The dental hiring challenge

Ginny Hegarty is known as a turnaround expert specializing in practice leadership, accountability and employee engagement. She says hiring well is not so much a race as a three-hour tour, and that hiring slowly and following a process is the best way to secure the right staff. This is episode eight of Beyond the Mouth, a podcast series in which Dr. Betsy Shapiro of the American Dental Association (ADA) chats with a diverse group of people who can help with the non-clinical challenges dentists experience every day. This episode was released on April 24, 2019.

Ginny Hegarty, SPHR

Ginny Hegarty is a dental practice management strategist, speaker, writer and coach. She is the founder and president of Dental Practice Development, Inc., which has provided practice management and team development services to dentistry since 1997. She proudly serves as an ADA Consultant to the Council on Dental Practice. She is a Past-President of the Academy of Dental Management Consultants.

Ginny’s book, PIVOT, Practice Leadership Redefined, was released in the fall of 2016, and she is introducing the book to dental study clubs around the country with her new program, PIVOT Leadership Live!




This transcript has been edited for clarity.

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.

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. 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.

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. 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.

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.

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.

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. I think those are two things I could probably handle. Breathe deeply and then think about it a little bit more with an 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."

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?

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?

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.

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.

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.

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.

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. 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. So you can't give up everything else to go through a hiring process.

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? 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 that.

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?

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?

Then you're going to get this core 20% of the 20%, 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?

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.

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. 

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 like to see how people squirm under pressure, yeah, ask that question.

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. 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.

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.

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 oftentimes, 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. 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?

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. She had some good points. 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.

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. That objectivity is huge.

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. 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.

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.

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.

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?

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.

Unfortunately, the days of being able to simply make the calls yourself are slowly disappearing. 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?

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.