Managing dental staff

Betsy Shapiro: Welcome to the American Dental Association 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 hiring new staff. Joining me today is Ginny Hegarty. Ginny is a dental practice management strategist, a speaker, a writer, and a coach, and frankly, a friend of the ADA's. Since 1997, she's been the founder and president of the Dental Practice Development, Inc., which provides practice management and team development services. Ginny, welcome to the show.

Ginny Hegarty: Thank you. It's a pleasure to be here, Betsy.

Betsy Shapiro: I think shudders just went down the spines of dentists when we said hiring. I remember from my private practice days when you knew someone was leaving, and it didn't happen often to me, and it always happened for good reasons, I want that on the record, it still was unfortunate. And I dreaded the hiring process. So I think you're going to provide a certain level of comfort to all our dentists out there when we talk about this topic.

Ginny Hegarty: That's exactly what my goal is. Love to be able to do that.

Betsy Shapiro: For the really big picture, what is the hiring environment like right now?

Ginny Hegarty: Well, it's really a tight market right now. I mean, we all know that unemployment is low, and yet, I don't want doctors to see that as an obstacle because the best people are always looking for the right environment, right? And so I think there's great opportunity when we can distinguish the practice. We'll get some attention, and we will be able... I haven't had anybody not be able to find anyone. So when the market is tight, people are much more confident about looking for their ideal position, and that's a good thing.

Betsy Shapiro: Well, see, you're starting to comfort us already. What do you think are some of the biggest myths about hiring?

Ginny Hegarty: Well, I think you've already touched on one, and that's that well, my team is happy, so I'm not going to have to deal with turnover. But turnover happens for good reasons too, right, and happy reasons. And so we have to be prepared. The things I hear most often are, "Well, hiring, it just takes too much time." And more than anything, people say, "Well, there just aren't any good people in my area," right, but I hear that in every area, so I can help you with that. And also, "The new workforce lacks the work ethic. They weren't brought up the same way we were. They don't work at the same level that we do," but again, I'd have to tell you I think those are things that I can help with.

Ginny Hegarty: Number one, a systematic approach is going to help you be more successful. We already know systems work in every other area of the practice. So instead of looking at the obstacles, let's look at the opportunity. So we put a system in place. Then, there are plenty of good people. We're just going to talk about how we can draw them out.

Ginny Hegarty: And I think having raised two people in this new workforce, they're really good workers. I know that. And I'm not the only mom who did that. So my experience in practices and in watching my kids and their friends and friends' friends is this new workforce thrives on challenge and on feedback. I mean, this is the Google generation. So I think that the answer here is that we from previous generations need to step up, keep them engaged. And my experience is they respond beautifully. They need information a lot faster than we were used to getting information.

Ginny Hegarty: So I think these are opportunities. The only thing we can do is change ourselves, right? And the thing that keeps us most successful in business is being agile and understanding when we need to adjust. So I would say the stakes are so high here, that really does warrant your attention. And doctors, you could have a practice administrator who does the hiring for you, so that's wonderful, but you still need to be engaged a bit here. So I think raise the bar on how we hire, realize the importance here because the reality is a payroll's the biggest line item on the P&L. So our team can either be an asset or a liability, and there's a major benefit to making sure they're an asset.

Ginny Hegarty: And most of the time, we hire too quickly, we end up getting a wrong fit, and then we increase stress and drama and more turnover. So because turnover is so costly, both in profitability and morale, I think it's important that we put some focus on this. It doesn't have to be a lot actually. Once you've learned some of the key steps you can take and changes you can make, then it can just roll like all the other systems that you have in your practice.

Ginny Hegarty: So the good news is yes, there are some challenges if you haven't updated the way you do your hiring, and frankly doctors, most people say, "Nobody ever taught me how to hire," so don't feel bad. This is an opportunity for you to learn some of the things that are going to help you hire the right person the first time and get that team back on track.

Betsy Shapiro: So far what I'm taking from this is do not panic and don't hurry to fill the job and try to be more flexible. So I think those are two things I could probably handle. Breathe deeply and then think about it a little bit more.

Ginny Hegarty: Open mind.

Betsy Shapiro: Open mind. And you talked about frankly just being a little bit more thoughtful about the whole process. And for me as a dentist, I would look at that as starting out with writing a job description and placing an ad. So what are the opportunities with an ad?

Ginny Hegarty: You are so on target here. No wonder you didn't have much negative turnover, right? Because absolutely, you want to hire slowly, right? And know as you're creating this ad, you need to learn from the past. Why are you hiring right now? Why is this position open, right? So rather than do what we had done the last time, let's spend just a little while, could be getting together with your team for a meeting and saying, "All right, let's set ourselves up for success here."

Ginny Hegarty: If you know the old movie Groundhog Day with Bill Murray, he had to keep repeating things that happened until he got it right. What we want to do is do a little Groundhog Day exercise on what happened with the last hire. We're not talking about the person. We're talking about the results. So what did we learn from that last hire that we want to make sure we do repeat or we don't want to repeat? Let's get the job description out and update it because job descriptions, with the pace of the innovation in dentistry right now, they change on a regular basis. So learn some the past, update the job description, right?

Ginny Hegarty: And then before you get started, realize that you are hiring the person, okay? You can train or refine skills for the right person, right? But if you have someone who doesn't have the personality, the core values, the initiative, the drive, the passion, that kind of stuff, if they don't have that, you can't train it. So I think there's a little business secret in here that I always share with my clients, that it's worth taking the time to find the right person because that good person, that real good fit, is going to do two to three times the work of the average person. And they're not going to cost you two to three times, right?

Ginny Hegarty: And as we get into getting the ad ready, we're going to tap into some of the other tools that allow us to learn more quicker, right? So that sets you up to then sit down and say, "Okay, what can I do with the ad?" Number one point of awareness is that the best people are already working, most likely. Unless you have somebody who is relocating, this best person, the one you're looking for, right, they're in someone else's office.

Ginny Hegarty: So I think three things can make a difference for you. Number one, realize this ad is your magnet, okay? There was a day years ago, those of us who have been in dentistry long enough remember, when you would place an ad and it would cost you hundreds of dollars each week to run this ad. So you got really good at abbreviations, and everything was just as short and sweet as it could be so you could spend this $400 and get it out there, right? That cost is not involved anymore.

Ginny Hegarty: So I think that the biggest opportunity we have is to realize this ad is our magnet. We want to entice these people who are already working to raise their hand, right? So we need to get creative with it. And we certainly don't want a lot of abbreviations, right? We want to be able to paint the greener pasture that this person dreams about. They're okay. They go to this job every day. They put their heart into it. It's not everything they want though, so if there was something better, they would potentially step up.

Ginny Hegarty: But the next key is I don't believe in blind ads, the ones that don't say your name, right, and let people know where they're applying. Because that person who has a good job but it's not their dream job, they are not going to opt into that for fear that number one, it could be their own job that they're applying for.

Betsy Shapiro: Oh, no.

Ginny Hegarty: Yeah, wouldn't that be bad, right? Or it could be they were applying for a job with one of their boss's good friends, so then they're outed, right? So we have to create a safe environment there. So I suggest putting your name, boldly putting your name, putting your website, telling them you're on Facebook, inviting them to learn about you. And then throw out a challenge. In this ad, I would say something like, "We invite you to visit our website, visit our Facebook page, learn about our practice, and then along with your resume, please send a cover letter telling us how you feel you could be a great asset to our team."

Betsy Shapiro: Do you think though, Ginny... I think all of that sounds wonderful, and I like words, so I would have no problem doing those kinds of things. But would the readers of today, the job seekers, read that much? It's a lot of information. How would we want to structure it to incorporate those things but be succinct?

Ginny Hegarty: You can actually do that in a matter of about four sentences.

Betsy Shapiro: Okay, then.

Ginny Hegarty: Yeah, you can.

Betsy Shapiro: That's your challenge to us.

Ginny Hegarty: And that's a challenge. But you know what? You're not alone. Get your team involved and say, "What would appeal to you?" If you have some millennials on the team and you think, "I want to say this in a way that they would read it and be like, 'cool, that's exactly what I'm looking for,'" right, then ask them to help with it because this is the magnet. This is the game changer. When that ads spells out what this person sitting there is dreaming about, and they're confident, and they can look at your website and your social media presence and say, "Oh, wow, this looks like a great office," then they're more likely to raise their hand. So offer the challenge, and then let's see who steps up to it.

Betsy Shapiro: Very good. So where do you find the best places to post these ads?

Ginny Hegarty: I think there's a range, and part of it depends on where your practice is located. So number one, I would always start with the current team and make sure everybody knows that you would love for them, if they know someone, to invite them to go to the ad and formally through the process. We want everybody to go through all the steps so that they have the best opportunity to shine and make a great impression. And so yes, I would absolutely go with current team. And then Craigslist works for many. I have a lot of practices who are very happy with that. Indeed is another one. And oftentimes when you're on Indeed, it puts you on other sites as well.

Ginny Hegarty: And if you're in a metropolitan area, DentalPost is wonderful. They have great resources for you, and there are an awful lot of people who have registered there. So what you want to be getting to is the person who, like I said, is already working. And your team member may know someone who could just mention it, and if they're interested, they'll jump in. DentalPost, if somebody's on that, they're probably looking to see what's current, what's around here, right? So those areas tend to work really well. And like I said, DentalPost is absolutely wonderful, but if you're in a small rural area, there's probably not a whole lot of activity there. So that's something to keep in mind.

Betsy Shapiro: Yes, considering I practiced in a small rural area, and I would agree with you that probably wouldn't have done much for us there, I would add one other thing that came from my practice experience at my local dental society meetings. If you were looking for someone, very often one of us would just say, "I have a assistant position to fill." And perhaps one of the other dentists was scaling down and had a really good staff person or had had someone give them a resume, but they really weren't looking at that time. And that was always a good way to seek people too, which was helpful for me anyway.

Ginny Hegarty: I think talking about it is huge and getting your team involved can make a big difference there too, including your doctors who are going to these meetings.

Betsy Shapiro: Okay, so let's presume you've put the ad in the right place, whatever that might be for wherever you are, and the resumes start flooding in. Any quick tips on how to review them before you get to the interview state?

Ginny Hegarty: This is the part where everybody's saying, "Please, please have a tip for me."

Betsy Shapiro:Yes, exactly. It looks good on paper, but can it be true?

Ginny Hegarty: I have practices who have called me and said, "Okay, the good news, the ad must be well done. The bad news, I've got 80 responses. What do I do with that," right? Your time is valuable, and in many cases, this isn't the doctor. It's going to be a practice administrator, but whoever it is, your role in the practice is valuable, and the practice needs you in those key roles, right? So you can't give up everything else to go through a hiring process.

Ginny Hegarty: So I think the key in reviewing resumes is to evaluate, did this applicant take your challenge? That's why you threw out a challenge. Did they step up to it, right? So you ask them for a cover letter. 80% of your responses will not have cover letters. I know that from 10 years of this.

Betsy Shapiro: Very good point, yep. I didn't think of-

Ginny Hegarty: 80% of people will hit send and send you their resume. Well, if they're not going to show you some initiative and some enthusiasm at this point, what's the likelihood they will once they're on board, right? Probably not very strong. So legally, you have to hold onto the resumes that you get in response to an ad for a period of between two and three years. There's some guidelines there. I would set up a folder on your computer. And for every response that comes back without the cover letter, I would just put them into an incomplete folder. Then you have completed the ones who did what you asked, right?

Ginny Hegarty: And when you look at those, again through experience, what I know is 80% of the people who did send you the cover letter, the cover letter will say something like, and this is crazy that it says this, but it'll say, "To whom it may concern, I'm very interested in your position. Please call me." And you think, "Okay, that's somebody who's going to check things off," right? But they're not going to put their heart and soul into it, right? So those, again, incomplete. They're no's, right?

Ginny Hegarty: Then you're going to get this core 20% of the 20%, right, who will give you something that jumps off the page. And you can tell they looked at the website. They looked at the Facebook page. They're excited. They have shown me the initiative I'm looking for, and that's who you spend your time with. So you start with this big number, and you're not going to end up having to work with that many people. You will significantly cut the amount of time that you're going to be investing if you follow that strategy.

Betsy Shapiro: So that is comfort point number two that you just gave us because that really is a fast way to sort through and just be able to focus on the critical folks, the ones that seem to so far have made the mark that they can be a part of your team.

Ginny Hegarty: Yes.

Betsy Shapiro: Okay. What about the interview? What's the best strategy, the best?

Ginny Hegarty: Okay, now we got to that, right? The first thing is that I would do a phone interview before I ever invited anyone in because again, we only want to invest our time with the people who have the greatest likelihood of being successful on your team. And if you ask the right questions in that phone interview, you're going to learn so much, right?

Ginny Hegarty: So I'm going to backtrack for a minute. Most important thing is know the laws and follow them. So you don't want to get into trouble. So know what the laws are about what you can and can't ask. What most people do is just go with their gut. And the interesting thing is that many people think that hiring is simply intuitive, and there is some intuitive nature to what we're doing, but oftentimes, our intuition will lead us the wrong way.

Ginny Hegarty: So I would say the first thing that you want to do is the phone interview. And let's just for an example here, so I can make this feel like something real that people could see themselves doing, let's say on your phone interview you had six questions because that's what I use on mine. Each one of those questions is worth five points. So they could get a total of 30 points. So I would want you to think what's your magic number. What would somebody have to score out of 30 points? So five points each, six questions, what's the minimum score that you would accept to schedule the personal interview?

Betsy Shapiro: That's a very interesting process. I like that.

Ginny Hegarty: So everybody will have their own number. But I can tell you most people tell me 24, 25, 26, somewhere in there because they're thinking, "Okay, I want them to have above average on most of the questions," right? So as you're asking these questions, the most important thing is not that you write down every word they say, but you listen intently, you circle a number, and then you can add. Even I don't do air math very well, but even I can look at that and say, "Okay, we did not reach 25, so I am going to thank them so much for their time and wish them all the best."

Betsy Shapiro: That's really helpful.

Ginny Hegarty: So for those who scored higher, then I'm going to invite them in.

Betsy Shapiro: I appreciate that you referenced being sure you know what the laws are and what you can ask because I think that's one of the big challenges for our dentists. If we think about it in our profession, we interview people every single day. Because every time we have a new patient, it's an interview. But the questions we ask our new patients in order to build a comfort level and a rapport with them and be interested in their lives, about their families, about their children, about everything like that, are never things we can ask in an interview. And we sometimes have a hard time separating those two fields. So that's a pearl of wisdom there for everyone listening.

Ginny Hegarty: And also sometimes the candidates have a hard time. They start to lead with all the personal information to which I will generally say, "Oh, my goodness. I'd love to learn more about that. But for the purpose of the interview, let's focus on you at work, right, and how you work. Not how many-

Betsy Shapiro: Nice deflection, yes.

Ginny Hegarty: Yeah, not how many children you have. I am not supposed to know that.

Betsy Shapiro: Right, right. So any particular kinds of questions that should be asked?

Ginny Hegarty: Absolutely. The thing that most people do, and I think if we're all honest with ourselves, we've all done it. I mean, I've been in dentistry for almost 30 years. I surely did this before I learned better. We just Google what are the best interview questions to ask, right? And then we feel so good that we've got the best questions, right? And we laugh when people say, "What kind of animal are you? And if you were an animal, what would you be?" And it's not really those kinds of questions that are going to get you to the meat of what you need to know. If you to see how people squirm under pressure, yeah, ask that question, right?

Ginny Hegarty: But really, I think we can break it down into three types of questions. The traditional kind, like the getting to know you, tell me about yourself and how you approach work, those kinds of questions, right? Tell me what you love most about your work. Not everybody's in dentistry, but we can certainly learn from what they love most about what they're doing.

Ginny Hegarty: Behavioral questions, and most of them begin with something like tell me about a time when... So what we're getting at there is, how did they behave when this situation happened? Because past performance is the best predictor of future performance. So we really want to lean into that and get some good behavioral questions in there.

Ginny Hegarty: And then there are going to be some situational ones, how would you react if, right? And so we'll learn about their critical thinking and judgment and the ability to think in the moment. And I would rather have that be about a potential situation within the practice, a challenge they might face than what animal they think they are, right? I think they have a much better chance of being able to give you more insight into who they are.

Betsy Shapiro: So without trying to lead them down rabbit holes and really focusing on the topic at hand, how they're going to fit in with your practice, how do you structure follow-up questions? What's the best follow-up question?

Ginny Hegarty: I tell you, if you only have one, this is it. And it's not even a question. It's a statement. You just listen intently and say, "Oh, tell me more," right?

Betsy Shapiro: Oh, tell me more about that, Ginny.

Ginny Hegarty: Tell me more, yeah. So really, our goal in any interview is to do 20% of the talking, no more.

Betsy Shapiro: Yes.

Ginny Hegarty: And oftentime, we're trying to sell ourselves, right? So we keep telling them all this wonderful stuff about the practice and the team. We're trying to... Because they're interviewing us too, right? But we also want to focus in on what we really need to know here, right? So I think that the best thing you can do is be fully present. Do not be taking notes while the person is talking. You can learn so much if you maintain eye contact with them when you ask the question and listen to them answer it. 55% of what we communicate comes through our physiology or our body language. And if you've got your head down on the paper writing down everything they're saying, you're missing 55% of their message, right?

Ginny Hegarty: And what ends up happening is when we do that, because that's the way most of us did it, is that we hire somebody who can talk the talk, right? Then when they show up, we start thinking, "Wait a minute, what happened to that person I interviewed," because you didn't get the full message. If you're looking at that person, you're going to see the changes in their body language. And you don't have to be a body language expert for this, but if somebody has got that deer in the headlights look or if somebody is staring at the sky like, "Please bring the answer to me. Let me think of something intelligent to say here," right, then that's when, "Tell me more." You can't really go too deep if you're making it up.

Betsy Shapiro: Very true and actually, what you've just been talking about means that my mother was right when she used to tell me that I was brought into this world with two ears, two eyes, and one mouth, and learn to use them proportionately with the gifts I have.

Ginny Hegarty: Smart mom advice, right?

Betsy Shapiro: Yeah, yeah. Hate it when she was right.

Ginny Hegarty: Yeah.

Betsy Shapiro: I'm seeing that more and more as I age.

Ginny Hegarty: Yes. Yeah, isn't that-

Betsy Shapiro: She had some good points.

Ginny Hegarty: Mm-hmm (affirmative).

Betsy Shapiro: So what if the interview's gone really well, then what do I do?

Ginny Hegarty: Well, I would say your big challenge right here before you determine the interview has gone well I think is really to make sure you're focused on objectivity. That's probably the biggest hurdle in any of these personal interviews because we naturally bring all of our subconscious bias with us, right? Somebody walks in, and they have visible tattoos, or they have an unnatural color of hair, or they answer a question and it's maybe something that we didn't have a good experience with or a school that we didn't like growing up something, and all of a sudden, we're not as in tune, right? We're not being as objective.

Ginny Hegarty: So what ends up happening, and this is across industry, most hiring managers make their decision within the first 10 minutes of meeting a candidate and then look for evidence to support what they've already decided. And we miss a lot of opportunity there. The numbers of millennials who will have visible tattoos is only increasing. So for those of us who might personally not like that, we can't let that influence us in this part of the process, right? Because we can always say they need to be covered during work hours, right? So let's not let that get in the way. So that objectivity is huge.

Ginny Hegarty: And again, I'm going to do the same thing I did in the phone interview. In my personal interview, I have nine questions. They're each worth five points, right? So we have a total of 45. I'm being quantitative here because that's how I have the best chance of trying to be objective, right? I'm listening to say, "Overall, how would I rate this answer?" That helps an awful lot because otherwise, if we're not measuring, then we're guessing. And sometimes, we get really surprised after we've interviewed multiple people and we think, "Wow, I didn't have a positive feeling towards that person, but their score is higher than anybody else's." And that should give you pause to say, "I have to go a little deeper."

Betsy Shapiro: I think that's a really helpful tip there because in dentistry, we all have this science background, and that helps us separate right brain and left brain a little bit as a way to outline our choices and think about them a little bit more rationally. That's helpful. Thank you.

Ginny Hegarty: Yeah. If we're not measuring, we're guessing. The fact that you are more scientific, that should actually appeal to you.

Betsy Shapiro: Yes. Yes, it does. It demystifies the process too a little bit.

Ginny Hegarty: Yeah, a little bit, yeah. So hiring is always going to be more of an art than a science. However, there are tools that we can use and systems we can follow that make it more predictable. And the other thing that happens this way is we're evaluating our candidates against the job instead of just against each other. The first thing we have to do is evaluate them against the job. Otherwise, we run the risk of hiring the best of the bunch, and that's where we go wrong sometimes. You think, "Oh, but she was the best person I interviewed." Well, maybe you didn't have the right pool of applicants yet. So that's where that hire slowly comes in, right? We don't want to set ourselves up for failure.

Betsy Shapiro: So you've given us some excellent tools here and a way to get through the hiring process. Let's presume we've gotten the perfect candidate, and we're bringing them in, and because they're a good person, and they know things, and we've calculated their skills against the job, should we bring them in and leave them alone, or what's the best way to onboard them?

Ginny Hegarty: Well, it's interesting. That is the old adage, isn't it? Hire good people. Leave them alone. I don't believe that's best. And I say that based on many years of experience because the best people I think are the ones that benefit most from clear expectations and boundaries. Every team that I work with, it's amazing where they say, "We want to all get on the same page," right, that old expression.

Ginny Hegarty: Well, most of the team, I would evaluate it as high as 90% of the teams I work with who are in crisis, whether they have hit some speed bumps or lots of turnover, or they have reached a plateau, it's not because they don't have the right people on board. It's because all of these people have their own plan for how we're going to get to the goal, and you work against each other, right? So I think you hire good people, you set clear expectations, and you provide boundaries, right, so that they know how to operate. Then they thrive, right? But if we miss that key step, I think that's where we get to trouble.

Betsy Shapiro: Thank you.

Ginny Hegarty: Thank you for the opportunity.

Betsy Shapiro: Now, we're at the part of the show where we answer a question we've received from a member. In the Practice Institute here at the ADA, we answer member questions every day and wanted to share one we've received with you, our listeners. Ginny, we're going to ask for your help on this one. The question is about conducting background checks on potential new hires. What is a background check, and what are your suggestions for incorporating this as part of the hiring process, keeping in mind that most dentists don't really have an HR department to turn to for help?

Ginny Hegarty: So great question because it's really a key component of a successful hire. You don't want to be blindsided by something, right? So if I could take you through just a couple steps, interview goes really well. Schedule a second interview, right? So it's kind of like a skills assessment. They're not doing any productive work, but it's a realistic preview, right? I like to have a hiring assessment there with me to conduct that second interview. And the person has gone online ahead of time, answered the questions, right? And so now I have insight.

Ginny Hegarty: So before I invest in a full background check, I want to see is this fit as good as I think it is, right? What's their behavioral style? What's their drive and their energy and their proactivity and emotional intelligence, social agility, core competencies, work ethic, all that, right? So then I get some... This is how we've up-leveled the hiring process. Now I can say, "Okay, they did really well in my interview, and okay, the skills assessment is helping. And now this hiring assessment is helping me to see deeper," right? So now you can ask the questions to see how much training is going to be involved if we work with this person, right?

Ginny Hegarty: Then if everything looks good, I would make a conditional offer of employment conditioned on the background check. You don't need to have a hiring department to do it. There are companies out there that can help you. If anybody wants to reach out to me, I'll let you know who I work with. But the background check is going to basically run depending on the one that you do, right? Make sure they have a valid social security number. That's an important thing, right? That you also want to look to see what kind of criminal record might be there, and then you want to verify their employment and do reference checks.

Ginny Hegarty: So unfortunately, the days of being able to simply make the calls yourself are slowly disappearing. So many people have set themselves up, especially if there's someone who wants to pull one over on you, they'll have a burner phone and a friend answering the phone. So I never go by the reference numbers they provide. I always Google the office and look it up. You don't want to take the resume at face value. You want some research done because very often, they never even worked there, right? So that background check can give you the sense of this is actually all confirmed, right?

Ginny Hegarty: Because we have a responsibility. If there have been issues in the past, we can't subject our team to a harmful situation or our patients. So we don't want to be in a situation of negligent hiring. We want to make sure we've gone, had somebody who knows what they're doing, go through that. And it's under a couple hundred dollars, but it can give you that sense of comfort. You could have somebody do an education or a license verification. If they're going to be doing any driving within the practice, you can have them check a driving record. For most people if someone's doing some minimal driving for them, they just get the insurance information and the current driver's license, so that wouldn't necessarily be part of the background check. But I think having a professional who knows how to do this and get it done as quickly as possible is the best way to go.

Betsy Shapiro: Thank you so very much. That's a complete answer, and I really appreciate it, and I think our members will as well. If anyone listening wants to find out more about Ginny on her website at ginnyhegarty.com, that's G-I-N-N-Y-H-E-G-A-R-T-Y.com. You can also find more information and tips on hiring staff if you visit the ADA's website at success.ada.org and search the word staff or contact us at our email address, centerforprofessionalsuccess@ada.org. That's all one word, centerforprofessionalsuccess@ada.org. When you're looking there, you'll find a number of articles that Ginny has contributed on this very topic and all things surrounding it. When you visit her website, you'll find more information about many of the things she's done, including some publications and opportunities to engage with her further. We'd also like to thank our sponsor, ADA Member Advantage for their support and to [Sandburg 00:34:14] Media for producing this podcast. And thank you for listening to Beyond the Mouth.

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.

Betsy Shapiro: 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.

Ginny Hegarty: So, 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.

Ginny Hegarty: 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, right?

Ginny Hegarty: 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.

Ginny Hegarty: So, 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. So, 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. So, 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.

Ginny Hegarty: 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 reimagine my practice?" So everybody's willing to make some changes right now. We know we have to. So, 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.

Ginny Hegarty: So, 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. So, 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 reimagine. 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." So, 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 homeschool 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.

Ginny Hegarty: 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. So 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."

Ginny Hegarty: 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. So, there are many companies out there right now that can help you with that, so you have one less person in the office, but you're still getting everything done.

Ginny Hegarty: 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 desk-lessness, 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. So, 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.

Ginny Hegarty: 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?"

Ginny Hegarty: 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.

Ginny Hegarty: 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."

Ginny Hegarty: 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.

Ginny Hegarty: So, 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? So, first create that ad, that's, make them raise their hand and say, "That sounds like what I'm looking for, and maybe this can be a great opportunity for me." So, 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.

Ginny Hegarty: 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.

Betsy Shapiro: Now, we're at the Part of the show where we answer a question we've received from a member. In the Practice Institute here at the ADA, we answer member questions every day, and wanted to share one we've received with our listeners. To help us, we welcome Katie Call, a manager with the Practice Institute, who's instrumental in assisting our members get answers to their questions. Katie, thank you for joining us.

Katie Call: Sure, thanks for having me, Betsy.

Betsy Shapiro: I know you've heard this question: "I'm a new practice owner, and I'm just sort of overwhelmed by managing staff. Is there a good resource that starts with the basics that I can use?"

Katie Call: Absolutely, yes. We have a really great resource available online to our member dentists for free, or available to everyone to purchase in the ADA catalog, and it's called The Guidelines for Practice Success. And one of the modules in the guidelines, is all about managing the dental team. The resource details much of what you need to know in order to assemble and keep a really strong dental team in your practice. The module helps to guide people through different aspects of managing a dental team, including the hiring process, training, coaching, motivating, compensating, and much, much more. Members can go to ada.org/dentalteam, and log in to see the full content online. Or both members and non-members, can go to the ADA catalog and purchase a printed book that will be shipped to you.

Betsy Shapiro: Thank you, Katie. I think that'll help all the advice Ginny gave us, too.

Betsy Shapiro: If you have any questions for Ginny, you may visit her website at ginnyhegarty.com. That's spelled, G-I-N-N-Y, H-E-G-A-R-T-Y, ginnyhegarty.com. And if you want more information on any other practice management resources, you can visit our website at success.ada.org, or contact us at our email address, centerforprofessionalsuccess@ada.org. We want to thank our sponsor, ADA Member Advantage for their support, and to Sandberg Media for producing this podcast. And thank you for listening to Beyond The Mouth.