt a bit defensive about this, we realized that by formalizing our management practices, we could attract better employees with more potential for growing with the company. We began to develop a formal interview process to screen job candidates. Screening aside, it was what we did with new employees that made the difference between success and failure. This began with our attitude toward them.

Learning from a Hospital

There's a Harvard Business School case study on Shouldice Hospital, a hernia care facility in Ontario, Canada, that I've always found instructive for companies seeking to improve the way they bring new staff members aboard. From the first day, Shouldice staff members receive a high level of company support. The hospital leaves no room for misunderstandings about how any job should be performed. Everything is well planned and executed, including the amount of contact staff members have with patients on a daily basis. A good example of this emphasis on training can be seen in the way the hospital prepares physicians for surgeries. New doctors must observe surgeries for a period of time before they can enter the operating room alone.

This support for valued staff members comes in lieu of firing them when they're going through troubled times. For example, when a few incidents of drug or alcohol abuse were uncovered, offenders were sent to rehabilitation, supported through their ordeal and returned to full-time positions when they were ready.

To improve working conditions, Shouldice maintains an open communication policy to elicit opinions and advice from staff. But once a decision is made, they understand their responsibilities and meet them consistently.

While formal policies make it easier for employees to act and work professionally, the primary reason for the hospital's management success is the way the institution "onboards" new staff members. Onboarding is a method of assimilating new hires into the company environment. It's how new employees learn what is required of them and learn about the history of the firm, the company's culture and its strategic vision. Shouldice spends a significant amount of time orienting new surgeons to its philosophy, culture and discipline.