Who Leads While the Dentist Treats? (EP-336)

“If the doctor and the manager are not visibly united, the team will divide them privately.”
– Joanne Miles

Brief Overview of the Episode

A strong office manager does more than keep the day moving.

Joanne Miles explains why practice leadership requires awareness, accountability, empathy, and the ability to recognize friction before it becomes a bigger problem. From schedules and team communication to patient retention and case acceptance, small warning signs can reveal when leadership is missing.

The conversation also looks at the doctor’s role. Asking someone to lead is not enough. Practice leaders need the trust, authority, development, and visible support to actually do it.

What This Episode Reveals

The doctor may be responsible for the practice, but they cannot lead every part of it while focused on clinical care.

That is why the relationship between the doctor and office manager matters so much.

When a manager is empowered to lead, they can watch the systems, support the team, solve problems, and protect the patient experience without everything landing back on the doctor’s desk.

What You’ll Learn

• The difference between a task-driven office manager and a practice leader
• Small warning signs that something in the practice is beginning to break down
• Why great leaders pay attention to what is happening beyond their own desk
• How to balance accountability with empathy
• Why giving responsibility without authority creates problems
• How a united doctor and office manager can provide clearer leadership for the team

If This Sounds Familiar

You are treating patients, but team problems still constantly make their way back to you.

Your office manager is busy all day, but the same issues keep resurfacing.

You have asked someone to lead, but the team still looks to you whenever they disagree with a decision.

The issue may not be how much your manager is doing.

It may be whether they have been developed and empowered to truly lead.

Next Steps

Joanne and Sara created Emerging Leaders to give dental office managers a place to develop their leadership skills, learn from other managers, and work through the real challenges that come with leading a practice.

Register for Emerging Leaders:
https://productivedentist.zoom.us/meeting/register/66WY74JYS2SNK9l4lXqMpg#/registration

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TRANSCRIPT

Joanne

00:00:00 Sara Hansen: You want to kick us off again?

00:00:09 Regan Robertson: I’m looking at it right now. Okay. Yeah. Doctors, it’s really common to spend most of your day focused on clinical care. And that leaves lots of room for leadership in your practice. My question for you today is who is leading your team while you are in the chair? The guest today that we have is joining us for a series leading up to the conference, so that you have everything you need to help your office managers go from being exactly that to the leaders that your practice deserve. Jo Ann Miles de Dom r d, a lead investment grade practice business advisor. It is our honor to have you on the show today.

00:00:59 Joanne Miles: I’m super excited to be here.

00:01:01 Regan Robertson: Thank you. I know you were often called the Swiss Army Knife of Dentistry, which I’ve always thought is a really fitting title for you. And Sarah has had the opportunity to work with you intimately as well. And, and you seem to be particularly passionate about solving problems in a variety of ways. I think that leads to the Swiss Army knife. What. Tell us quickly about your road to where you are today, and why you care so passionately about developing office managers into leaders.

00:01:30 Joanne Miles: Yeah. So, um, you know, originally many, many, many years ago, I wanted to be a nurse. And so I was going to school for that and getting my prereqs. And then I walked by the dental assisting program, which was at that time a two year program. And I just, I don’t know, there was something about it that I had an attraction to. And me being a little bit of an analytical nerd, I actually opened up the newspaper because at the time, that’s where the Help Wanted ads were in the newspaper and I saw three pages of ads of like employment for dentistry. And I thought, bulletproof. That’s where I’m going. And nobody hopefully dies on you there versus nursing.

00:02:09 Regan Robertson: So hopefully the risk is quite reduced. You’re absolutely right.

00:02:14 Joanne Miles: So yes. So then I became a registered dental assistant. And I’m a curious by nature, um, I’m always asking the why questions to understand more. And that is sort of the, the trajectory that took me on the path to sit in different chairs. And, um, my story is not very different from many, many, many office managers and our, in our industry. Um, yeah, I was baptized one day by thrown into the deep end into the fire because the office manager that was in the office I was in embezzled.

00:02:51 Regan Robertson: Oh, you really did get thrown into the deep end.

00:02:55 Joanne Miles: Just told you’re now going to be the office manager with little to no training.

00:03:01 Sara Hansen: Yep.

00:03:02 Regan Robertson: So you learned a trial by fire.

00:03:05 Joanne Miles: For by fire and staying curious. And at that time, um, you know, because this is the late eighties, early nineties ish, um, there really wasn’t much for office managers until really Adam came along. The American Association of Dental Office Managers. There really was not a curriculum for our learning, unless you just were the curious one to go out there and, and get train, train yourself or find the mentors, which is huge.

00:03:34 Regan Robertson: I’m curious, from your perspective, since you’ve worked with so many practices, your road has been long filled with great potholes, and they are great potholes because they’ve helped you along the way to learn, to help others, to watch out for those potholes, to go from a dental assistant to the lead investment grade practice business advisor. Um, from your perspective, what is the difference between a practice that has an office manager that is acting as a leader, versus an office manager that is task driven and doesn’t have that mentorship, training, or even awareness of what proper leadership looks like.

00:04:11 Sara Hansen: Mhm.

00:04:11 Joanne Miles: The, um, and I’m sure Sarah can speak to this a lot too, because she’s an office was an office manager at, at one point in her career as well. Um, I, it is a baptism by fire and there are potholes. You have to be willing to look in the mirror to see. Um, and I, what I, what I’ve come to understand for myself and what I am seeing in many of our OMS in the, in the clients that I work with is you almost feel like you have to choose between two sides of how, what kind of a manager you’re going to be. And, and that is, are you going to be the taskmaster? Are you going to be the authority person. Are you going to be the person that just gets stuff done, you know? Or am I going to be that compassionate, empathetic manager? You know, am I going to always really look deeper and see the human side of things? And often we get stuck in that polarization. And the truth really is you have to be somewhere in the middle. You have to be good at at pulling out both. But then you have to know, have that distinction of where where the swing is. And the swing should never be one way to the extreme or the other. And so that’s really what I’m passionate about teaching now. Um, obviously I, I know many of the systems I love all the systems. I love to teach all the systems. But for me, there were some people along the way that saw something in me that I didn’t see in myself. And they, they stepped out and they said, we want to mentor you. We want to help you. And they encouraged me. And so I wouldn’t be here without those people. So that’s the piece. But that’s the distinction for me. I used to be a steamroller. I was very effective. I was very effective, but I had flat bodies behind me.

00:06:03 Regan Robertson: So it’s hard to it’s it’s great to be self-aware, but it is hard to look back on ourselves and be and take a really honest look at how we’ve approached leadership. I, I think about I took a couple of like airplane Cessna lessons one time, and I remember getting in the plane and them giving me the controls to the plane and freaking out because it was constant overcorrection. And that is exactly how I feel being a first time leader is especially if you don’t have the training. You go like you swing wildly over to like too harsh or wildly over too much to the empathetic side. And, and the truth is in that there’s that nuance and that balance in between, but it can be so difficult and so isolating, like so alone feeling if you’re trying your best. And it’s just not, it’s just not working. You have, you know, outcomes that you have to deliver. So you, you, you do like the steamroller thing, Joanne? I can totally picture that because, you know, you’ve got to get the practice to a certain point. You’ve got to get the systems running a certain way. And so you’re either like, you’re on board with me or you’re not. I don’t have time. I don’t have time to sit and, you know, explain this all to you. And, and I think it’s a really unfortunate position that’s completely preventable. And Sarah, I’m curious from your perspective too, what resonated with you as, as being a leader in the practice also and your own personal experience with it?

00:07:18 Sara Hansen: Yeah, my journey was very similar to Joanne’s in the fact that I started as a dental assistant, you know, worked my way through the practice, through all the different, um, opportunities that there were. Um, and then ultimately was the office manager. What is really interesting about that role and you spoke to it a little bit, Reagan, is that these office managers or practice leaders really are on an island by themselves. And Joanne, I, I want to get to that in a moment, kind of what you’ve done to fill that gap for these office managers. But I want to back us up just a little bit because we’re talking about recognizing, you know, a taskmaster. But can you help our doctors maybe understand what are some of those warning signs? What does that look like a taskmaster versus a practice leader? Because those are very, very different things. And what we know is that if an office manager or a practice leader is just focused on getting those tasks done, we’re going to have inefficiencies within our practice. So what can the doctors be looking for within those roles in their practice to really identify? Okay, we’ve got a pivot here a little bit, you know.

00:08:34 Joanne Miles: Right. Well, I mean, every dental practice is going to run on two things at once. You’ve got the whole clinical side of things and that’s where the dentist is living. I mean.

00:08:43 Sara Hansen: Yeah.

00:08:43 Joanne Miles: Doing their job right. That is where their, their, their butt is in the chair and they’re helping patients get healthy. So there’s that whole clinical side, the diagnostics, the treatment, the patient care. That’s where that happens. Then you’ve got this whole other side that requires support. So and that’s where the structure and the team communication and the decisions that are being made, how we’re managing the money and ultimately how profitable is the practice going to be? That’s the other side of it. And so what happens when this is breaking down? You could be, at the end of the day hitting your goal, but there’s a friction. There’s this weird, there’s like that ever, you know, walked and there’s this, this tiny little pebble in your shoe. It’s this station that is a, that just subtly wears on every system in the practice. And then all of a sudden some point there’s a stall in the practice, but it’s subtle and it’s, it’s, um, it’s, I would say almost like an irritant.

00:09:47 Sara Hansen: Mhm. Yeah.

00:09:49 Joanne Miles: And then that’s where that’s where that happens. And then and then obviously the team finds out, you know, kind of gets the gig. The gig is up.

00:09:57 Sara Hansen: Yeah.

00:09:57 Joanne Miles: During like, who’s running the asylum? What?

00:10:00 Regan Robertson: Yeah. What are some of those symptoms that the the small. Yeah, the small little ones that get easily overlooked because I. Man, I swear I’ve not been an office manager, but I, I can relate to this so hardcore.

00:10:12 Joanne Miles: Right.

00:10:12 Regan Robertson: Well, it’s easy to ignore.

00:10:14 Joanne Miles: If you, you know, you can look at systems. Your, your schedule is not running as smoothly as it used to. There’s you, you have more stress, daily stress. There could be. Um, I’ve heard doctors say like, I thought we’ve handled this before. I thought we had thought we had the answer to this. I thought we have the system. Why am I hearing about this again? You know, so there’s it’s it’s a again, it’s subtle. Many times sometimes you’re going to get the big, you know, sledgehammer that’s going to hit you. But often it’s the case. Acceptance starts to drop. Your patient retention is starting to drop because the patient experience is not quite where it we wanted it to be or where it used to be. It could come in forms of marketing where like your reviews start to wane a little bit, your referrals come down. I mean, your AR starts to to slip. There’s so many areas, the communication, you start losing team members, there starts to be retention problems. There’s, um, every system in the practice is dependent on that. Um, the cohesiveness between the doctor and the practice manager and the type of relationship they’ve created and the type of systems that they’ve put in place to trust, but verify if you will. And there’s clear lines of authority if you want to use that word, who. Who has the authority to do what and when? And then is the doctor backing that up when the. When the manager steps out to do it?

00:11:54 Sara Hansen: So, Joanne, what I’m hearing is really we’re talking about a role of a true leader. And, you know, so we’ve explained what some of those warning signs look like. And I think at least one of those every practice has felt with a team member from time to time. So what I’m wondering now is we know what to look for, but then what are those responsibilities? What should a good office manager or practice leader be doing if they’re truly stepping into this role? What does communication look like? What does, you know, maybe those team meetings look like and what do they need to be aware of? So it’s not always landing on the doctor’s desk.

00:12:36 Joanne Miles: Right. So I mean, you, you listed so many. We could probably have a podcast once a month.

00:12:40 Sara Hansen: Yeah.

00:12:42 Joanne Miles: But. And there’s there needs to be a structure in place. So for example, let me give you a couple examples. Like, um, I found for myself that I did my best thinking early in the morning when it was quiet before the team came in. So I typically would show up about an hour early and I would get a lot of the accounting things done, my QuickBooks things, anything financial, just quickly get some things away, look at some metrics, and then I’m ready for morning huddle. And then we and then that’s another system, right? Your morning huddle isn’t a place for correction. It’s a place to start. Start the day on the right foot, so to speak.

00:13:24 Sara Hansen: Yeah.

00:13:25 Joanne Miles: And it shouldn’t be positive. It’s not to sit there and demean people. It’s about okay, what patients are showing up where where are possible, you know, um, areas where we’re going to kind of come at a crossroads or we might hit a hit a pothole in the day. How do we make this a smooth day? How do we make this a great patient experience and then break everyone’s off getting ready and getting the first patient of the day? I didn’t go back to my office. I actually sat back in sterilization, which happened to be usually central to the entire clinical floor. He would just I would just listen. I would listen and hear, okay, what’s the verbiage? What’s happening? Are we getting those patients back on time? You know, what time are they actually getting into the chair? Because you put the you bring your first patient back late. How’s the rest of the day going to go?

00:14:18 Regan Robertson: It’s like an airline.

00:14:19 Joanne Miles: Yeah. Pretty much.

00:14:20 Regan Robertson: It really it stacks up. That gate.

00:14:22 Joanne Miles: Gets does it does.

00:14:23 Regan Robertson: So fast. Yeah.

00:14:25 Joanne Miles: And then the other piece of this is, is that, you know, maybe I was in sterilization. So I would help like get some trays ready. I would, I would get some wrap some cassettes and get them into the sterilizer that were left over from the night before.

00:14:38 Sara Hansen: What? Well, well hold on, Joanne, you’re participating in. I know day to day activities. You’re not just sitting in your office doing manager things.

00:14:50 Joanne Miles: Yeah.

00:14:50 Sara Hansen: Like I, I want to give pause there because I.

00:14:53 Regan Robertson: Yeah.

00:14:54 Sara Hansen: Joanne, you and I are sitting in those seats, right? We understand. You know, it is it is really hard to be a leader and having the role of maybe being a dental assistant and working your way through the practice, you understand what it’s like being in every single one of those positions. And what I love about that is you understand the frustrations, you understand the highs, the lows. And that is, I think when we talk about an office manager versus a practice leader, it’s right there. It’s exactly what you just said. It’s not about person sitting in their office, being in charge of everybody. It is a person who is truly leading the practice. And you’re speaking to this so beautifully, which is I am standing in the sterilization room listening to what’s going on with my team. I’m wrapping cassettes and putting putting them into the sterilizer. That is a true practice leader. So keep going, keep going. I love.

00:15:48 Regan Robertson: This. I have wait, I have one thing to interject because I have heard so many leaders say, you know, I this isn’t my job. I shouldn’t be doing this piece and your story. To me, Joanne, is a tangible example of what servant leadership looks like. So if you guys have ever heard of the book Servant Leadership, I, I definitely recommend that because you’ve just demonstrated by being hands on in my eyes that, that you are, are showing them that you are with them and you are being a leader. So I think it feels contradictory because I’ve heard lots of other leaders say, you know, everything should run without me, which is true, but how do you get to that place? I think you’re demonstrating that.

00:16:24 Joanne Miles: Yes. Well, and there’s, you know, I, I could pull, I don’t know, you know, ten office managers and I can ask them, when’s the last time you had to hold the plunger into the toilet? And they might have been, I would probably say like last week.

00:16:39 Regan Robertson: Great.

00:16:40 Joanne Miles: You are the plumber. You are the IT layperson. You are the, um, the construction, you know, fixing the little handy person that’s fixing this or fixing that or something with the milling unit breaks. If you have, you know, on site milling and, you know, I used to actually hoard little extra burrs and because milling unit, if the milling unit stopped working, then that means our productivity stopped working and the patient couldn’t get the crown delivered the same day that we promised. So. And hey, I’m going to just let’s just face it, sometimes things run out or they forget to order enough. So I would hoard little things.

00:17:19 Regan Robertson: It’s a great little secret. I never would have known.

00:17:22 Joanne Miles: Yeah. You know, like, so then they come to me and they say, we, we ran out of burrs and it stopped milling. And I’m like, ding, you know.

00:17:29 Sara Hansen: I’m here to save the day.

00:17:31 Regan Robertson: The emergency kit.

00:17:33 Joanne Miles: And I don’t know, maybe that’s a dental assistant in me, but, um, because you can never, ever once a dental assistant.

00:17:39 Sara Hansen: Always.

00:17:40 Joanne Miles: Got that blood. But girl.

00:17:42 Sara Hansen: I still go to my dentist and I’m like, I just want to, like, sit in on the next crown prep. Can I just be here? Oh, I, I love it, I love it, yes.

00:17:51 Joanne Miles: Oh, you know what the, you know what the true test is? Sarah and I catch myself this, like, I’ll grab a knife. Like we’re like getting ready for dinner. And I’m like, using my pinky. Yes, yes to hold things. Yes.

00:18:05 Sara Hansen: You’re getting ready to like, flip it over. Yes. So yeah, dental assisting is the best. I’m telling you it is. I loved it anyway.

00:18:15 Regan Robertson: Well, where I’m curious where a dentist who’s very busy, uh, who might be understaffed as it is and and running, you know, ragged. Where do they start? Like, what’s a good place to start the conversation and, and how much, how much, you know, should you invest in this time wise mentorship, wise training wise, like what does it look like? What does step one look like?

00:18:38 Joanne Miles: Well, step one looks like, um, first of all, you can, a doctor can do quite a bit. And then they do need to invest in their office manager. They absolutely have to put that effort in. And as you know, we’ve talked about Adam. That is a great resource. Um, the other piece of this is also that manager has to have that curiosity and willingness to learn as well. Reading certain leadership books, trying things out. And that’s why Sarah and I, I, gosh, I don’t know if it’s like three years ago now, maybe we started the emerging leaders program, where once, once a month we have a, a live Zoom meeting, ninety minutes. The first hour is sort of a formal, um, you know, some kind of learning that we’re doing on a specific topic. Um, and then, and then there’s a half an hour opened up. Okay. Tell us what, what’s on your mind? What’s your question? What what what’s going on? Because we do live on that island. We are often the buffer between the doctor and the team. And that you get can get banged around in the middle there. And you just need a place to find out you’re not alone, and that other managers can help help you source the solutions to things. I always say the answer is in the room and yes. And, and often it gives it sort of, I would say almost sometimes you feel like you’re a pressure cooker, and to be able to be in a room with other like minded people that are experiencing the same thing, and you find out you’re not alone, that releases the pressure. So you can go back to your desk and, and be your best self and take care of your team, take care of your patients, take care of the office. So it, it’s a combination of reading, getting sea going, you know, getting into these type of learning mastermind groups where it’s a small, you know, a smaller group where you can be safe and ask those questions. Our emerging leader calls are open to we’ve now opened it to all managers, whether they’re clients of ours or not. And once in a while we’ll let the doctors in. We don’t let them, you know. So if there’s a topic like in March, we did a whole profit and loss and balance sheet one on one. Um, and we brought in a subject matter expert, Chris Sands from Profi. And I mean, it was just the most robust hour of learning and the, the resources that were given afterwards that really helped them build their financial acumen. But we invited the doctors in because that’s the partnership that’s important. This coming month is going to be on the magnetic marketing. Actually, Sarah’s going to be our guest speaker for that.

00:21:26 Speaker 4: Yeah. Oh that’s.

00:21:26 Regan Robertson: Good. And that is that one open to the public.

00:21:29 Joanne Miles: That one is open to the public.

00:21:30 Regan Robertson: That’s amazing.

00:21:32 Sara Hansen: Yeah.

00:21:32 Joanne Miles: And the doctors, I should say more importantly. And then I think the the month after that, we are bringing in Amy Wood from the copper Penny, who is the expert on it, and cybersecurity and HIPAA and mitigating risks and all that. And then we’re going to have HR from health coming in to really talk about all those HR issues and, you know, minimizing risks. But it’s a it’s a space where we can go deeper.

00:21:59 Regan Robertson: Yeah. You know, I have heard, I have heard such phenomenal outcomes from, uh, people who have participated at emerging leaders and, and I wanted to call out that another myth that I’ve heard before is there’s, um, you know, an impression that the leader is the, the doctor owner. Like that is the leader de facto. And, and I would love for you to speak about the nuances of how we really define leadership and how I mean, Bruce Baird and Victoria Peterson, you know, taught me fifteen years ago that everyone has the opportunity to become a leader in their role, and that lifts up the practice as a whole. Um, what is your philosophy on that? And especially because you’re bringing in the doctors, uh, to some of these sessions.

00:22:40 Joanne Miles: So yes, it’s true. The doctor’s name is on the door, so the buck stops with them. But again, like we talked about, there are two massive systems running simultaneously at the same time. And the doctor doesn’t, you can’t split yourself in half and be clinical and then worry about the entire business side of the operation. And this is what makes dentistry so cool still, because it really is an entrepreneurial, you know, setting. And, and when we, if you really stop to think about the reality of what we’re giving, if you will, or we’re entrusting into our team, but then also the practice manager is often, you know, particularly if you’ve been out and you’ve been practicing for several years, you’re now into the multi million dollar range of a business.

00:23:31 Sara Hansen: Yeah, yeah.

00:23:32 Joanne Miles: So this isn’t. Yes, small business, but we’re talking about millions of dollars. Yeah. And, um, that takes energy, that takes, um, education, that takes a partnership that doesn’t happen by accident. It’s intentional. Are we having those regular leadership meetings? Are there specific agendas and specific metrics that we’re working on? Are there um, do we have cohesiveness with the team where they understand, you know, it’s kind of like you got the, the mom or dad or, you know, and the kids will, will divide, you know, and they know, you know, one of the most common patterns that you’ll see is that the manager is asked to lead, but isn’t fully empowered or supported.

00:24:25 Sara Hansen: Yes. Do it.

00:24:26 Joanne Miles: And let me.

00:24:27 Sara Hansen: Guess.

00:24:27 Joanne Miles: Something. If the doctor and the manager are not visibly united.

00:24:34 Sara Hansen: Oh, yeah.

00:24:35 Regan Robertson: Oh.

00:24:36 Joanne Miles: The team will divide them privately.

00:24:39 Sara Hansen: Yes.

00:24:40 Regan Robertson: Ugly Sarah’s like, preach, preach.

00:24:42 Sara Hansen: Oh, yeah. I’m like, say it for those in the back. Like, yeah. So and that’s.

00:24:47 Joanne Miles: That’s what gets hard as a manager.

00:24:49 Sara Hansen: Yes. Yeah. And that Joanne. I love emerging leaders. I love it not only for the office managers and the leaders of the practice, but I love it for the doctors. And why I love it is because ultimately, what we see when there is a true partnership between office manager and doctor, meaning doctor, trust them, the office manager is elevated within their role, right? They’re bringing leadership to the team. They’re bringing a good culture, they’re bringing systems, all those things. And that office manager feels empowered to stand in their role, how they are. You see the practice shift completely and it has been amazing watching some of these practices really shift and these office managers feeling empowered to stand within their role, but also supporting the doctor and the doctor is like, hey, whatever they say goes, you know, because they trust them enough and know that they truly care about the practice. They’re invested in this. Now, the doctor is like giving them permission to say, hey, go out, go learn, go bring back these good things to the practice, the culture shifting like it is this perfect, you know, you almost think of like a C-suite, right, of like perfect yin and yang where the doctor is leading these certain things. The office manager is leading specific things. And now this practice is thriving in such a beautiful way because the office manager feels like they’re standing within their leadership role. And I love it. Like it’s been such a powerful shift within the industry, you know, for for office managers to be a part of this emerging leaders group.

00:26:30 Joanne Miles: Yeah, I’m that’s why we started it. Yeah. There was I don’t I don’t believe that there’s enough of these type of groups out there. No, we, we chose not to monetize it. We chose to make it open. Yeah. And, um, and come, come as you are, whatever it is that your struggles are because trust me, I would guess it’s not new. Somebody in that group, whoever showed up that month has experienced it or understand it. And leadership is not, um, it’s such a, I don’t know, it’s like this big, it’s a big ball of twine and there’s a lot of different threads that you have to pull on. So to expect one person to be doing it all, like the doctor also needs development. Too often, you know, they go to dental school, they don’t go to business school. I mean, some of them, some of them have had like a minor in business, but most of them did not. And that partnership is important. And oftentimes in our emerging leaders, some of the questions come up where the manager really wants to have a better relationship with their doctor, but don’t know how to broach the topic, and we can help with that conversation. The one thing we always have said, that it’s not a bitch session and it never has been. That’s what I’m most proud of.

00:27:53 Sara Hansen: Yep. Yep. So Joanne, this, this episode, I mean, first of all, I want you to tell doctors how do they get their office managers involved with participating in emerging leaders? Um, and then, you know, to sum up kind of what we’ve talked about today, it really is about elevating the leader in your practice. Right. That can focus on the team, the training, the systems, the culture, so that the doctor can focus on what they’re really great at. And really, ultimately, the patients get the best dental experience they’ve had. So where can dentists find more information about emerging leaders and how do we get there? Office managers into that program.

00:28:38 Joanne Miles: So we actually have the whole year. This year is all planned out. There’s a PDF, I don’t know, maybe in the show notes we can put the link to get the PDF for the remainder. There’s a link in there for each month to register. And it’s, we just ask that you are on camera and you give yourself a budget of ninety minutes so you can be there the whole time for the, the formal education piece of it, and then the ability to just be part of the conversation, whatever that might be afterwards. Um, so, uh, more, the more the merrier. Like I said, you know, that we feed off of each other. We, we learn from each other and, and the more advice that we can bring into the room, the better. Um, and it’s very, it’s a very encouraging group. Um, like I said, there’s, it’s not a gossip group, it’s not a bitch session. It’s very much a supportive environment to succeed because we, we want our offices to succeed because ultimately that means the patient wins.

00:29:43 Sara Hansen: Yep. Well said. Well, Joanne, we’ve only scratched the surface with you. So we are going to continue this conversation. So doctors and listeners, stay tuned for our next conversation with Joanne. Thanks you guys.

00:30:01 Regan Robertson: Clap clap clap. That was so good. You know what’s so funny? I worked in a vet clinic for a couple of years when I was in high school, and I wanted to be a veterinarian because of that experience, or at least a vet tech. It was. And it, uh, I was responsible for the, uh, what do they call it? It was the little cauterizer like you would put it in, you’d put all the tools in it. So it was sterilization, essentially. And I you did. You heard everything. I almost jumped out of my skin when you said that. Like, I, you that is like the hub. And so you definitely knew what doctor was in what mood, who was going to be late, how surgery was going like, I mean, even even to where all like the, the animals were stored. Like it was really cool. I loved that job so much. It was fun. I just didn’t think about it in terms of dentistry. But yeah.

00:30:43 Joanne Miles: Oh no, you would, you would train it. Your ear would be trained to know when something was. It’s like a parent when the.

00:30:49 Regan Robertson: Oh yeah.

00:30:49 Joanne Miles: Quiet when the kids are home, you know.

00:30:51 Regan Robertson: Yes.

00:30:52 Joanne Miles: No, like I just, I would know just intuitively if I didn’t hear the milling machine moving by a certain point, I.

00:30:59 Regan Robertson: Knew.

00:30:59 Joanne Miles: It was wrong. If I didn’t, you know, if I just you can just tell.

00:31:05 Regan Robertson: Yeah, yeah. I the, the memory that came to mind was a day where everybody was running late. It was like one patient that went late and another and another. And I remembered being like, I know that that particular room has to be cleaned way faster, more so than other. And I think that is a big difference because I think anybody else, especially a high school kid, you know, you get a sheet when you come in as an assistant, you clean the cages, you do the sterilization, you, you know, swap out the meds or whatever, you know, your list of things to do. And I could see people, if their task manager driven, they’ll just be like, well, this is my next number. So I’m not going to pay attention to the world around me. And, um, yeah, you just blew my mind with that memory. That was that’s really cool, Joanne. Thank you. And both of you too, because Sarah, I love your voice in it. Um, having the office manager experience too. Yeah, yeah. Um, okay, so for this, we have ten minutes left for the next episode. I’m wondering if, do you guys want to drill it down into, since we talked a lot about the leadership capabilities and the, the metrics of it, the KPIs, could that be a short episode or is that one, Joanne, that you feel should be a longer episode? Um, or should we do turning the doctor’s vision into daily behaviors? What behaviors, uh, leaders in body versus task. You know.

00:32:22 Joanne Miles: And that one, you could really help provide some color to it because we could talk about sort of the, our, how our guiding principles and really creating that, you know, what is the.

00:32:34 Regan Robertson: Oh, the key characteristics and the critical actions that link with it.

00:32:38 Joanne Miles: Yeah. And then the exercise that we do generally in the office as a whole team, it’s like a whole day.

00:32:45 Regan Robertson: Oh yeah.

00:32:46 Joanne Miles: Workshop that we do once that’s created.

00:32:49 Regan Robertson: Yeah, that could be, that would be great. That turning the doctor’s visions into daily behavior with that. Um.

00:32:55 Joanne Miles: That could end up being its own little, little thing.

00:32:57 Regan Robertson: Yeah, it could definitely be its own podcast for sure.

00:33:00 Joanne Miles: Well, no, not that, but an actual.

00:33:02 Regan Robertson: Like.

00:33:03 Joanne Miles: Like.

00:33:04 Regan Robertson: Oh yeah.

00:33:06 Joanne Miles: Like if you’re like a culture camp.

00:33:09 Sara Hansen: Culture camp.

00:33:11 Regan Robertson: That is such a good name.

00:33:13 Joanne Miles: Well, everybody uses that name, but yes.

00:33:16 Sara Hansen: Oh, I was like, you better trademark that culture.

00:33:20 Joanne Miles: No, I people call that culture camp.

00:33:23 Sara Hansen: Oh.

00:33:24 Regan Robertson: Oh, that is so exceptional. That would be a really fun one to do. Yeah, you’re absolutely right. I know, I know we’re we’re sitting on a topic turn ins for next year. You were just we were just talking about that.

00:33:34 Joanne Miles: Yeah, yeah. I have to do my little short recording to explain what each of my topics are so I can get everything submitted.

00:33:43 Regan Robertson: And now you’re in pink.

00:33:47 Joanne Miles: At least a couple of them.

00:33:48 Regan Robertson: Okay, so for a shorter episode then, um, are you comfortable going down, uh, KPIs and how a leader looks and acts on KPIs versus a traditional, um, administrative office manager?

00:34:04 Joanne Miles: Yes.

00:34:05 Regan Robertson: Okay.

00:34:05 Joanne Miles: Because I could kind of go off of, um, our last emerging leaders, we, It was about looking on, looking. How to look around the corner and how to truly, um, take a step back and ask more questions rather than knee jerk. When you see one metric, it doesn’t mean, you know, sometimes we react too quickly. And so you need what’s called what I call the manager radar.

00:34:36 Regan Robertson: Oh.

00:34:37 Sara Hansen: Because doctors emotionally react.

00:34:41 Regan Robertson: Oh.

00:34:43 Sara Hansen: That’s why they’re, it’s a, they, I feel like we don’t have new patients coming in. I feel like what you know, and then the oh.

00:34:51 Regan Robertson: Sarah, can you kick us off to that next episode then right now. And yes, and I want you to just say it just like that, because that that’s the gap in between the emotional reaction and the result that sits on the other side of it. Okay.

00:35:03 Sara Hansen: Okay. Quack, quack, quack. Doctors, do you ever find yourself feeling that maybe you’re not attracting new patients? You’re low in collections. Patients aren’t accepting treatments. And then your office manager maybe brings you analytics or data that shows a different story. Doctors. That’s the gap we’re talking about today with podcast favorite Joanne Miles. I am joined by my girl Reagan. And we’re. This is going to be our second series with Joanne today, where we’re talking about that gap, the gap between as a doctor owner, oftentimes it’s our blood, sweat and tears that we’ve invested in this practice and we’ve grown it. And so of course, you’re emotionally invested and sometimes things can go away that we feel emotionally maybe disconnected to, or maybe it’s telling us a different story through emotions. And our office managers can come in with data that we’ve asked them. So Joanne, let’s talk about KPIs today and why is it important that our practice leaders and office managers have really great KPIs.

00:36:15 Joanne Miles: Yeah. So I might be throwing some of our managers a little curveball when we’re talking about KPIs because there’s a, there’s a filter, if you will, or a lens that I think that we miss. There’s an opportunity that’s missed on how we view our KPIs.

00:36:29 Regan Robertson: Mhm.

00:36:30 Joanne Miles: Um, because often what happens is like for an example, we could, I could look at a practice and I can look at, we’ll just pick one, the, the, um, active patient base and that. Yeah, that number. Right. And we know that number should be going up each each month. We don’t, we.

00:36:50 Regan Robertson: Would hope.

00:36:51 Joanne Miles: You would want to see it going down. Right. So I could look at a practice and say, wow, they had two thousand patients in January, but now they have fifteen hundred. Well, I could make up a story about that practice just from, you know, that one metric I could make up a story. Probably wouldn’t be a good one, right?

00:37:13 Regan Robertson: Mhm. Mhm.

00:37:14 Joanne Miles: Um, but it may not be the truth. And the question. And so that’s really the key. So yes, KPI’s are important. We need to keep our eye on KPIs. We need to understand the behaviors behind these KPIs. But if we’re not slowing down for a moment and using what I call kind of the lidar radar and asking more questions first.

00:37:38 Regan Robertson: Mhm. Right. Context is everything.

00:37:40 Joanne Miles: Context is everything.

00:37:42 Regan Robertson: Joanne and Sarah, both of you have taught me so much. Really. I mean, it is, it is the the the free education I get every day listening to you has helped me in my own leadership. Not to make knee jerk reactions when I see a number that I don’t like. So my brain went right away when you said two thousand to fifteen hundred. I was like, well, maybe the practice switched to fee for service. Maybe they’re saying higher value clients right now. And so that’s the reason why. But so there’s like a picture on it, but it can be really hard. It can be an emotionally charged conversation, especially if like our numbers aren’t like not just those numbers, but like our financial numbers aren’t looking good. It’s so easy to knee jerk. So tell me about this, this leadership, um, thing that you’ve developed here with this, this sounds great.

00:38:28 Joanne Miles: The leadership radar. Um, and it’s, I’ve taken the model of Swot, but I don’t like, oh, I don’t like Swot as it sits on its own. So Swot is this the strengths, the weaknesses, the opportunities, the threats. Right. But generally what happens when a team goes through a Swot exercise. Then the results are in this beautiful piece of paper and it goes into a drawer.

00:38:50 Regan Robertson: Yeah, yeah. It feels so abstract. Swot analysis like something a consultant gives you that lives in a binder and you’re like, you look. Yeah, okay, what do I do with this.

00:38:59 Joanne Miles: This.

00:39:00 Sara Hansen: This back end data that.

00:39:01 Regan Robertson: We pull from.

00:39:02 Sara Hansen: Strategy? Yeah.

00:39:03 Regan Robertson: Right.

00:39:03 Joanne Miles: So I like to, you know, me, I like to put spins on things and find different ways to look through, look at things. And this is more about as me as a manager and a leader. This is about a behavior change in myself on how I approach things, seeking first to understand more before I react. And so I sort of took that and kind of created this radar, which is like, okay, what are the internal wins? Which are the strengths, right? What are the internal friction of the practice that could be considered a weakness? But I like the, you know, me with language. This is about the internal friction. So it, it opens up a little bit more than you’re just looking for a weakness, right? Because a weakness is considered bad.

00:39:51 Regan Robertson: Yeah.

00:39:52 Joanne Miles: And then you have these emerging opportunities. What are these things that are emerging out of this analysis of looking at the internal wins and then the internal frictions. And then you have, okay, external risks are always there. We need to know what those are. And you look at that and you see, and then and then you put that into a framework. And then here’s the difference. Managers. You don’t need to have all the answers. You get to ask all the questions.

00:40:24 Sara Hansen: Okay. Joanne, you know, OMS, we want to have the answers for everything. I want to fix it all. Yeah. So I was going to say we’re the fixers of the practice. So okay, I’m going to slow you down. So they need to have more questions. What does that sound like for an Om to a doctor?

00:40:41 Joanne Miles: Yeah. So what it could be to the doctor and the team. I, I personally like to bring the entire team in.

00:40:48 Sara Hansen: Yeah.

00:40:48 Joanne Miles: And say, hey, this is what we’re looking at, you know, and what I’ve seen, I’ve done a little observation here are the areas we’re really winning. And here are the areas where I’m seeing there’s some friction. And I want to get your feedback to know if I’m like off or not. And then you know where, you know, what do you see as maybe some solutions that we could, we could do to bring this all together? And then is there anything kind of hidden that we’re not seeing, like what could potentially derail us? So once the solutions are kind of brought forward, okay, so what do you think would prevent us from being able to achieve these things? Right. And I think it’s important to, to, again, this is about slowing down in the process of finding a solution. Again, we don’t have to have all the answers our team actually have have the answers. They have ideas. They just want to be heard. They want to be have the space to have that freedom to be able to share it. So I know we started out on KPIs, which are super important, but one KPI alone isn’t going to give you the answer, right? Yeah. And to Reagan’s thing is like I learned the hard way. You do need to ask, well, did you just go out of network with some offices, you know, insurances because you will have attrition if it, you know, even the best laid runway, you’ll have some attrition, you know, so it’s better to understand that. And then once I had the answer to that, then guess what? I’m going to start looking at other KPIs at that point. Right? So I’m going to say, okay, sure. You went from two thousand to fifteen hundred, but now let me look at your productivity. Let me look at your let me look at your write offs. Let me look at your yes, you know, reappointment rates. Let me look at I mean, there are a plethora of other metrics that go to this, right? So it’s, um, KPIs are important. Managers should absolutely have the things like if let’s just say, for example, that you wanted to, the office wanted to make one of their big economic objectives that year to place more implants. So last year we did ten. This year we want to do twenty, right. So we break that out. We should have X amount of month. Let’s watch the metrics. Let’s do that. But then there’s behaviors around case acceptance for implants. Are we identifying missing spaces. Are we having great conversations like so there’s always a behavior behind a metric. And that’s where you help your team realize that you’re not, you’re not judging them on numbers. You’re just the metric is the metric. It’s just a way for us to measure how well are we getting patients happy? How well are we getting patients healthy? How well are they having that experience in our practice? It’s not a measurement of the hygienist value as a human being and being able to tease it apart. You know.

00:43:58 Regan Robertson: Language is powerful. Joanne.

00:44:00 Joanne Miles: There’s more to metrics than just a number.

00:44:04 Regan Robertson: Yep. Well, I love how you’ve, um, diminished the emotional, the negative emotional impact of changing weakness to friction, for example, so people can get sensitive, um, defensive. And when you hear weakness, it’s, it’s almost intuitive to want to downplay it or hide it or like, let’s not, let’s not highlight that. Like, let’s not talk about it because weakness makes it feel like, well, I’m then weak. That’s to that point of, you know, I’m not valuable or, or wherever negative root your brain might take it to. Whereas friction feels like something that can be ironed out. It feels like it can definitely, um, it’s not, it’s not an, it’s not dire to the point where it’s, um, you know, career ending, for example, like it, it doesn’t trigger that type of response. Is that why you changed it to friction? Were you seeing it is.

00:44:52 Joanne Miles: Yeah. Because I believe words have power.

00:44:54 Regan Robertson: Mhm.

00:44:55 Joanne Miles: They they have the power to build us up or tear us down. Even within our own mind. We may not even speak them out loud. Actually, I think what we say to ourselves quietly is more damaging. So I, I have and I know that for myself, right? So if that’s happening to me, then how I lead and the words that I use are very important because they can empower somebody to, you know, maybe step outside of their own comfort zone to, to try to take a chance and succeed or not. And if you’re going around, I mean, weakness is okay, weakness is weakness, whatever. But I think everybody, to your point, has an interpretation. There’s a there they take a, they take a little trip with that word. So if I can soften it but still give the same message friction to me feels um, I, you can, you can find solutions to friction.

00:45:57 Regan Robertson: Right? Yeah.

00:45:58 Sara Hansen: Oh.

00:45:59 Joanne Miles: Definitely it’s more empowering than, well, weakness could just be your weakness.

00:46:04 Regan Robertson: Yeah. What you mentioned active patience as being one of the numbers that can be misinterpreted unless you ask great questions. What are the other top metrics that you’ve seen that can, that can really, you know, put a wrench between the office manager and the dentist and the team, if not properly investigated?

00:46:24 Joanne Miles: Well, case acceptance.

00:46:26 Regan Robertson: Oh, sure.

00:46:27 Joanne Miles: Yeah, that’s a huge one. And it’s one of those where I, you know, I kind of get on my soapbox a little bit, but every, you know, yes, there’s percentages, right? Oh, we have, uh, thirty, you know, a fifty percent case acceptance. We’re doing great. But if we’re not looking at the dollars that are attached to that metric, then you don’t really know for sure. How do you know that you’re diagnosing enough that is going to actually help you meet your goals. Unless you look at the actual dollars, because fifty percent of one hundred dollars diagnosed is fifty dollars.

00:47:06 Sara Hansen: Yep.

00:47:06 Joanne Miles: Right. You know, versus, you know, you could do ten percent of one hundred thousand. It’s more right. So the percentage alone is not. Yes. It’s a piece of the metric, but there’s a deeper story to it. So you have to look at what are you diagnosing. How much is being diagnosed versus how much is actually being accepted. And you have to look at those dollars because I’ve seen, I’ve seen practices go from fifty percent to thirty five percent, but yet their productivity has gone up two or three hundred zero zero zero. And that could be because the doctor has chosen, you know, has worked with us to get their philosophy of care locked in, say, and have gone through the clinical calibration and really, truly understand, like, I went to school and then I went and did all this extra C because I want to comprehensively diagnose. But the behaviors of myself and my team weren’t in alignment with what that philosophy was. So yes, that metric might have been fifty percent, but now we did all this work and yeah, it’s dropped to thirty. But now I’m truly diagnosing comprehensively and I’m getting the acceptance for it.

00:48:20 Sara Hansen: Yeah.

00:48:21 Joanne Miles: So it’s a, it’s like a, like a seesaw.

00:48:24 Sara Hansen: That yeah, that’s what I was thinking. It’s like this, this perfect marriage of, you know, behaviors, metrics, reactions, like how it all comes together, how we move forward with the team of finding, you know, what’s holding us back, what does that look like? What are the steps we’re going to take to, to fix that? So I love what you’re saying, Reagan. You had a big idea, I could tell.

00:48:50 Regan Robertson: Well, the road to acceptance is so bumpy and, and it’s filled with so many micro moments leading up to the big ask that I think it’s something I love that you called that out as a metric. It is wildly multifaceted and and it does warrant a lot of attention to look at each of those micro, micro touchpoints that the patient has along the way to kind of figure out what may be having friction, what may be breaking down that can be remedied to that. I know that you have an emerging leaders, um, group session that you that you run, is it every month? Joanne with office managers. Okay. In the last episode, listeners, if you if you missed Joanne’s first appearance with us, definitely go back where we talk about what makes an office manager a leader and where we talked about emerging leaders as well. And Sarah, I believe you’re joining. Yes, emerging Leaders group. So Joanne, could you quickly tell us what that is? And I know we’re opening it up to the public. So I think that could be a wonderful way for them to experience your learning and Sarah’s learning in real time.

00:49:58 Joanne Miles: Yeah. So Sarah and I started the Emerging Leaders program about three years ago, I would say. And it came out of our our just desire to create a space for office managers to come because we often feel like we are on the island. We are we are in between managing a team and managing the doctor and then managing this financially viable business. And a lot it gets messy. Um, and leadership is a learned skill. Everybody can learn it. Everybody can. Um, but it’s not, it’s, it’s not the same path for everybody. That how you, how you arrive is a different path. And so we wanted to create this space where we are actually tackling the topics that really matter to make us better leaders. It can be in how we have conversations with team. We’ve had episodes on making the distinction between solving a problem versus solving and managing a dilemma. Two very, very distinct things. You know, we’ve done HR things, we’ve done profit and loss. And what are the true benchmarks of a healthy practice? And then what are the levers that you should be pulling to affect your pals and make sure that the doctor has a very high EBITDA at the end of the year. So there are it’s just this gamut of, of topics that we do. It’s monthly, it’s ninety minutes. And we are now, now that we’ve really kind of we’ve, we’ve figured out the formula for this. We’re opening it up to all managers, whether you’re clients of ours or not. And every once in a while we during the year, we will ask and open it up to the doctors because doctors are like, well, I want to come. And we’re like, no, no, get our space or one space. But we do have topics that we. We tackle that the doctors have to be part of again, because the manager and the doctor are the true leadership partnership. So there are times where we have to cultivate both.

00:52:02 Sara Hansen: It’s it’s a really great opportunity. Doctors, um, get your office manager signed up. Um, I’m telling you, it will it will be the best ninety minutes of the month that they invest in their time. So Joanne, how do they get signed up? Reach out to you. Um, maybe we can have a link in the show notes. What does that look like?

00:52:24 Joanne Miles: We could do a link in the show notes with the remainder topics for the rest of this year in each. Yeah. In that calendar, there’s a link to register for each one. Um, I would say go ahead and register for the rest for the year. And, and managers, you, you deserve ninety minutes out of an entire month where you can step away. And if you can’t, then this will be your first task is to put that on your calendar. Let your team know that I have ninety minutes uninterrupted and you will see the sky won’t fall, so the toilet might plug up, but the sky will fall. You know. Um, and come, come, you deserve it. You deserve it. And then, um, we could, um, you can always email me. It’s Joanne Miles at productive dentist dot com and I can get you connected with it as well.

00:53:21 Regan Robertson: Awesome. Thank you Joanne, it’s been a pleasure. I know we have another episode coming up where we are going to dive into the behaviors that make a great office manager, a leader. So listeners, stay tuned to that. And Joanne, thank you again.

00:53:35 Joanne Miles: Yeah, thanks.

00:53:37 Regan Robertson: Clap clap clap. Awesome. Oh my gosh. Okay. Two great episodes we got. Um, we’ll get you on the books to get the, get the third one if you’re okay with that.