THE MILLIONAIRE DENTIST PODCAST

EPISODE 61 TRANSCRIPTION

Announcer:
Hello, everyone. Welcome to the Millionaire Dentist podcast, brought to you by Four Quadrants Advisory. On this podcast, we break down the world of dentistry finances and business practices to help you become the millionaire dentist you deserve to be. Please be advised we do speak with an honest tongue and may not be safe for work.

Casey Hiers:
Hello and welcome. This is Casey Hiers back at it on the Millionaire Dentist podcast. We have Jarrod Bridgeman co-hosting today. Jarrod, we have a very special guest in studio, our Chief Operations Officer, part owner, Brogan Baxter. We don't get you on more than a handful of these in a given year. So I appreciate you joining us.

Brogan Baxter:
Yeah, sure. Happy to be here. Casey, thanks for the time. Jarrod, good to see you as always.

Jarrod Bridgeman:
Hey, good to see you.

Casey Hiers:
Let me set the table. I wanted to talk about leadership. Brogan, I wanted to get some insight from you and I know our listeners will appreciate this because you have this national perspective of practice owners in areas that maybe they need help in, leadership is probably one of those. People saw the title, clicked on this and they're interested. Here's the setup, practice owners, they're at a distinct disadvantage compared to CEOs around the country. Doctors have to not only be the practice's chief executive, but also its main producer. Dentists are most productive, not when managing or leading people, but when they're treating patients. Brogan, how do so many practice owners handle this dynamic of being the chief executive, but also the primary producer?

Brogan Baxter:
Well, that's a good question because you're right, these dentists make their money being in the back, seeing patients, being in patient's mouth all day. When that's being done, it's hard for them to keep an eye on everything else in the practice. The general business model is that they would hire an office manager that should be doing this as well in watching, being the eyes and the ears when the dentist can't be. So they're the ones that are working on the management portion while the dentist though, the CEO is back being the worker bee.

Casey Hiers:
How does that typically end up going? That's loaded because office managers, it's rare when there's a really good one who can actually take a lot off of the practice owners plate.

Brogan Baxter:
Right. That's true. We're big into systems and processes here. We like when there's some sort of protocol and some sort of management style that is implemented where there's some free sharing of information back and forth. Now a lot of that goes with trying to make sure you make the right hire to begin with, but let's just take the quantum leap and hope that someone has actually made the correct hire.

Brogan Baxter:
If they do make that higher, they've got somebody who can be the eyes and the ears. The office manager that is the eyes and the ears needs to have some sort of consistent scheduled time, or some sort of consistent way to share progress reports and updates, and keep the owner abreast of employee relations all the time. From what I've seen in practice, there's no system or structure to get that done. Usually when it's brought to the attention of the dentist is when something should have been done a long time ago.

Casey Hiers:
It's too late, right?

Brogan Baxter:
Correct.

Casey Hiers:
What are the two biggest characteristics a practice owner needs to have when looking for that right office manager? If you had to say these two things are non-negotiable, if you're out there hiring this position, what would you say the top two are?

Brogan Baxter:
I like having someone who has good soft skills, good people skills. Dentists for as brilliant as they are clinically, the soft skills are usually not something that dentists are known for. It's no offense to them, it just goes against their personality.

Jarrod Bridgeman:
Is it called the chair side manners?

Brogan Baxter:
Yeah, well-

Jarrod Bridgeman:
Bedside manners, is that what it's called?

Brogan Baxter:
Yeah chairside.

Jarrod Bridgeman:
Chairside. Yeah, yeah.

Brogan Baxter:
Yes. But the chair side manner, how they treat patients is a little different than how to treat staff. Dentists generally are conflict avoiders, so anything that's not great they usually really have a hard time relaying that information. One thing is having good soft skills because when a dentist is upset about something with some staff, it's generally best for them to have the office manager handle it, or have the dentist be part of it with the office manager leading the conversation, because the dentist just generally aren't good at it.

Jarrod Bridgeman:
In this role, it seems like the office manager would also play the role of HR too?

Brogan Baxter:
Yeah. They do-

Jarrod Bridgeman:
They're not HR itself, but that kind of persona?

Brogan Baxter:
Yeah, that's exactly it. Frankly, to take it a step further, I like having office managers that have that autonomy, that actually even do the hiring and the interviewing and all that. It's more of a formality by the time it ultimately gets to the dental owner.

Casey Hiers:
It sounds like good with people, soft skills, people skills, good communicator, but also not afraid of confrontation to counterbalance a lot of practice owners.

Brogan Baxter:
Right. Don't be afraid of it, but don't seek it out. Okay. We don't want to be a jerk because for as good of people skills that they have to be able to utilize it for the benefit of the dentist by making sure that employees are acting the right way. They also have to use it to sooth over issues that patients might have, because ultimately it has to go to somebody. If it's not the dentist who can be that guard and that buffer between the dentist and the patient if there's a conflict or some issue there? Someone who's good at conflict resolution is really good, and that gets back to those people skills.

Casey Hiers:
Why is it important for a practice owner, maybe if they're not great with leadership, why is it important for them to not only maybe find a good office manager, but for them to also improve themselves in that area?

Brogan Baxter:
I like having somebody to do that. The dentists have a tendency to become a little myopic. Again, it's not in their nature to be these massive visionaries of business models and all this. The better you come with leadership, the more you can see beyond what's directly in front of you. I like to give dentists that vision so then they have opportunities to ultimately grow their practice, grow their staff, realize that what's good enough for the patients might not be good enough for where they want to take that and ultimately be able to graduate from that. Not that we're big proponents of somebody turning over their staff all the time. But the fact of the matter is I sit in these meetings with clients when they fly in for their one meeting a year that they sit down and as we're sitting there brainstorming, we talk about things that are frustrations.

Brogan Baxter:
Almost every time at the top of that list or the top two or three of that list it's always staffed for people that are newer here. Because they're upset with the staff, they've got staff turnover. Their people aren't doing things the way they want them to, staff's slacking off, whatever the case is.

Jarrod Bridgeman:
I guess that comes to a question I was going to ask, which is, it's not just enough to delegate.

Brogan Baxter:
Right.

Jarrod Bridgeman:
You'll have to still be that proponent of again, the word leadership and what we're talking about today.

Brogan Baxter:
Yeah. You definitely don't want to be an absentee owner. You don't want to fiddle while Rome burns here. You don't want to be Nero in this case.

Jarrod Bridgeman:
Whoa. Hitting us with some history right there. Okay.

Brogan Baxter:
Classical mythology. So no, the, the idea is that you're not absentee. That's why you put good systems and processes in place. So you're in the know enough to keep your pulse on what's going on in your practice, but you're removed enough to know that everything's going to be handled for you so you can focus on what you're good at, which is working with patients.

Casey Hiers:
Well, you hit on it, traveling, presenting CE to groups, ultimately their biggest challenges. They typically lead with my biggest frustration is my team or my staff, right, culture, all those things. That's can be tricky because more times than not, it comes back to well, practice on how is your leadership? How are you leading your practice? More times than not, they want to check out on that, and they want somebody to do it for them, which raises the importance of finding a good office manager. But it comes back to leadership. Their biggest complaint is typically what they may be the weakest in. That's a tricky proposition and you have to talk to practice owners all the time about it. How common is it a practice owner to realize they need to be better at that and to improve themselves and maybe an office manager? I mean that that's not an easy task.

Brogan Baxter:
I think a lot of them know that they need to improve. I don't think a lot of them necessarily proactively want to go through, or even frankly know where to start, to try to want to improve in some of those areas. If it's left to the dentist, especially if they have a week or no office manager, I've seen that. I don't recommend it, but I've seen it. A lot of dentists will try to hire the people with the same personality type as them. You got to remember what that is, is somebody who doesn't really have people skills. Might be gifted clinically, but they don't have the best clinical skills overall. That just doesn't translate well when that's somebody upfront, you want that person to generally be somebody bubbly, and the patients like, that has a charismatic personality that they bring to the table. So that's why if you've got a strong office manager and you say, "These are the characteristics I'm looking for, go find this person." Then they just get pulled in whenever it's needed. That's how you can lead an organization.

Jarrod Bridgeman:
It actually makes a lot of sense. I was just thinking about my dentist that I go to and how I really liked the lady that's up front and everybody handles that stuff. The actual dentist, I see for three minutes. What other people I talked to you on the phone constantly.

Brogan Baxter:
Yeah. Part of being a good leader is really looking at yourself saying, where do I lack? Let's build a good team that can help support the areas that I'm lacking. Sometimes that's a hard look in the mirror for S for some dentists. Sometimes you get blinded by some of the relationships that you have with some of your staff now, because man, I really like Becky, but she doesn't really fit with what I really want to do. So how does that happen? Again, we get back to the ringing of the hands because they're conflict avoider.

Casey Hiers:
I like to quantify things, Brogan. I know you like numbers.

Brogan Baxter:
I like numbers.

Casey Hiers:
How can poor leadership affect the practice owner's money? You've seen it right? If it's a poor culture, you've got a lot of turnover. The cascading negative effects of a lack of leadership. Let's quantify it. Let's put some numbers to it, or at least potentially what can happen if you have a revolving door of employees, office managers, lack of leadership.

Brogan Baxter:
Boy, that is an absolute loaded question, that can go 100 different ways, but picture this, most dentists that are listening to this right now know what they produce on a daily basis. I'm talking the entire practice here, so whether that's $3000, $5,000, $8,000 or $18,000 a day, what happens when you have poor staff that can't show up to work, that always call in, that you have high turnover? Or people that are setting bad example, so it spreads and you're creating a negative culture where everybody becomes entitled. Nobody's doing what they say, there's no authority. What is that worth to you? 20% efficiency? 30% efficiency? 30% on $18,000 is about $5,400 a day. You multiply that out by a year and you're talking about a lot of money there. So I want to make sure that the message going out today is, you need to fire anybody who doesn't agree with you.

Brogan Baxter:
But what it does need to be is if somebody is not where you want them to be, what can you do to breadcrumb your way to get them to where you want them to be? What do I need to do now? What steps can I take now? This week? This month? Today to get them to where they want to be to where I want them to be in a year? Or when do I decide that if they're not by this date where I want them to be with a little bit of help from me and or my office manager, other employees, whatever the case may be, what do I do then? How do I do that?

Casey Hiers:
So if I'm a listener out there, I'm thinking, okay, that makes sense. So what are some of those breadcrumbs that you need to get them to be where they want to be?

Brogan Baxter:
Sure. So let's say you have somebody that you would like for them to show more initiative. Okay. So what you can do is mentioned to them, "Hey, I'd really like for you to start doing some additional things in the practice." You keep it vague or even ask them, what are some areas you'd like to learn more about in the practice? Okay. You find out what those things are and then you say, "Okay, I'd like for you to start running with doing that. Come talk to me for whatever that initiative is." Let's say they've got somebody that they want to start perio charting better for the prophy exams. So they want to make sure they want to start implementing a strategy.

Brogan Baxter:
Okay. So how are we going to track that? How are we going to know if there's even any progress in this? Do we know how many people we're doing this for on a daily basis? Is there a goal we need to hit? How are we going to do that? Empower them to come up with some ideas, "Hey, if you're really passionate about perio and I want you to take more initiative, what's some things we can do in the practice here to start doing that. Let's start working towards that. You can start with a goal and work yourself backwards.

Brogan Baxter:
If the goal is we want to do it to 80% of the people that come into the office. Okay. Well, how many people do we see in the office? How many patients? All right. Work backwards from there. So what do we need to do on a daily basis? Whenever you find out what that is. Let's say you do 20 of those exams perio charting, you're doing the perio charting on 20 different patients a day, but you're doing it on two now. Well, that seems like a long way. So what do we need to do to build up to 20? What sort of timeframe do we want to do to build up to 20? Is this the person to do it? Then it comes to the important part, actually holding them accountable to be able to do it.

Brogan Baxter:
Okay. Well, we all agreed that this is a reasonable number, and this is a reasonable plan of attack, so why are we only doing it to four patients after four months, a day, instead of 20. We agreed that we wanted to be at this point 16, so what's getting in your way? Again, in this specific example of initiative, you're giving someone an opportunity to be able to improve, but giving them the opportunity and then following up on it to make sure it's actually being done or delegating somebody else to, "Hey, make sure that we hit these numbers." Then you're going to figure out where the weak link ultimately is and you're also going to enrich your employees by either figuring out yes, they can do some of these additional things that they've been given in this specific example, like implementing a perio program. Which is more self-worth to those employees, makes them feel better. But then the flip side of it too is, he's empowering employees, assuming that the dentists in this examples is male.

Casey Hiers:
That is linked to a conversation I had, another organization was talking about this, and they said one of the most important components within their group and their culture is truth over harmony. A lot of times practice owners want the harmony, to your point, they're not confrontational, and it's not good for anybody versus, if truth drives things, truth over harmony will ultimately have a better result than conflict avoiders like you had mentioned, or just letting a bad culture fester.

Brogan Baxter:
I can almost assure you that three out of the four people listening to this right now are running through their head going, "Okay. So he's talking about this employee in my office, and I just need to figure out how I want to try to do this." This is what happens. I'll tell you people out there and wherever you're listening to this at, you are not alone. This is very, very normal, but it's trying to implement things to try again, try to make things where you want them to ultimately go. It's taking a step as opposed to no steps.

Jarrod Bridgeman:
In case he does touch upon what he said with the truth over harmony part. I was thinking about if you have a employee that you need to talk to, it is better to talk to them now, instead of letting it sit and fester, as you said, for weeks and months where it can become like a really, really bad habit for them to continue to do this and think it's okay. Then a year from now, when you're fed up with it, you let them go. They're like, "Why I've been doing this, and you've known this this whole time."

Brogan Baxter:
Right. Yeah. "I've never heard about this until now." So that's where it's good and there's a fine line there between trying to make sure things are going the way you want them to go and being a micromanager. I think that difference is empowering people and trying to give the authority to be able to do some of these things, but also try to curtail things that are not going the way you would like them to go sooner on the front end to your point.

Casey Hiers:
They typically don't just fix themselves as much as our listeners probably wish that were the case.

Brogan Baxter:
Yeah. Boy, hell, the world would be a hell of a lot easier that way.

Casey Hiers:
Yeah, right. So what can a practice owner do who is overwhelmed, right? Who hears this and just almost feels a little deflated because they are so overwhelmed and they're realizing I'm going to have to do something about this.

Brogan Baxter:
What I would do first is I would pour yourself a stiff drink, if that's what you need to do, if that's your thing. Really think about all of your staff, write all their names down. What I would do is I would evaluate, okay, on a scale of one to 10, let's say, were 10 is high and one is very, very low. How ideal are these people in doing what you want them to do in your practice the way you want to do it? Okay. Then there needs to be a second column of that, where they go, okay, regardless of where they rank otherwise, how important are these people to you in the practice? Where the high score there would be, it would be absolutely catastrophic if we lost this person.

Brogan Baxter:
Okay. Then I would start with trying to work your way from the bottom up. I mean, as far as like the biggest hole in the dyke, so to speak. Moving forward, plug that hole first and try to figure out what do I need to do to get this person to where they need to be, where are they lacking? Who else can I involve in my practice to be able to do that? Now, if you do that, and everybody's a problem.

Jarrod Bridgeman:
That's a real big issue.

Brogan Baxter:
I mean, that's a real big issue and quite frankly, that's probably where you want to probably involve someone from practice management to be able to help you out. There's a time and a place for practice management. If we're talking about significant wholesale changes like that, that's probably where you want to bring in someone to be able to help you out with those regards.

Brogan Baxter:
If we're talking about one or two, you can also look at some of the allies you have in the office. Like some of these other people I think can help train this person to get them where they need to be, they can be part of the solution too. That's another point, never underestimate having the employee themselves that you have the issue with, be part of the solution. Make them part of the solution, give them an opportunity to be able to come up with a course of action that they feel like is going to get them on board for where they want to be. When they get done and it's not the case, they created the damn thing.

Casey Hiers:
No, I would say if they're going to go stack rank their employees and they want to keep the emotion out and may want to pour the stiff drink after they stack rank them-

Jarrod Bridgeman:
They might want to pour two rounds.

Casey Hiers:
Because that's the key. When you're stack ranking them. I mean, I hear this practice owners all the time. There's so much emotion, right? Somebody may not be the best employee, but they've seen their child grow up and overcome a sickness.

Brogan Baxter:
Family friend I feel for them personally, whatever the case is, I've seen it.

Casey Hiers:
So you've got it. When you stack rank employees, you've got to pull out the emotion.

Jarrod Bridgeman:
Well, it's hard in offices like that, where there's only a handful of employees. Of course, you're going to be close on some level.

Brogan Baxter:
Very much so it's intimate, especially if you've ever had any turnover in a few years, but what happens, it's just human nature, it's easy to get complacent. It's complacent until there's some reason for it not to be. So be that catalyst to make everyone not complacent. You're a driven dentist that has done nothing but succeed in their entire life. Why do you want to settle now?

Casey Hiers:
Amen to that. I think that's a good place to put a bow on it. Again, to the listeners and the practice owners out there, this affects your wallet. It also affects your day to day happiness, because we hear it all the time, "We're frustrated with this or that, or our team, or our staff. It's up to you, be a leader to do something about it, that's the first step and there's help out there. Brogan, I appreciate you being on today and sharing some of your wisdom to our listeners. Jarrod, and as always. Thank you, sir.

Jarrod Bridgeman:
Thank you.

Casey Hiers:
Be well.

Brogan Baxter:
Thank you gentlemen.

Announcer:
That's all the time we have today. Thank you to our guests for their insight and for sharing some really great information. Thank you to you, the listener, for tuning in. The Millionaire Dentist podcast is brought to you by Four Quadrants Advisory. To see if they might be a good fit for you and your practice, go on over to fourquadrantsadvisory.com and see why year after year, they retain over 95% of their clients. Thank you again for joining us and we'll see you next time.