Alleviating HR Headaches

What does it take for group practices to make a great hire?

EGP-MayJune16-sDentists are spot-on when it comes to providing great dental healthcare. But, hiring and managing office staff often is outside their area of expertise – particularly when they are new to the industry. As business owners, however, it’s imperative that they hire the right people who will support the office culture and mission, and dental service organizations offer their members the support they need to accomplish this.

Efficiency in Group Practice reached out to several DSO executives to discuss what dentists should – and should not – do to ensure they hire a staff they can depend on.

Efficiency in Group Practice (EGP): What are some of the biggest mistakes dentists (and their office managers) make when hiring new staff?

Aspen Dental Management Inc. (ADMI) (John Murphy, director of talent): Often times, dentists and dental office managers move too quickly when hiring new staff, particularly in a busy practice, where there may be a tendency to fill the need as quickly as possible. To simplify, they should evaluate for strength, motivation and fit. This means asking questions like:

  • “Does the person have the skills to do the job well?”
  • “Are their motivations in line with the values of the practice?”
  • “Can this person assimilate into the culture of the office?”

Avitus Dental Management Solutions (Quinn Dufurrena, DDS, JD, president and CEO): Some of the biggest mistakes include not providing new employees with a job description and clear expectations of the job; not completing the I-9 correctly and obtaining required documentation; not giving new employees a handbook outlining the practice rules on their first day; and not providing adequate training.

Heartland (Jayme Schultheis, director of human resources, Sabrina Sennett-Eveland, vice president of operations; Kim Urso, vice president of operations): At times, dentists and dental office managers tend to hire candidates too fast, without focusing on their technical, commitment and personality skills. In addition, they sometimes pay lower wages to new team members.

Great Expressions Dental Centers (GEDC) (Kristy Loomis, vice president of human resources; Rich Beckman, CEO; Greg Nodland, COO; Dr. Robert Brody, chief clinical officer): Dental offices sometimes make the mistake of selecting someone to plug a hole when the candidate does not show a pattern of past work success or stability. Additionally, this can be a side effect of waiting for turnover. Once it happens, offices scramble to put someone in place, even though that person might not be the right fit for long-term success. We encourage practices to build a pipeline of great people so they improve their chances at filling that position when turnover occurs. Other hiring mistakes include:

  • Some dentists are not willing to train, especially dental assistants. This is one reason we launched a dedicated training department called GEDCU. We want to set up the candidate for success, and it saves us money in replacing employees, job postings, etc. So it is truly beneficial for both parties.
  • Focusing solely on experience. Many practices only interview candidates with a lot of years of dental experience. Experience in some roles is a positive thing, but dental practices should also focus on natural talent and ability to learn, as a lot of things are teachable in a dental office. If you find a great new practice administrator who comes from the outside with one year experience, and [he/she] is also hungry to grow, picks up on new materials quickly, is willing to adapt to your culture and has managed a team, it may be worth bringing that person in for an interview. At Great Expressions Dental Centers, we have some of the best dental software in the industry, and a dedicated training department (GEDCU), so that when we find the right person, we can get them trained and set up for success at GEDC.
  • Not being clear on what you want from the candidate. The dental office is a busy environment, so writing down what you are looking for in a candidate helps you evaluate candidates and set expectations for both parties.
  • Hiring people for the office who are not into providing care/customer service. They are there for the steady paycheck – not to take care of and interact with patients.

EGP: What direction can the DSO provide for its members as they look to hire new staff?

ADMI: This is a critical service of any DSO. The DSO should be able to help the practice owner clarify its employee value proposition (EVP) and recognize the importance of building a strong team. The DSO should also provide them with the tools, systems and support to identify and select the right person. Dentists in the Aspen Dental network, supported by ADMI, recognize that it takes a cohesive team with a shared purpose to make a difference and to achieve great results. The collective belief is that the patient experience will never exceed that of the team experience.

Avitus Dental Management Solutions: DSOs can assist with taking the burden of recruiting off of the dentist’s plate. They can ensure that staff is on-boarded correctly from a federal document perspective.

Heartland: DSOs can offer supported dentists information on market rate value, as well as help them utilize a thorough interview process to identify candidates who are at least an 80 percent match for the position.

GEDC: We can provide the most cost effective solutions by utilizing synergies due to volume, with advertising on job boards. In addition, our talent database has become very strong over the years and we have a large volume of resumes and candidates to call.

 

EGP: What ongoing support can the DSO offer to help dentists retain good staff?

ADMI: It starts with the tools and mindset to make the right decision in hiring. From there, it continues with strong on-boarding and training programs, ensuring the new team member understands what the values of the practice are and that there is a vision for their continued growth. ADMI and the practice owners we support have developed learning journeys for the office staff so they have clarity on the skills required to grow professionally and what they need to do to ready themselves for the next step. Interestingly, of the nearly 600 office managers in the Aspen Dental network, the vast majority has been promoted from within.

Avitus Dental Management Solutions: We offer benefits that the practice doesn’t [necessarily] provide. We assist with training dentists and their staff on HR best practices to ensure employees are being treated fairly. We also help with standardization of HR documents so that everyone is treated fairly.

Heartland: DSOs offer supported dentists training and access to bonus programs. DSOs also focus on helping dentists grow as leaders, so they can build and lead strong teams.

GEDC: We encourage the doctor to partner with the practice administrator on hiring and termination decisions. The doctor and the PA need to be in sync, and the doctor needs to be a visible leader in the office, just as if it was his/her very own practice. In addition, good team members are hard to find, and even harder to replace. We talked to our employees and the things they wanted most were positive, caring relationships; recognition of achievement; pride in the dental group; and opportunities for growth and advancement. The factors above led to our development of the Leadership Development Program, which is a program designed specifically to help team members reach their career goals. We also launched our Power of One Rewards site, which allows doctors and office team members to electronically recognize an employee for a job well done, or for going above and beyond. We see positive comments posted and we want to share that with others in the organization through the Rewards site, our internal newsletter and more.

 

EGP: How can dentists and office managers ensure that the staff they hire supports the mission and vision of the practice?

ADMI: This is harder than it sounds. Talking about the mission and vision of the practice frequently, and embracing the values and using them to guide attitudes and daily decision-making, will ensure each new hire is aligned. The support team at ADMI has created a BLUE Health Check to help practice owners recognize and reward their teams when they exhibit the behaviors that reflect the office’s mission. This is quite helpful in leading their teams effectively.

Avitus Dental Management Solutions: They can do so by conducting in-depth telephone screening and in-person interviews. They should shape their interview questions around the practice, while keeping them job-specific. In addition, dentists should include background checks and include the practice’s mission and vision in the employee handbook.

Heartland: Dentists must continually communicate the mission and vision of their office, as well as the why behind it. This can be shared at weekly meetings, huddles, etc. Dentists must relate the work of their team members to that mission and vision, in order to truly gain buy-in from team members.

GEDC: They need to set clear expectations upfront in the interview; explain what are – and are not – allowable standards of patient care; explain how we have higher expectations; and ensure that they are comfortable following more stringent procedures in order to take their career and patient care to the next level. In addition, they need to put it in writing: let [the staff] see things like your dental group’s mission and vision written on paper, in the art in your office, etc. One of the best things we can do for future and current employees is set the expectation.

 

EGP: What does it take to provide a rewarding work environment and retain office staff? Good benefits package? Education opportunities? Immediate feedback about performance? Up-to-date technology? Office culture?

ADMI: All of the above are certainly helpful and play a role. But the key is, without a doubt, creating a culture that empowers team members to fulfill the purpose of their practice: helping patients get the care they need.

Avitus Dental Management Solutions: All of the above are important.

Heartland: All of these items can make a positive impact for team members. There’s not just one thing that retains office staff. All of these things need to be implemented. Appreciation must be shown.

GEDC: All of the above, really. Each item may have a different weight of importance to each employee. It’s up to the manager and doctor to understand and flex their style with each person. In addition:

  • We perform performance reviews, offer benefits and are constantly looking to add additional benefits. We also offer GEDCU, our own training department with hundreds of courses and classes. Our offices are continually adding new technology and moving to 100 percent digital offices.
  • Culture is important to all dental groups, as well as companies, for that matter. Creating the right culture and finding candidates that can thrive in your culture is essential to a rewarding work environment. We want employees to be happy, while at the same time be the right fit for us.
  • Another way GEDC helps provide a rewarding environment is through charity work and giving back to our communities. In dental, that is part of the employees’ DNA – they help people on a daily basis. So we donate to certain charities every year, and we have created avenues where employees can get involved, like participating in GEDCs partnership with Feeding Children Everywhere, where employees come to a GEDC location and make meals for hungry children; providing oral care products should an employee go on a dental mission trip; and hosting community events with our Smile Center tent in each market (e.g., Tampa Ribfest, Atlanta Dogwood Festival, Detroit Winterblast, etc.), where employees can educate the public about oral care and interact with the public.

 

EGP: What is the dentist’s responsibility with regard to assisting with the cost of his/her staff’s continuing education? What is the DSO’s responsibility?

ADMI: It’s the practice owner’s responsibility as the leader of the practice to encourage continued learning and development of skills; to engage with the team in dialogue about their learnings and experiences; and to champion collaboration with their peers. It’s also the practice owner’s responsibility to identify specific areas for continued improvement, whereas the DSO’s role is to make continuing education available to the owner dentists and their staffs.

Avitus Dental Management Solutions: Most practices offer some sort of training or certification reimbursement. If it’s training at the request of the practice, the practice should pay. If it’s something the employee elects to do, the practice can choose to reimburse at a rate they wish.

Heartland: Both the DSO and supported dentists take responsibility for the cost, and [they should] expect the knowledge team members’ gain to make an impact in the practice.

GEDC: You can go in many different directions in regards to staying current and up-to-date on your CE requirements for license renewals. At GEDC, we have thousands of online courses for our clinical staff, which meet the requirements needed to get their licenses renewed. We provide these online courses at no cost. In addition, our doctors can participate in other leadership programs and pod meetings. Pod meetings are when a group of doctors get together to study cases and learn from each other or from a specialty doctor in our group. GEDC offers in-office CEs designed to train the entire staff, which are conducted by GEDC doctors or experts in a particular field.

 

EGP: How important are job descriptions?

ADMI: They are critically important. Accurate job descriptions help create a realistic preview of the job for a prospective new hire, clarify expectations and communicate how the respective employee will be evaluated.

Avitus Dental Management Solutions: They are very important! Job descriptions set the basic guidelines for the position. They should be used during a performance improvement plan, work comp claim (if needed) and for ADA accommodations. They should be accurate and include the verbiage, “other duties as assigned.”

Heartland: For DSO support positions, job descriptions are important, but they do change as the company changes. Starting with the goals of the position will help define the overall focus for the role. Even if tasks and responsibilities fluctuate, the overall focus of a position should stay relatively [constant]. Descriptions are important for producing guidelines for the team member to work toward.

GEDC: Job descriptions provide some function in regards to workforce planning and job evaluations for work accommodations. They also are good for setting expectations. However, on a daily basis, a job description should not really play into the day-to-day business.

 

EGP: How important is it for job descriptions to be consistent throughout the DSO?

ADMI: The job description typically spells out the responsibilities of the job. From practice to practice, these responsibilities may shift based on the direction of the owner dentist or regulations in a particular state. The DSO, in an effort to build efficiencies, should at the very least have a template for jobs, which the practice owner can amend to fit his/her individual direction.

Avitus Dental Management Solutions: We provide customized job descriptions, as well as template job descriptions. It is important that everyone have job descriptions so that things are consistent across the board, and certain employees aren’t treated differently. This can quickly lead to a legal claim.

Heartland: At Heartland Dental, we do provide consistent job designs. This helps us stay consistent to our systems. If job designs become more and more customized, that consistency can become difficult to maintain.

GEDC: To have a meaningful training department and onboarding, a certain level of consistency is required. Otherwise, training cannot be developed. At the same time, you must have flexibility within the office to ensure the office staff adapts to patient needs. We have a job description for all key titles and job families. However, just because we have job descriptions doesn’t restrict us – or the dental office – from modifying what each person must do in order to make that office successful. The job description probably covers 85 percent of the responsibilities; there are another 15 percent that are not always captured.

 

EGP: How often should dentists and office managers hold staff meetings, and what important points should be covered at these meetings?

ADMI: Daily. At Aspen Dental practices, most doctors hold a morning huddle that brings together every member of the team. In addition to reviewing the schedule for the day, they also talk about what went well the day before, celebrate successes, and recognize members of the team.

Avitus Dental Management Solutions: Weekly staff meetings are important, either at the start or at the end of the week. Any new treatments, education, policies, procedures, situations, etc. should be discussed at these meetings.

Heartland: Communication is key in a practice, and the relationship between the dentist and office manager is very important. Dentists should be clear on what the office goals are and what their expectations are. A road map to achieving these goals should also be created and communicated. Specifically, teams should huddle every morning and have a team meeting one time per week. There, patients, the team and the business should be discussed.

GEDC: At GEDC, our model teaches to have morning huddles and afternoon strategy meetings from an operational standpoint to ensure the team is serving the patients the best. However, from an employee relations standpoint, it really depends on each office. If there are a lot of changes or new employees, you may want to hold them more frequently, say weekly. If everything is business as normal, then probably monthly would be fine for that team.

 

EGP: How important is if for the office to be a fun place to work? How can dentists and office managers create a fun, yet professional office environment?

ADMI: It’s important that people know why they come to work every day and that their values are aligned with those of the practice and the team. When you have a strong team and strong leadership focused on delivering great service, the fun just sort of happens organically! And that benefits the patients.

Avitus Dental Management Solutions: Fun is subjective. I could be having fun, and someone else could be hating [the task]. I think a clean and safe practice is the #1 priority. Lining the walls with attractive pictures and colors is also important. Dentists should have regular (monthly) employee lunches and openly acknowledge good ideas with [everyone in the office]. Respect for one another is mandatory; employees need to feel comfortable talking about issues with their supervisors.

Heartland: It is definitely possible to create a fun and professional office environment. It takes teamwork and everyone doing their part for this to be successful. The team’s attitude in the office can make or break how successful it can be. It is a game changer when an office becomes a fun place to work. The impossible becomes possible. Goals are met and retention is often achievable. People want to have fun at work.

GEDC: We believe the workplace is what you make it. When you join a team, it is not about yourself and what your needs and wants are. Teams will truly have FUN when they put themselves aside and put a smile on their face. Fun is winning; treating patients and seeing patients smile due to great service is winning. Setting team goals and taking a moment to celebrate those successes keeps it fun, and gives the employees the recognition they want. Additionally, creating the understanding of the value of the service makes for a more enjoyable work environment.

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