What does it take to lead a dental team out of the pandemic? [Podcast]

Getting past employment disruptions

Since March 2020, many dental offices have experienced employment disruptions such as a furlough, layoff, reduction of hours, or unpaid leave. In this episode, we catch up with season one guest Ginny Hegarty, dental practice management strategist, speaker, coach and author, to talk about the new dental hiring challenges today. Ginny shares her expertise on helping dentists develop their leadership skills as they guide their offices into recovery from the pandemic.

This is episode 21 of Beyond the Mouth, a podcast series in which ADA’s Dr. Betsy Shapiro chats with a diverse group of people who can help with the non-clinical challenges dentists experience every day.

This episode was released on November 18, 2020.

Ginny Hegarty, senior professional in human resources (SPHR), is a dental practice management strategist, speaker, writer, and coach passionate about helping dental professionals create their next level of success and a practice that they love. She is best known for her expertise in practice growth and leadership with a focus on breakthrough communication success and employee engagement. Ginny is the founder and president of Dental Practice Development, Inc., providing practice management and team development services to dentistry since 1997.

She proudly serves as an ADA consultant to the Council on Dental Practice. Ginny is a past-president of The Academy of Dental Management Consultants. Her book, PIVOT, Practice Leadership Redefined, is available on Amazon. Ginny also offers HR GPS, a series of online courses on hiring, onboarding and developing your winning team.



This transcript was edited for clarity.

Betsy Shapiro: Welcome to the American Dental Association's Practice Podcast, Beyond the Mouth, where we won't discuss clinical dentistry, but everything else is fair game. I'm Dr. Betsy Shapiro, a director with the Practice Institute of the ADA. In this episode, we're talking about leading dental teams during a pandemic. Joining me is returning guest, Ginny Hegarty. Dental practice management strategist, speaker, coach, and author. Ginny has 30 years of experience in helping dental professionals create a practice that they love. She's best known for her expertise in practice growth and leadership, with a focus on breakthrough communication success and employee engagement. Ginny is the founder and president of Dental Practice Development, Inc. And she proudly serves as an ADA consultant to the Council on Dental Practice. Ginny is the past president of the Academy of Dental Management Consultants, and for those of you Beyond the Mouth loyal listeners, who have joined us for every episode, you may recognize Ginny's voice as a guest from our first season, when she shared her insights for the episode titled, The Dental Hiring Challenge. Hello Ginny, and welcome back.

Ginny Hegarty: Hi, thank you so much. Great to be here.

Betsy Shapiro: I laugh, when I was looking up the title of the past episode, and it's, The Dental Hiring Challenge, we thought we had challenges then. Ha, little did we know, right?

Ginny Hegarty: Absolutely right. That's one thing we can always count on, that we will have challenges, right? That's how we grow.

Betsy Shapiro: Good point. Excellent, positive spin on that. We've received a lot of queries from members over the course of the pandemic around staffing issues. I'm guessing you have too. Can you tell us what your clients are experiencing, and what each end of the spectrum looks like?

Ginny Hegarty: Well, you're so right to call it each end of the spectrum, because there are some doctors who are very fortunate. We talk about how when you plant seeds, you then have a wonderful harvest. There's some doctors who both from skill and luck, they have managed to have a very tight team that has been able to stay with them. And they are creating a new normal within their practice, but staffing issues have not been a challenge for them. They have been able to maintain the team that they had. So, that doesn't mean there are not challenges, but they at least are working with the same group of people that they know. And we can get back to the challenges that come with that. When we look at the other spectrum, there are some doctors who are really coming head on with the challenge of, I don't know my team as well, so I'm not quite sure how to predict what's happening. I'm not quite sure how to communicate with them, because that hasn't been my relationship. That might not be the business model that wasn't in place.

Those are the two ends that we're working with. And some of those doctors have lost team members. Many of those doctors have lost team members when there hasn't been that tight connection. So, we have challenges on both ends of the spectrum. And then we have a lot of doctors right in the middle.

Betsy Shapiro: Let's focus on the positive. You talked about some have the skills and luck, and I'm guessing it's a lot of skill and maybe a little luck, but can you tell us why those doctors are bouncing back a little better? What are the skills? What are they doing well, that's helping them through all their career, but especially through this?

Ginny Hegarty: I know from my clients that have gotten back to me to share their successes, when you talk to a doctor who says, "I feel like for many years there was an easier way to do some things, but I followed your advice and I stepped out of my comfort zone." Most doctors say, "I got into dentistry because I love the clinical challenge and helping patients, managing care with patients. I didn't anticipate all the employer challenges I was going to have, with hiring, and onboarding and developing great team members, and having that be sustainable." So, the doctors who has put that work in, have created teams that they're engaged, they're really behind the doctor, really sharing that purpose.

And that's the key right now, because for many doctors we've been able to focus on strategy. If you have the right strategy, you can move things forward and create something sustainable. That's all based on the past. What worked in the past we can use in the future. Well, that is no longer the case in this pandemic, because none of us have been here before. So, if we were counting on the past to inform the future, we're kind of shaking our heads saying, now what?

So, back to the doctor who had that great relationship with the team, they can now adjust. They are sharing a purpose, they're on the same page. They're just going to adjust what they're doing. So, they have to be able to innovate, and they already have the relationships so that they can innovate quicker. So, for the doctor who didn't have the relationships, there's more of a challenge there. We can't rely on the past, so what we have to do is embrace something brand new for the future. It's very doable. So for a doctor, who's saying, "Oh, is that why this is so hard?" Well, that's also the path forward. So when you just accept, okay, I don't have the past history to help me here, so I have to be willing to look for something different. I have to be willing to be able to innovate, step out of my comfort zone and create a different culture. And that can be done in little baby steps, but it reverberates, so it can create change faster.

Betsy Shapiro: When you talk about that culture and having those relationships, are you specifically talking about the trust that's built, and the good communication and all of those things? Is that what you mean would still carry through?

Ginny Hegarty: Spot on, absolutely. Because really, the first dentist I worked for, I was so blessed that he taught me, dentistry is far more a relationship business than a team business. And that has stuck with me for 30 years, the relationships, both with your patients and with your team. And trust here is so important, because in order to be able to move out of crisis, we have to have psychological safety. So, when you have crisis, crisis wants chaos, and we have seen that in our world. It thrives on chaos. You need to provide a sense of calm and direction for your team. So instead of being the leader who had to have all the answers, you can't have all the answers, because we don't even know all the questions yet.

Instead of trying to be top down leadership who knew everything, what we're looking for now, is a leader who will be a role model. So, you're going to model the energy, model the calm, model the agility that's going to make the difference. And the first question that my clients always say is, "The agility? What's agility mean here?" And here, when we talk about agility, it's a combination of setting the tone for your team, and also being able to be willing to put yourself out there, try something and redo it if you have to. Knowing that we're doing right now, we're innovating. We might not get the perfect answer right away, but if we're all on the same page, we're going to go the course together. When I teach doctors agility, I tell them to think of it as like rolling the dice, which sounds funny when you think really? We're trying to get some stability here.

But if you think of the dice, the D-I-C-E, as be decisive, be innovative, be collaborative, be empathetic. Decisive. We don't have a lot of time to make the first move. There is a natural tendency to want things to be as they always were. But when I talk to doctors, they're telling me, "You know what, if I'm honest with myself? The way it was, wasn't really all I wanted it to be anyway. So, couldn't this be an opportunity for me to step up, so not just recover, but re-imagine my practice?" So everybody's willing to make some changes right now. We know we have to. Decisive, in that moment make some decisions. Innovate, try things we never did before, and then come together as a team. And here's the real key, I think, it's understanding that it takes some emotional intelligence to be able to do all of these things, and to be empathetic, to see things from other people's point of view.

Instead of that top down leadership that we were talking about, we're now talking about bottom up leadership. My favorite expression for this is, "Unleash the collective genius," because you know you've got it. And it's so important for all of our practice leaders, to realize that in this situation, some people are going to step up. Don't hold on to your former view of what your employees did, or were, or said, everybody right now is facing this challenge to innovate and re-imagine. And doctors are saying to me, "Unbelievable, somebody who had been quiet and did what I asked her to do, but never came forward with ideas, is now on fire." When we go bottom up and we let people know, there's no wrong question, there's no bad answer. As a team, we're going to decide what makes sense. The leader creates that role model energy, the energy creates the enthusiasm. And as a team, you make the decisions to move forward.

Betsy Shapiro: I love that silver lining take on all of this, because I think that's absolutely true. And I will tell you, I'm not much of a gambler, but now I have a whole new thing about dice. So thank you, thank you for that.

Ginny Hegarty: Well, I think it gets people's attention when they're like, "Roll the dice? I don't know if I want to."

Betsy Shapiro: "She's a crazy lady," yeah.

Ginny Hegarty: You have to make some things fun, right? And readjusting at this level is going to be stressful.

Betsy Shapiro: Sure. Let's talk about readjusting, on a specific issue that we've been hearing a lot about. Many, many dental office employees are young women who have family duties, or have parental care duties, or multitudes of things tugging at their time. And what we're hearing, is that there are a lot of team members who are asking for more flexible hours, or they're just giving notice because they feel like they can't do everything they need, and take care of their kids and be the home school mom for virtual learning. Do you have any ideas how dentists should respond to this, and what are some strategies they can try?

Ginny Hegarty: The number one piece of advice that I would give our dentists, is don't burn bridges. Don't take this personally. A lot of times, doctors will say, and I get it, I totally get it. They'll say, "I have invested so much in training this person, and taking care of them, and giving them all the flexibility they needed, and now they're leaving." But I think most of us would say, given the choice of working or taking care of my family, who really needs me, I hope I'd be in a position where I could take care of my family.

Some people are going to be extremely stressed because they need to be able to do both, they can't not work. Others have the ability to stop working for a little while. So, don't burn bridges, because you can still maintain relationships. You can create new opportunities, and this isn't going to last forever. Hopefully this time next year, we're looking at things getting back to normal, hopefully even before then, but people could come back. But if you burn the bridge, they're not going to. If we're thinking about the approach that we're taking with bottom up leadership, the doctor doesn't have to have all the answers. Doctors, that's great news for you. You don't have to come into this with the answers. You have to come into it just with a willingness to listen, and you'd be surprised how often your team members will solve the issue. And you think, "Man, I never would have thought of that. That's perfect."

So, what some people are doing is job share. They're saying, "If I can do mornings and you can do afternoons, can we cover each other? And that way we're going to share a position." You can absolutely make that work. That could also involve a virtual position. Now, you need to follow the laws regarding HIPAA and things like that. Be careful that you have somebody helping you with the technology to do that, but you absolutely can have a virtual position, for somebody who used to manage your phones or your insurance or billing, different things like that, that happened in the practice. You can share a position, have a virtual position, you can outsource some of the administrative positions. There are many companies out there right now that can help you with that, you have one less person in the office, but you're still getting everything done.

Another innovative strategy I've seen, is hiring very strategically for a dual purpose, so that you have one employee has the ability to move between roles. Many years ago, we heard a lot of talk about front desklessness, and it never meant you didn't have a front desk. But one way that it was implemented, was you would have one team member who greeted the patient when they arrived, brought them back into the treatment room, stayed with them for the treatment, took them to a private office when it was done, to review all the fees and the next visit, and take care of the financials, and then dismiss them. It was really one person who handled the administrative and clinical role. There are still other practices that I work with, who are hiring only hygienists to fill administrative or clinical positions right now, so that they always have a backup hygienist in the practice, so they're never short a producer if something should happen to cause one of the hygienists to be out.

What you should be seeing here is that collective genius that's coming out, where people are saying, "I really want to make this work, so how about we try this? How about we try that?" And then you get decisive, you get innovative, you get collaborative, you're empathetic to what's going on with each person. And then you make the decisions to say is it working, or do we need to pivot and go to the next step? That's a lot, but that's many of the different ways that people are looking at this.

Betsy Shapiro: Those are some absolutely great suggestions. And as you said, a lot of them, so I'm certain people can find at least a pearl somewhere in there, that applies to their particular situation. Overall, we've just had a short conversation, but responsibilities are changing a lot since this pandemic started, is what I'm hearing. The dentists are trying to be good leaders in helping their staff cope, but changing the leadership structure just a little bit, perhaps. Schedules are becoming more flexible, trying to accommodate both the staff, and the patients, and everything under the sun. Safety procedures have changed just within the office, and then there's that whole concept of psychological safety, and making sure the team feels comfortable in what they're doing. How does all of that impact the hiring and the onboarding? How do you hire someone and you say, "But we might be flexible, we might adapt. I don't know," how does that work, Ginny?

Ginny Hegarty: You have to be very agile. We're going to go right back to that. There's going to be a little dancing that goes on here. But it's the agile leader who is going to be able to innovate. If you're stuck in, "This is the way we do things here," you're going to be stuck. So, we really want the agility. When you're hiring... I just had a conversation with a client who said to me, "I panicked a little bit when my front office person, my administrative assistant, said, 'I hate to say this, but I can't be here. I need to be home with kids and parents.'" So he said, "I totally understood, I hope she's back quick. But now I have to hire again." And he said, "What do I do? Get the first warm body I can get, to get them in here?" And I said, "Who are you asking that question to?"

He's like, "Yeah, we know each other." He said, "What I found out was when I went for the right energy, and the person who had the right enthusiasm for the role, that was my answer." And he said, "You and I have gone back and forth on this a couple of times when I've begged you, please just let me hire somebody and get them in here." And he said, "Every time I have found out, okay, not a good fit. We have to redo it." Well in a normal environment. If you take one step forward and one step back, it's a little speed bump. But in a COVID environment, if you take a step forward, you feel sometimes like you have to take three steps back to start over. Because everybody on your team is challenged a little bit right now.

What this doctor said to me is, "I really focused on the energy that the person was bringing, and the level of enthusiasm. Do they have a shared purpose here? Do they love what I'm trying to create here? My business model, my passion for dentistry." And he said, "You're not going to believe this, but I hired somebody to be the one person working at my front office, who has no dental experience. But she came from a corporate environment, and she's used to working hard, working strategically and working well with others. And she really loved the idea of stepping into dentistry."

And he said, "I'm going to be honest. I had to pay more than I thought I should. Now I think I've got a deal, because she's really got this place going, and I think we're going to end up keeping her when we bring the other person back." So, other dentists that I have worked with to help with the hiring have said, "It becomes so important right now, that we're looking for somebody who truly wants to be here. Somebody who's willing to do whatever it takes." That old WIT philosophy, whatever it takes to make things work. I can work in the front, I can work in the back, I can help in sterilization. What do you need? That's going to be the biggest difference.

In hiring I tell clients, "Create that picture in your ad." Because so many people, when I go on and look at Indeed across the country, the ads all read the same. The best people right now are working, in most cases, that working. So, how do I appeal to somebody who has a steady job right now? In this environment, that's an important thing. That's part of taking care of themselves and their families. How do I appeal to them, to think about greener pastures? First, create that ad, that makes them raise their hand and say, "That sounds like what I'm looking for, and maybe this can be a great opportunity for me." I think when you can start out with hiring the person whose personality, whose approach to work, whose work ethic, whose emotional intelligence levels, all just work beautifully within your office culture, then you're going to have success there.

And there are online assessments we can do that measure all of those things, so you don't just have to go with your gut, because sometimes our gut doesn't serve us well. But there are ways when you know what you're looking for, and then when you can evaluate, does this person feel like a fit to this culture I'm creating? Because you don't want to put all this work into creating a new, innovative culture within the practice, maybe even in a practice where you had to downsize a little bit, or where you were stressed, and are bringing someone in who plays a pivotal role from the get-go. You want to make sure you have people who really want to be there.

Betsy Shapiro: Ginny, this has just been wonderful. And we could go on for hours, but we can't, because our listeners' ears will fall off. So, is there any one last thing you'd like to add to share with us?

Ginny Hegarty: Yes, I would love to share a point of view in that, when a doctor hires a new person, they often feel that sense of relief, like we did it, now let's get back to work. And I would say my best advice to you is going to be, hiring is the first step. The onboarding process is huge. You can't just throw somebody into the fire. When you have that brainstorming session going on, that collective genius, get everybody together and create an onboarding plan. I have onboarding trackers and courses, because I know how important this is, that we really map out what the first week should look like, and then the next three weeks, so that we're not surprised down the road, and disappointed that people aren't doing things they never even knew they were responsible for. So, it's a way to help somebody just move beautifully into this new position, and it becomes so much more predictable for everyone.

Betsy Shapiro: Excellent. Excellent next step, we can't forget that part ever. I agree. Thank you again, Ginny, for joining us.

Ginny Hegarty: You're very welcome. It's always my pleasure.