Coaches Corner - Teachability Wins: Hiring, Training, and Standards of Care that Stick

(upbeat music) Welcome to the Shared Practices podcast. I am back with Caitlin Embry, and we are doing another coaches' quarter episode today. And we're gonna talk about hiring, the thing that is terrifying in dentistry sometimes because it feels like an uphill battle depending on what position we're hiring for. And it sometimes holds us hostage because we're so paranoid and worried of like, oh no, if I lose it, a key team member. And this is one of the big challenges in dentistry is that we have so few team members. We're not a corporation of 100 people that it hurts when someone leaves and we kind of get into this panic mode of, oh no, we gotta start over and find someone and train them and all of that. So I think we wanna ease that pain today. What are your thoughts, Caitlin? - I think it's an important episode because turnover is inevitable and a lot of the conversations I've had as of late are okay, I'm sifting through resumes and I've met with a couple of people and you really like this one person because of their wonderful personality and they were just awesome on the phone and everyone could just love them and they walk in the office. They don't have a lot of experience though, maybe hardly any versus we have had other applicants with many years of experience. They'd probably be plug and play. You know, how do we choose between these two? Are we hiring for attitude or are we hiring for skill? And what happens when you don't have both in one person, you know? - Yeah, it's interesting when I think about this last entry and in-point office that I really was the main provider and running. There's three team members I can think of that were surprisingly really young. Like they were fresh out of high school, like 1920 or maybe there was one who had a college degree but not any dental experience, all three of them. Did not have dental experience. One was applying to dental school. The other one wanted to be a hygienist and the other one had a degree. So you know, interestingly, they all were seeking higher education in one shape or form. They were all smart so they could acquire skills and they were self-motivated and they were our best team members, like hands down but we had to train them on everything. They didn't know anything but it wasn't a problem because of who they were and then also the ability to articulate. Here's what our standards of care are. Here's what we expect of you and how to do it. It wasn't a big deal to not have that dental experience that we had to unlearn and unteach. So I wanna hear from you both are current clients that you're working with and that you've seen over the past years, but also yourself. Like, you know, what are you seeing amongst our clients? And where would you lean personally? If you had to hire how much for the different positions would you care about dental experience? - So I believe there should be entry points to dentistry in each practice. I think there are certain positions in the front office. For me, I would usually say the patient care coordinator. That's kind of their entry. We might hire someone who has experience and maybe that's super plug and play and easy but we might actually use that as a chance to give someone a way into dentistry for the first time and start teaching them there. You know, that is very much reception duties and then some. It's ideally we're really obsessed with the hygiene schedule when we teach them the hygiene codes first and kind of get their feet wet that way and then eventually move on to learning the doctor's chair side of things. And so if we're hiring for that position, I'm definitely hiring for attitude. As an example, they're because that's the face of the practice. That's that smiling face when you walk in the door. That's that wonderful bubbly voice over the phone. So in that scenario, if I had to choose, honestly, I might go personality there and somebody I just want to be around but I know my patients will want to be around because I can teach from that level. Now, if I'm hiring for treatment coordinator, that's one where you might need to hire someone at least with some assisting background suddenly like that 'cause it's hard to not know the dentistry at all and be talking dental treatment and financial arrangements when you don't know what any of that means. But I think hiring in that PCC role, starting to cross train them early and then moving that person up into a TC role, if you know there's that need there and then starting over in the PCC could be a way to solve that, right? And then to your point in dental assisting, you know, I've had some clients with busy practices that I've said, okay, we need another assistant, we need someone with experience, place an ad, see who you've got and I have some clients who have huge hearts and they hire like the person who's been a patient for 10 years and has always wanted to get into dentistry and it's like, you didn't even place the ad but you're kind of giving yourself this hardship of training this person. But if it sometimes it works out great to your point, right? It's like, no, this is someone who really wants to work for me and we've got the time to train them. So, you know, I know it's a great area but I think sterilization tech is an example. They start there, they're training rooms, they're doing sterilization and then slowly they can learn the chair side. - And also depends on, you know, state regulation and what people can, and what certifications and all that. But, you know, going back to those front desk, front office positions with the patient care coordinator answering phones and being like friendly and nice and being someone that like can be resilient when a patient's upset that can just handle stuff and fill the schedule. Those are things that those personality traits I think are harder to train than the skills of the position. I also think with treatment care coordinator that sales is one of those that's really hard to train. It can be done and we can give them frameworks and in dentistry, unless you're doing like really high end, 10, 15, 20, $40,000 treatment plans, maybe that isn't the kind of end-all be-all. But someone who can really comfortably talk about money and advocate for the patients, you know, we say sales and sometimes that's a dirty word. But, you know, really like I see the best person there as the person who can advocate for the patient and say, I really want you to get this dentistry done. I want you to be able to get it done now so that it doesn't hurt more and cost more in the future. And how can we get that done for you and get that done in as few visits as possible? Find solutions. But you're right, there is this like, if you don't understand all the codes and the technicalities and the back end, it's much harder to maybe train those than those other positions. So it's a weird trade-off of like, it kind of depends on what's your bottleneck. And if you're doing larger cases, then that might push you back towards case acceptance and kind of quote unquote, sales experience, trumps a little bit the other skills because that's harder to find and train. So I do think the needs of the practice can oftentimes bias or dictate how you lean in these situations. (upbeat music) One of my favorite experiences as shared practices is when I met Suzanne and we began the process of really taking what was an idea that I had into what is now a very robust practice management philosophy. And you may have heard of our philosophy. We call it hygiene-led growth at times. We talk about the dental three pointer. We talk about profitable, simple, sustainable. We maybe talk about our avatars. You're starting avatar, you're point A, maybe your point B avatar. All of this language that we use now is there was a story that I told where the key idea that I had that led to our philosophy was I had the idea that if you just grow the hygiene department, the practice will grow on accident. And so you can maybe think about that as a core idea and then build a whole practice management philosophy around growing the hygiene department as aggressively as possible. And so I was in the room with Suzanne and I was telling her about this idea. And Suzanne has, I would call it exceptional infrastructure experience prior to that. She had been a lead for 37 in office consultants going into practices all over the country. And so she had so much knowledge on how to execute practice management. And as I was explaining this idea, she had this moment of frustration where she was like, man, she didn't use man, she was the cuss word. And she said, why didn't I think of this? And then what happened from that was that idea that founded the shared practices philosophy combined with Suzanne's practice management execution skills brought our philosophy to life. And we've been doing this now for four years, Suzanne and I, and consistently year over year, we have had all of our clients collections growth from 37 to 39% per year, which means it's now over 100 clients who grow with this philosophy with our help. And on average year over year, all of our clients average, which has always been kind of close to this number about 100 is 37 to 39% collections growth every year. So, I mean, that's just from our perspective, we think it's completely unheard of. And we're so proud of it. And the way it started was, it was so much fun. I was sitting there in a conference room with Suzanne, we were talking about this. And then her years of experience on execution combined with my idea has really led to what we think are really powerful results. And so if you are a practice owner who wants growth, I would invite you to a call with Suzanne, where what Suzanne will do is she will take a look at your practice and we'll identify where is point A on our precision growth pathways we call them now. And we'd say, okay, and where do you want to go? So spend some time getting to understand your vision and then we'll try to identify point B. And that's the avatar that is your current final destination. Then what are the steps to grow from point A to point B? And that's what Suzanne does. And I would guide anybody to go to sharedpraxis.com and do a free practice assessment. And that allows us to do that free assessment of where is point A, where is point B? Just so you know, where are you today and where do you want to go? And so I would suggest you go to sharepraxis.com, click free practice assessment and schedule a discovery call with Suzanne. And in that call, you'll also get to realize maybe how our unique approach is probably the best way for you to get from point A to point B in your practice. (upbeat music) - You know, we're talking about all of this as if everyone has a luxury of choice. You know, do I want to dive in and hire this person with no experience or minimal experience? Should I take a chance on them? But a lot of times we feel held hostage by the fact that we don't have time to train or we don't have the right leaders in place to train. So we're doing ourselves or we don't have the right materials in place to train. So we're gonna be starting from scratch. And so we end up just kind of forcibly choosing the person who we're hoping is plug and play, who someone else has trained them their way for years. And we're gonna have to untrain some bad habits and retrains of new ones. But it's easier than starting from scratch. And so I wanna talk about things you could go and work on right now that could set yourself up better for the future so that you're not in these difficult positions where you feel like you're forced to just kind of go with someone you don't really want to because it might be easy. And I think it can kind of be applied to not being held hostage by keeping team members when they're no longer the right fit for the organization and also not being held hostage by hiring the wrong team members for your culture. - It's funny you talk about being held hostage by like not having the training resources or the training experience. And we're talking about standards of care and that operations manual here in this episode too. I actually always look at every time we hire someone, it's kind of fun because it's like we need to revisit this. This is forcing us to make our training better. - Right, right. - So it ends up for me like right now, I've hired some team members from the Philippines and I haven't necessarily been ready. I haven't had positions fully fleshed out. But I've realized every time I make a hire, it forces me to flesh it out. And I have to be able to train and teach and then document and then the next time. And sometimes I, because I have more people to pull from, I treat this as like worst case scenario, now I've fleshed it all out. Like it's forced me to get really crystal clear and next time, if there needs to be a next time, then at least I actually know what I'm fully hiring for and training for and all of that. But I do think too, there is this mindset shift that we might need to have in dentistry around treating hiring like marketing. So when we're marketing, we're marketing for patients. And it's something we do on a continuous basis and we have to make the practice attractive to those patients, somewhere that patients would want to go. We collect leads over time and you know, depending on how robust our marketing is, sometimes we're following up with those leads or sending out emails or multiple flyers or campaigns. I think we might need to look at hiring in the same way of are we always kind of putting feelers out there so that we have a candidate in the wings, we can look at more people over time, rather than it being this thing that we never think about and then all of a sudden we have to think about it because we're forced to. What are your thoughts on that as like a framework for thinking about hiring within a dental practice? - I love it, I've actually seen one or two offices that have a careers page on their dental practice website which you don't see very often. But to your point, mindset shifted our industry because just about any other industry if you go to that website there's a careers path and there's just an open inbox of hey, drop your resume like always be hiring kind of thing, and so maybe you click on that careers and there's a list of open positions that might not necessarily be the case maybe it is maybe if you have a mega group practice or multi-location practice maybe there is but it could be as simple as just an email to submit a resume to. And maybe you make that one kind of separate and it's careers at mynentalbreakers.com and you have a bucket to pull from whenever you need it and or maybe someone comes across your desk and it's a hygiene resume and you're like, you know, I kind of want that extra two days of hygiene I just didn't feel like recruiting for it but here's this person, give them a call, you know? - 100%. - Let's talk about, you know, if we feel like we don't have these standards of care built out just real quick, you know, where would we start? And I think going back to this idea of using the hiring opportunity as the chance to build things out I had a conversation with George recently where he, I was talking to him about making a marketing hire and he's like, okay, what is the score sheet? Like what exactly do you want them to do? And what is the score sheet of how well they're doing their job and do those two things first and then create the listing? And so it was like an opportunity to get really clear on this position and what we're looking for and the expectations we're setting. How would you tie these together of using hiring as an opportunity to work on the standards of care? - It's absolutely correct that now is the time it's, you know, you're already going to have to be putting together something to train in this person, hopefully. And so I'm always telling clients, okay, use this, put this, get a folder together, whether it's digitally, Google Drive, OneDrive, or it's on your, your drive on your actual office computer or maybe you're doing a binder and start an operations manual, just start somewhere and break it up by department. You've got doctor department, assisting hygiene front. This is separate from an employee manual. You know, the employee manual of a handbook is how to be an employee at this practice no matter your position. The operations manual is how to be a team member working inside of this practice on a daily basis, sometimes very much dependent on your position and what you are being asked to do. And it's never finished, but you have to start somewhere and just everything gets added. And so a lot of times it's coaching, I'm starting out, we're building out roles in our responsibilities, we notice there's a gap. We need to hire for this gap or someone's turning over now their opportunity. And I say, okay, this is your first like post coaching hire and I love when it's an office manager that I'm coaching this on and I'm going, okay, here's our toolbox of a lot of our SOCs that are, they're not just done, they're meant to be downloaded and normalized and customized with your logo. I want you to delete this and say, "Precly an open dental, not your software," right? There's lots of customizing to be done. It's not just copy and paste, but you're going to grab the training checklist for this position. And okay, let's look through this. Okay, membership plan. Do you guys have a membership plan? Yeah, we do, okay. Is there a document kind of written out about how to explain that to a patient, how much it costs? We have a pamphlet. Okay, that needs to be turned in though into an internal document. Here's the rules around this, here's the fine print, here's how often they get filled for this, here's what it's called, here's when to bring this up. Okay, we need an SOC for in-house membership plan 'cause that's on your training checklist. There needs to be something written for you to reference a, "Oh, hey, grab this." Okay, new patient phone call training checklist. Okay, do you have an intake form for new patients? Yeah, we do, but sometimes we use it sometimes we don't. Okay, let's pull that up. Now, here's the shared practices version. Let's blend these together and you know, make it perfect for your practice. Are we hitting all these? That goes in your operations manual. And I always say like every resource I send you or every time there's a problem in your office and you're going to Google or chat GPT for it, don't just solve for it for, okay, this one person needs checklist for this. Clearly that was a gap in your practice. Make it a refined SOC for smiles dental and put it in the operations manual so you're never having to reinvent the wheel again. Richard, though, I can't tell you, I'm kind of venting here. I can't tell you how many offices, it doesn't matter, doctor, OM, it could be any, all of them do it. It's, we've been working together for years and we just hired an assistant. It's like our fourth one together that we've hired and oh, this is going on. So, so and so has been taking photos of trace setups and showing them to her for like root canal and for build up and crown. And I'm like, I kind of feel like we've already done this a couple of years ago, right? Like taking photos of what doctor likes for this and shouldn't that be in the operations manual? And it's like, oh yeah, we kind of forgot and if you're gonna do it, like go back to it, refine it, don't waste so much time retraining the same thing to someone new every two years. Have these SOC's build on top of themselves and then before you know it, you've got this beautiful packet of welcome to our practice, your dental assistant here. Here's 30 different, you know, SOCs that you can go through as time goes on to kind of help you through what we're asking you to do. - One of my favorite experiences as shared practices is when I met Suzanne and we began the process of really taking what was an idea that I had into what is now a very robust practice management philosophy. And you may have heard of our philosophy, we call it hygiene-led growth at times, we talk about the dental three pointer, we talk about profitable, simple, sustainable, we maybe talk about our avatars, your starting avatar, your point A, maybe your point B avatar. So I mean, that's just from our perspective, we think it's completely unheard of. I was sitting there in a conference room with Suzanne, we were talking about this and then her years of experience on execution combined with my idea has really led to what we think are really powerful results. She'll spend some time getting to understand your vision and then we'll try to identify point B. (upbeat music) - You brought up chat GPT, so I have to talk about this. Here's the thing, people can get kind of lazy with chat GPT, but you can also use this as an accelerator. You can take your whole office manual and say that Caitlyn's like, here's a document that is the shared practices version of this. You throw both of those together and chat GPT's only as good as the prompts that you give it. And as you can say, hey, the more clear that you can set your intention of here is or current office manual, it might be outdated. So you can't take this as gospel. Here is a new system and input for my coach. I wanna bring these together and create a new standard of care and training and position description. Can you walk me through and check, ask me questions until you have all the information and give me a first draft of what this would look like. And then get that from chat GPT and work on it. And you can start to build a whole Google drive of documents that you then feed back into and use in chat GPT super powerfully and super efficiently. It's never been faster to create, do it in an intelligent way. You kinda have no excuse now. - That's what I was gonna say. There's really no excuse. It puts you into editor mode. That's what our SP toolbox does is is, I say, hey, this is editor mode for you. So start here, but make it yours. And I think another tool is, especially when we're developing more clinical SOCs that are really intricate and it's specific to like how that doctor wants things done. You can do voice to text as a doctor and say, like you're driving home and you're frustrated because you don't feel like any of your assistants really know how you want your temps made and then you can't really rely on anyone for this right now. Okay, that means there's a gap in your systems and they've been trained, maybe they've been told by you, but we clearly need something to reference as, hey, this is how you do this from start to finish. Do voice to text in your phone as you're driving home frustrated and say, this is what I want and you can just shumble it all up. It does not have to be pretty. Here's what I want from start to finish. Oh yeah, I forgot this. Did I want this on the tray? I want this to be designed this way. I don't want the patient to be alone for X amount of time. The appointment should run no longer than this. This is when you come get me and just plug that in and say, make this a beautiful standard operating procedure with step-by-step instructions and a final checklist and boom. - And right there too, the speed with which you update these things. So rather than like, this is a manual we do once and we never touch, if you've built that this way, like you said, you kind of throw stuff in there, you get it to where it's like pretty good and then you print it off and you use it. Now go back to the idea of like, we're going to follow the checklist. And if something's, I'm actually going to be upset if you do it the right way, but you didn't follow the checklist because I need to figure out where the checklist is not the truth. Follow the checklist, like kind of pretend like you're dumb and you've never done this before. - Yeah, absolutely. - And then quickly, fair it out. Like anytime something goes wrong, go back and say, was this on the checklist? And if it wasn't, do the same thing. Take that document, throw it into JetGPT and do an angry voice to text on the way home. - Yeah, yeah. - You update this and then print it off the next day and put it in there and I've been fleshing out an onboarding process for the men who are joining my weird fitness group, Next Little Fathers. And I've iterated on it every single time I do an onboarding. I just like, it's a Google sheet and I tweak it a little bit and I add some clarity, I'll add something in there. It's been like a nine month process of refining my onboarding because I just want this to be really easy for them. I wanted to be easy for me. And so I think the more you can treat these as living documents and you take the photo out of editing and kind of reprinting or reprinting these, throw away the old one, print it again. And then anytime you're upset, you should be upset at yourself first, is this in it? And if it is, then you can be upset at your team members for not following it. - Right. - But or it's a training opportunity and you don't have to be upset at your team members. But if it's not, then you have no one to be upset about other than yourself. And it's a great opportunity to quickly, quickly update it. - Yep. And you know what used to be, now let's shift gears into developing front office standards of care. It used to be recommending that we actually take screenshots to develop these like keystrokes. So I would say, hey, we need a document that is how to enter and apply a payment into the ledger so that the next person that joins your front office team can follow this step-by-step with screenshots. You know, where do I click and what do I enter and how do I know I'm done? What does it look like when I'm done? And so maybe there's five or six images in this like word document that you kind of put captions to. But nowadays, we've got better technology, better AI. There are video tools like Loom. There are plugins that you can add to your Chrome or whatever your desktop that kind of follow your keystrokes as you go through something and it spits out. I template for you and SOC for you. And so that technology do the work. We're going on a chat GPT AI tangent here, which you know, hey, it is the future. It's here. So how do we apply it in dentistry and make it work for us? But you know, all of this to say, working on this monthly and making these living documents, I love that framework, gives you the power for your next hire or for your next fire to say, we're going to be okay because we've got the system, the standard. We've got tools and means to hand someone something and say, this is how to be a team member in this practice. Here's how to be successful in your position. We are still going to have to breathe life into these resources. It's not just, here's the handbook, figure it out by Monday. But it's not having to reinvent the wheel every time that you do hire someone new. And perhaps you're really attracted to someone's attitude and vibe and just what they could bring to the culture of your practice. You get to choose that person instead of somebody who comes with 10 years of experience because you have confidence in what you've developed. And that's truly sustainability in a practice, in my opinion. And this goes back to opening yourself up to the full palette of options when it comes to hiring and being able to hire for, in my mind, attitude, intelligence, hunger, desire to learn, to improve, versus I feel comfortable because I've done this before, but maybe they come with some baggage or they're your only option. Now you've got more options because you're not tied down to the very small dental pool in whatever your area is or very competitive dental pool. So this is a lot of fun, too. And then the other thing, this goes to-- I brought up the Philippines and outsourcing and we've had to reach on the podcast recently. As you start to develop these, you can also be looking for opportunities to outsource things. And what are the very rare things that, man, if we had a team member who could just handle this that would take a load off of my team? And can we use some of these companies and tools to outsource stuff like this? So it's fun when you start to identify what all needs to be done in your practice and you can get creative with who you're hiring and where you're hiring, how you're operating. But I'm really glad that we got into-- people talk about AI and dentistry. I think this is the lowest hanging fruit of AI and dentistry is the speed of editing, creating office manuals, their standards of care, and our ability to train and hire and build these resources that are going to serve our team and serve our practice. If you're not using AI for these, you're doing it the hard way. You're doing it the slow way. And it's a great opportunity to learn the fluency of like, how do I use this tool? How do I put things into it? How do I have it edit and pull things and create new tools and resources? It's a fun challenge. If you like learning new stuff, which if you're a practice owner, sorry, buckle up, like that's actually the name of the game, this is a great opportunity for that. Yeah, absolutely. And there's a lot of platforms out there. So send us an email, and there's a list that I'm thinking of in my mind. I can't really rattle off, and I'm sure they've got competitors who are great too. But there's specific tools for developing all these different SOCs that use AI to a certain degree, but you don't necessarily need to prop chat GPT, even it could be easier than that. So, and then, you know, housing, your operations manual, you're mentioning making them live in documents. It's kind of another reason. I'm not as big of a player, I have a printed binder. I really do prefer more of a digital viewership of that so that you can constantly edit. And there are platforms, I live in the Google Drive, but I know that, and I've seen clients use platforms that are even greater than that, that are living documents inside there that make it easy to onboard and train. And so, their options have really opened up and many are forced to because the hiring pool is not experienced, folks. And so, they're like, okay, we better buckle up and we better train, and that makes us better too. So, I think it's an important topic. And to your point in the very beginning, and it goes back to previous episodes that we've done on Vision, a lot of times the bottleneck to your vision could be like patient flow, right? But sometimes it's team infrastructure and you might hire a coach and the coach might say, okay, you need another assistant. Okay, we need a financial coordinator because your AR is not being managed well enough as it is your front office team is too busy. And it's like, okay, well, I've tried. I've had the add out forever. So, this is where being able to happen to virtual assistant options for that type of stuff, if you've got SOCs in place, that makes it easier to get those people on board. This is something you can control in sometimes an area of your practice that feels like a possible to control. Well, we talked about in that same episode on Vision, we talked about bottlenecks. And ultimately, when you look at it on a macro view, your practice can have only two major bottlenecks. One is supply, which is can we do more dentistry? If we had more people knocking on the door, could we take more new patients? We had more procedures to do, could we fit them in the schedule? And demand, do we have more new patients? And we constantly are having to work on both sides of those. How can we predictably deliver the standard of care that we want and can we do that at a high enough volume and high enough level that we can then take on new patients? Well, now we gotta go figure out how to get new patients. Well, once we figure out how to get new patients, we gotta figure out how to deliver more. And so this is half of the equation. You have to be able to grow and hire and deliver and train at a high level. Otherwise, this will always be a bottleneck. So this is a core competency of practice ownership, and you can't kind of like skirt or lean out of it. Absolutely. If someone's looking for help or wants to have a conversation with you, what is the email and how do we spell Katelyn at shared practices to get a hold of you? Yeah, send me an email at C-A-I-T-L-I-N at sharedpractices.com. We can talk coaching, we can talk, developing SSEs for your team, and go from there. So as always, I love getting on here and chatting with you all. This has been a blast, Katelyn. Thank you so much, and we'll talk to you next time on the Shared Practices podcast. (upbeat music) (gentle music)