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November 2nd, 2021

Episode 14 – Deeper Dive: Simplifying Dental HR

“HR is unpredictable. You can get away with something today that comes around and bites you in the ass tomorrow.”

I get fired up about HR. I had so much fun digging into this topic with Ali Oromchian in the episode before this one. When I think about managing employees nothing can get my blood pressure up faster because I think it causes so many deep emotions for us as owners. 

In small businesses like dental offices where you may be together 2, 5, 10, or 20 years, you start to connect on a deeper level. When things get tough or go sideways, it can feel so much more personal. So how do you as a leader and owner keep your cool when there’s so much chaos going on around you and everything seems so personal? 

As a boss, your responsibility is to provide a harassment free environment at a competitive wage. That’s it! But that’s not enough to keep a high-performance team engaged and ready to go to the next level. 

As you may know, even now 41% of dental offices in the country are still not up to full capacity as far as serving their patients. Team retention and creating a thriving work environment where patients are served well and the team is active and focused is a struggle many owners deal with.

I know owning and leading a business is stressful. I know managing people is super tough. But a supportive, thriving team is the backbone of your Investment Grade PracticeTM. So let’s make HR a little less confusing by:

  • Making your life easier with this specific mindset
  • Exploring practical advice on attracting the right team members
  • Walking through a tolerance exercise to hone your leadership and HR mindset


HR is unpredictable. You can get away with something today that absolutely bite you in the ass tomorrow. Hi, I’m Victoria Peterson, the founder of the investment grade practice podcast and co-founder of Productive Dentist Academy. Oh my gosh, do I get fired up about this topic. And it was a whirlwind journey with my good friend Ali Orangey. And as we talked about HR, I sure hope you got a lot from his podcast. I know I did. And I’ll tell you when when I think about managing employees, but nothing can get my blood pressure up faster. And I think it’s because as owners, it just causes so many deep emotions, you know, in small businesses and family owned businesses and dental practices where you might be together for 235 1020 years, you really start to get into each other’s stuff, right? And you start to really connect in a way that might be deeper than if you were in an industry where turnover is common and expected, like restaurant industries or things like that. So how do you as an owner, keep your cool when there’s so much chaos around you. And here we are in late 2021 41% of dental practices across the land are still not up to full capacity in terms of employees and being able to serve their patients.

The Great Escape from work in general is still on, how do we help make it a little bit easier and a little less confusing with HR. And I will share with you a couple of things that have helped me over the years. Number one, and this is the hardest, you can’t take anything personally. When people come on board with you, you know, they’ll say great and gracious things, when they leave, they’ll see some really nasty things. Sometimes it is an opportunity to pause, see what you could do better. But all in all people do things for their own reasons. So let’s be clear about that. As an owner, your responsibility is to provide a harassment free place of work at a competitive wage. And that’s really about it. And yet, that’s not enough to keep a high performance team engaged and ready to go to the next level. So think about HR, yes, there’s a compliance piece to it. But if you’re into the compliance part of HR, it’s usually because a lot of other things have gone wrong, like marketing for the position, how you market and advertise, really is the first step in determining who to show on your door. So think about yourself, marketing, as an employer, as a member of the community.

So shift from marketing to patients to attract demand for care and shift into I’m marketing to design my ideal team. If I were to send you to the dental Olympics, is this the team that you would take? Or are you settling because you’re afraid that there’s just no good people out there? I’m going to encourage you even in this tough market. Keep on trying to number one, go to your team and say what would make this a better, more attractive workplace? What makes you get up in the morning and want to be here as we onboard new people? What’s the one thing you really want them to know that we stand for? Get clear about the core values and why you and your team show up every day and then put that out there in your advertising? No so many ads are very dull and dry and boring. They they go to the basics it’s kind of like when you sell your practice there’s five operatories 2000 patients a hygienist and assistant and office manager if you’re marketing that way to attract new talent I can tell you that you’re gonna miss the mark. So a traditional ad says you know treatment coordinator full time busy practice clinical background a plus must have five years experience right sorry but if negotiable. But what if your ad depending on where you put it? You really talked about that. Up in more detail, the general dental practice seeking highly engaged treatment coordinator, not just a treatment coordinator, a highly engaged treatment coordinator, our team of dedicated professional and fun loving people work together to provide patients with a sense of hope in regard to their oral health so that they can gain the healthy smile they deserve. You see, this makes you stand out already. I’m like, Who are these people, that they’re fun loving, and they provide hope to their patients. If you’re as passionate about oral health and removing obstacles to care, this may be the place for you.

Two years experience in dentistry or other customer service roles is helpful. Ongoing training and continuing education and sure grow throughout your career. Our generous benefit package includes group health insurance $10,000, life insurance policy, two weeks paid vacation, flexible scheduling and non matching 401k. This role is full time four days a week with alternating Friday or Wednesday off and includes six days of paid holiday per year, please submit your resume to blank. This is I’m painting a picture I’m showing the story of what happens within the four walls of my practice versus a task list and a job role. The second step is to make sure that you have a standardized process for interviewing, this is where you can get tripped up and trapped. Because if you’re not asking the same questions every time, you can’t really gauge the response or the quality of the candidates that you get. Also, having a script keeps you on task. So you don’t accidentally say things like I think she’s too old to keep pace with us. You see, if you don’t ask about PACE, then you can’t assume she’s too old to keep pace that gets into discrimination. So work on a set of questions that keep you clearly on the right side of the law, so that you don’t make these accidental mistakes. The toughest question I hear my doctors asking, though, is not about the hiring and the onboarding, the training, that’s stressful enough. It’s the unspoken drama. I’ll have to say it’s not unspoken entirely. It’s simply unspoken to you, as the owner, until things escalate to the point that there’s a total nuclear meltdown. There are probably signs and symptoms before this happens. But if you think about being a boss, being a leader, working with your employees, more as a relationship to be nurtured and cultivated, than it is a boss and manager, an employee type hierarchy, I think you’re going to come out on the winning side.

You see there are certain things that we do as leaders that can absolutely destroy all the good work that came ahead of it. And I want you to take out a pen right now. And write down one or two annoying habits that you have as a boss, we all have them. Mine in particular, I asked too many questions. And I asked questions without a good pre frame. So when I pick up the phone, and I call people or I jump on a zoom and I immediately say whatever happened to XYZ or where are we at with this project? If I don’t give context, my team tells me that it feels like they’re on the firing line and they’re going to be in trouble. Now that’s not my intent. That’s just my annoying habit. I also have the annoying habit that because I had success in the past, or success in one area of my life. I assume that I’m great at everything. And my team often reminds me that indeed No, you’re not great at everything. That’s why you have us. So write down one habit. Maybe you get frustrated and and you throw instruments or you sigh or you yell unexpectedly now you might go back and apologize and clean it up. But what are these angry outbursts costing you? What does disorganization costing you? What is lack of clarity costing you? What is something in your style costing you?

Here’s where your pens gonna come in handy. Write down the average team salary. You can pick a position and write down that salary or you can just do an amalgamation for easy math. Let’s say it’s 20 bucks an hour. And now I want you to think about how long does it really take to onboard someone new in your practice? So you know, day one, they know nothing. They’ve got to learn the software system, your coding system, all the people’s names, the patient’s the room setups, the hours of operation, heck, even the directions to your practice. So, I have found that on average, this could take up to four months, six months, when people feel comfortable. So let’s call it 600 hours just for grants. That’s $12,000 per position, simply to hire an onboard, we now have to think about what does it cost you in downtime, you know, because this person’s not working as efficiently as the previous. So let’s say that that cost you another $5,000. And perhaps there’s regulatory classes CPR, HIPAA training, OSHA training, things like that, you’ve got to get them up to speed, we’ll throw in another 500 bucks just for good measure. So now I am.

Let’s do the math here. 20. times 600 is $12,000 plus $7,000. In lack of efficiency, plus $500. To 19,500. Again, for easy math. Bullet Point $20,000 per team member turnover. Now look back over the past 12 months, how many team member? How many positions have turned over? Is it one? Is it two? Is it 10? Let’s say you had five, that’s $100,000. It’s $100,000. in lost productivity, and training and onboarding. Now go look back at your habit is that habit that you have as a leader is if that is part of the reason that we’re having staff turnover, maybe you’re tolerating you say, Hey, I’m perfect. They’re all leaving because so and so at the front desk is a real tyrant or the hygienist is hard to get along with or the assistants just can’t keep that third assistant around. Whatever you’re tolerating whatever the common ground is, it’s costing you at least $100,000.

Want to play an even more fun game Dinny Hall taught me this, and she actually contributed to this chapter on HR, divide that $100,000 by the average patient value, let’s call it 1400. For a new patient, you would have to onboard 71 new patients to cover the cost of that team turnover. Now, for most of us, there’s there’s a lot of expense, time and effort that go into attracting the new patients. So high tea turnover cost you in dollars and cents, it also cost you and reputation. It costs you in lost momentum with your new patients and your customer service. So HR is one of the things we talk about in the investment grade practice book. It’s also part of what we really focus on with our IGP consulting. I know it’s stressful, I’ve had up to 55 employees and various states around the country keeping up with health insurance and all the benefits and the regulation is super tough. So the takeaway from my time with Ollie, would be to really go back and think about your personal core values, what you’re bringing to the business, and what you expect your team to honor. Once you get down to closing the gap about who I am and how I expect people to behave, how we expect them to show up for the job. Everything else gets relatively easy. It’s a matter of clarifying job roles, having frequent growth conferences, and annual compensation reviews. Again, HR, it’s one of those things that you can get away with a lot of stuff for a while until you don’t and then it comes in bite you in the ass. Thanks for tuning in this week. I look forward to another episode of helping you build your investment great practice.

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