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339 Human Resource Management with Ann Marie Gorczyca : Dentistry Uncensored with Howard Farran

339 Human Resource Management with Ann Marie Gorczyca : Dentistry Uncensored with Howard Farran

3/21/2016 2:49:47 PM   |   Comments: 0   |   Views: 406

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VIDEO - DUwHF #339 - Ann Marie Gorczyca



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AUDIO - DUwHF #339 - Ann Marie Gorczyca


 

This episode’s discussion:

- Recruitment

- Integration

- Scheduling/Management

- Reviews

- Distribution of Resources

- Termination

- Teamwork

- A Positive Workplace

- Leadership

- Work-Life Balance 

 

Dr. Ann Marie Gorczyca is a Board Certified orthodontist and clinical professor at the Arthur A. Dugoni School of Dentistry, University of the Pacific. She speaks on practice management topics including marketing, teamwork, treatment coordination, customer service, management systems, and human resource management.  She is author of two books "It All Starts With Marketing: 201 Marketing Tips for Growing a Dental Practice" and "Beyond the Morning Huddle: HR Management for a Successful Dental Practice."  She has spoken at the AAO Annual Sessions and will speak again in 2016.  She has teaching awards from both UCSF and U of P Dental Schools. Her orthodontic practice Gorczyca Orthodontics is located in Antioch, California.  


www.clubbraces.com 

Howard:

It is a huge honor to me to have you come back for round two, is Dr. Ann Marie Gorczyca, like the island Corsica, out from Antioch, California. How many books have you actually written, Ann?

 

Ann Marie:

Well, this is the second one, and I'm working on my third.

 

Howard:

Go through it. What was the first one? The second one? What is the third one you're working on and when should we expect that, and will you come back for a third one when you come out with your third book?

 

Ann Marie:

Oh, sure. I'd love to. Well, this all started by teaching at the University of the Pacific Dental School in the Practice Management course for the orthodontic residents. In the Practice Management course, there are six lectures that I give. The first one is marketing. The second one is teamwork. The third one is treatment coordination. The fourth one is customer service. The fifth one is management systems, and the last one is human resource management. My first book, It All Starts With Marketing, that came out three years ago, and I decided to do the human resource management book second, because I feel there is such a need for educational materials in this area.

 

 

I skipped the sequence, and I decided, "I'm going to just jump right to human resource management, because if you go to Amazon, and you put in human resource management, dentistry, my book is the only book. I wonder even if dentists know the full range and ramifications of human resource management, but classic human resource management has six functions. It starts with recruitment. It goes to the integration process of a new team member.

 

 

Then it goes to management, or the scheduling. Then it's the responsibility of developing and reviewing your team members, knowing the law, and then lastly, termination. Those are the six things that dentists need to know. I'm happy to say I'm now a member of the Society of Human Resource Managers, and human resource management is an area that's not popular. It's not attractive. It's something that dentists are challenged with, but it's one of the most important aspects of practice management.

 

Howard:

And it's the hardest thing about life. The greatest thing about being alive is the other seven billion talking monkeys that you share it with, and the worst thing about life is sharing it with the other seven billion ... I mean, humans are just the most complex. They're far more complex than doing orthodontics, or endodontics, or perio, wouldn't you agree?

 

Ann Marie:

That's right. Human resource management is fifty percent psychology, and the other fifty percent employment law. The psychology of human beings, you're absolutely right. Whether you're an organizational structure or a family, or a country, there will always be challenges with human beings working together in perfect harmony. That's our challenge as the leaders in our own dental practices, is how are we going to make it all work? How are we going to groom good citizenship behaviors, and good work behaviors, good performance behaviors, and eliminate dysfunctional behaviors and poor citizenship behaviors?

 

Howard:

Well, I want you to come to the next Farran family Thanksgiving dinner and first solve it between my two oldest sisters, who are Catholic nuns and my youngest brother, who's gay. If you could just solve that human resource issue at the Farran family Thanksgiving, I would give you a Nobel prize. It is, because people start with their belief systems, whatever that may be, and then to even make it more confusing, you go into dental offices and the dentist is an old guy from the greatest generation, and then the front desk is a Baby Boomer, and the hygienist is a millennial and the assistant is a Generation Nexter, and they just all believe different things, don't they?

 

Ann Marie:

Well, everyone has a different work pattern. I think of hiring a new person the same way I would think about dating. When you start out, you're going to maybe get fifty resumes. You're going to go through the resumes and you're just going to look for things that you are looking for. I look for perfect attendance, I look for a high GPA, and then you are going to make the initial phone call. You're just going to ask questions, listen to their voice, listen to how professional is this person? Some people won't even make it past the initial phone call. You won't even invite them for a meet and greet in your office.

 

 

Then maybe you narrow it down to ten, and then you bring in ten candidates for a meet and greet, and the first thing you should be asking yourself is, "Do I like this person?" Because you are going to be spending more time with them than perhaps your own family or spouse. The team has to like each other. If there is tension or dislike among the team members, it's not going to work.

 

 

For the initial meeting, I would consider it a meet and greet. You're going to ask the candidate a few questions, but you're really looking for a gut feeling, and the greatest HR manager of all time, Jack Welch, he always talked about you've got to go with your gut feeling. Before you even get to performance, you are going to screen this person, and then you're going to ask your team, "What do you think? Do you like this person? Do you want to invite them back for an interview?"

 

Howard:

But in the field, when you're in real dental offices, what percent of the dentists even expose the new candidate to the rest of the team?

 

Ann Marie:

They have to. It's not going to work.

 

Howard:

But they almost never do, though. Would you agree that they almost never do?

 

Ann Marie:

I don't know that, but that is a huge mistake if they don't. If the manager or the doctor do not take a poll of their team, and not only that, I would make it mandatory that the new hire is unanimous decision with the team, because when it's unanimous decision, that everyone has decided this is the best candidate, they are vested. Your team is vested in making that new person a success, and no one can go back and say, "Well, I didn't really agree." No. You made the commitment as a team to hire this new person, and then you're going to work together to make them successful in the office.

 

 

Moving on, once you get the unanimous decision of the team, let's go for a skills assessment. Whatever job function you're looking for, you want to invite the candidate for a non-paid skills assessment, and just ask them to do the job you're asking them to do. If they're going to answer the phone, have them answer the phone maybe two or three times. If they're going to be doing general dentistry, I don't know, maybe you could ask them to set up a tray or clean up a unit. In orthodontics maybe you could have them tie an arch wire in, or untie an arch wire, or fit a band.

 

 

I would recommend you do it on a typodont, because there's liability with doing it on one of your patients, but I would do a skills assessment, not only once. I would do it twice just to be certain that this person has the skills that you're looking for, or that they're trainable. They might not even need the skills, but you want to pick up how fast does this person learn and are they trainable? In my book, one thing I mention is a little test. I call it the common sense test. When someone in my office comes for their skills assessment, especially if they're a chair-side assistant, I casually just take a cotton roll and I just throw it to the ground in front of their feet.

 

 

I'm looking to see does that person have enough sense on their own to pick up that cotton roll, pick it up and put it in the garbage? Because if they don't have enough common sense on their own to do that, I don't want someone that I'm continuously telling them to do every single step of their job. This is something that Bruce Tulgan, the great HR consultant, wrote about in his books, is in restaurants, restaurant owners are continuously frustrated that they hire people that walk past the salad bar and something is out of place, maybe a piece of lettuce fell on the floor, and they don't pick it up. They don't tidy up the restaurant.

 

 

It's the same in dentistry. You want someone, on their own, who's always thinking about customer service, how can they make the office better, how can they make the patient more comfortable, and how can they assist in the success of the office and assist the doctor? Once you get through all that, skills assessment, and your team says, "Yes. This is the best candidate," then you are going to make the job offer. It's your offer. It's not a negotiation.

 

 

It's, "This is the position. This is your skill set. This is what I'm willing to pay you in my office." You make the negotiation and then finally you do the background check. If someone is going to be handling money, you definitely want to make sure they don't have a criminal record, or they've been arrested or whatever. You do the final background check and then it's smooth sailing from there on. In my book, I list a thirteen-step process, and time spent hiring is time well spent. You do not want to rush it. You want to hire people for life the best way that you can.

 

 

Now, that being said, thirty-one percent of workers hired in the United States quit their job within the first six months, so even if you do everything, and you hire the best person for the job, there are still reasons that the person may not stay in the job. Those reasons include the job isn't what they thought, it was too much work, they decide they don't like the job. Maybe they don't think it's challenging, or maybe they just don't like the culture, or they don't fit into the culture.

 

 

Now, culture is not optional. You, as a business owner, whatever your practice culture is, that is the new employed person's job to fit into your culture, not for you to adjust your culture to fit the person. That ninety-day introductory period is extremely important, and you should consider it like dating. Ninety-day introductory period, you're not married yet, so if you need to make a break that first day, second day, third day, if someone isn't in sync by the third day, and everyone on the team is already questioning, "I don't know if she's going to be able to do this job," I think it's preferable to make a break.

 

 

Just say, "You know, your talents are not really suited for this job." In my book I give an example of a receptionist I hired. I thought her interview was fine. I thought she was fine. She came to perform her job. First day, couldn't do it, second day, couldn't do it. We made the break. Why torture yourself and torture the other person for six months to figure out they cannot do the job? That's what great HR managers know. Not everyone has unlimited potential, and they may not be suited for the job that you're trying to get done in your office.

 

Howard:

Would you say that HR is the single most important part of running any business?

 

Ann Marie:

Well, yes, I think it is. It is your business. The people in your business, working for you, they are your business.

 

Howard:

I mean, you're up there by the 49ers, and I'm down here with the Cardinals. Every NFL team takes HR, the most important. They know if you get the best quarterback, the best running back, the best receivers. What I see is a dentist who will have an assistant give two weeks notice because she's moving, and they'll wait until the second week to run an ad on Craig's List. Two people will come by the office and drop off a resume, and they'll hire one of those two. I just don't ever see it taken serious.

 

Ann Marie:

Yeah. When you hire a new person, I would give it one month. If someone were to give me their notice on Monday, I would place the ad on Monday, and I would start looking at the resumes Tuesday. I would have the new person help me try to find their replacement. It is a team effort. Jack Welch, in his book, Winning, which is one of the greatest HR books ever written, says that the head of human resource management is more important than the Chief Financial Officer at a company. That is true. You're absolutely a hundred percent right. Your people are your business. You cannot run your business without a good team. Time spent on hiring is time well spent. You've got to take it slow, and you've got to do the absolute best that you can to hire the most talented person that you can find.

 

Howard:

When I go into the Dentaltown app and I go to practice managers and staff issues, it seems like the thing most stressful about staff to any dentist is letting someone one. They're literally sick about it, and humans don't like ... They like to make other humans happy. They don't want to go tell someone, "You're fired."

 

Ann Marie:

Right.

 

Howard:

You got any tips? What would you say to a dentist who's just nauseous right now, listening to you on this HR ... Because they know they've got to go in there and someday, sooner rather than later, fire one of their team members? What advice would you give them to make that less painful?

 

Ann Marie:

Okay, this is the advice. I have never fired anyone in twenty-five years. What I do, which has been one hundred percent successful for me, is I keep the pressure on performance. I am totally honest with what I'm expecting for performance, and when someone is not delivering what I'm asking them to do, sooner or later they will quit, because no one wants to let the team down, and no one wants to do a job they're not capable of. Rather than worry about letting someone go, I always say for HR it takes courage, it takes communication, and it takes candor to be honest about what's going on.

 

 

If someone is not delivering, whatever that might be, attendance or they work slow, or whatever the problem is, you need to bring it to their attention immediately and say, "Sally, we are a high attendance office. Dr. Gorczyca has not been absent one day in twenty-five years, and none of our team members are absent, ever. If being absent once a month is going to be your mode of operation around here, it's not going to work out for you, so either be present or maybe this is not the job for you." Now, let's talk about attendance, because I hear that that's a big problem for dentists.

 

 

I write in my book, and I dedicate the book to my mother, who was an elementary school principal for thirty-two years. Now, if you think running a dental office is hard, with maybe six or twelve employees, imagine running an entire public school with four hundred fifty children, nine hundred parents, forty teachers, all the auxiliary personnel, all the janitors, policemen visiting, firemen visiting, and doing the HR management for an entire school. That's what I grew up with, and every night at dinner, as your dad talked about the management systems of the burger place, my mother was talking about HR issues.

 

 

In the public school system, they have something called truancy. If a kid doesn't show up for school, you find out why. You call, you find out why, you go and talk to the parents. It's the same way in a dental office. If someone doesn't show up, it's not okay just to call, "I'm not coming in tomorrow." "Well, why?" "Uh, my grandmother has a doctor's appointment." "Well, that is not an acceptable excuse, so I expect you here tomorrow."

 

 

If that person doesn't show up, you have the right, if it's written in your team handbook that that's not an acceptable excuse, you have the right to immediately terminate them. In fact, they've terminated themselves by not reporting for duty in your office. I would say to every dentist, when someone calls or texts ... A text is definitely unacceptable. They must call and either speak to the doctor or speak to the HR director, say what the problem is, why they are not coming in. I would call the person at home, and ask them, "How are you feeling?" If they're not at home, that's a bad sign. Right?

 

Howard:

Right.

 

Ann Marie:

I think that if you live to those standards, attendance is not going to be a problem in your dental office.

 

Howard:

I see this as a common thing. [inaudible 00:20:13] dentists. I see dentists all the time, and they say things like ... I'll say, "Well, what bothers you the most about your office?" They say, "My assistant and my front desk, or my hygienist ..." Two people just, it's stressful because they just know they don't get along.

 

Ann Marie:

Okay, you know what I would do? First of all, there are two ways they cannot get along. One way is the silent treatment. Have you ever had that, Howard?

 

Howard:

Yes.

 

Ann Marie:

Two people not talking to each other. That is passive aggression, silent treatment. I would go up to the two of them, and I would say, "I notice that the two of you are not communicating. Why is that?" I would just ask the question. "Why are you not communicating?" Find out the reason. Now, if they're not communicating because they can't get along, I would probably send both of them home. I would say, "Why don't the two of you go home for the day, and come back when you're ready to get along."

 

 

Now, if it's a serious problem, like one person is causing the problem, you have to find out who is causing the problem. Maybe it's just one person. I would probably go for the new person that you just hired, because if you have time seasoned professionals in your office that have been with you for eighteen years, and a new person comes along and they don't get along with that person, I would take the new person aside and say, "Look, you're the new person here. This other person has an eighteen year history in my office. It is your job to get along with her. If you cannot get along with her, then you need to go."

 

Howard:

Another thing that I see in offices, and it depends on the conservative nature of the dentist or where they're born and raised ... Everybody comes from a different tribe, but I see a lot of issues of people freaking out because someone shows up to work out of nowhere with a nose pin, or a new tattoo, or the doctor's spouse works in the office and thinks the assistant is dressing too appropriate. How do you deal with nose pins, tattoos, amount of skin showing? How do you address those ... Are those things that are soft issues?

 

Ann Marie:

No, these are hard issues.

 

Howard:

These are hard issues?

 

Ann Marie:

Because this is your brand. This is your brand. This is the first impression that your new patient gets. Do you want that first impression to be Tiffany's? Nordstrom's? Or do you want that first impression to be a tattoo parlor? This is where the team handbook is critical.

 

Howard:

What is Tiffany's?

 

Ann Marie:

Tiffany's jewelry store, Howard.

 

Howard:

Okay, Tiffany's jewelry and Nordstrom's, and what was, or a tattoo parlor. Okay.

 

Ann Marie:

Or the Four Seasons Hotel or Ritz-Carlton, or even ... I can't speak about Walt Disney World. I don't know what their standard of dress code is, but in your team handbook, in your office policy and procedure manual, which I write in my book, if you are practicing without a policy and procedure manual, it is like you're living in a lawless land. You cannot enforce anything. It's like living in a country without laws. You have got to have that manual. In your manual is clearly specified tattoos must be covered, nose rings cannot be worn, tongue rings cannot be worn. One pair of earrings, one ring on each hand, how long the fingernails are going to be, that when you turn your wrist over, you should not see your fingernails, because that will stab a patient.

 

 

Everything about dress code is written down in your team handbook. Now, even the Mayo Clinic, if you go to work at the Mayo Clinic, and you have a tattoo, if you read their book on customer service, they talk about this very issue, that they have a requirement. You have a tattoo, you have to wear long sleeves, but they do not want your tattoo showing. If you have a tattoo on your neck, you get a big bandage, you cover it up with a bandage. It doesn't mean you don't hire the person. It just means they have to cover their tattoos because we are a health service industry, and tattoos don't go with health service. It's not a health type item. That's my take on that. You do have the right to set the standard of dress code in your office.

 

Howard:

You know why I have no tattoos?

 

Ann Marie:

Why?

 

Howard:

Because you'll never see a bumper sticker on a Ferrari.

 

Ann Marie:

That's right. That's right.

 

Howard:

I don't have any tattoos, just a different generation. I want to go back to this HR manual you were talking about. The bottom line, Ann Marie, I've been out there for twenty-eight years, four out of five dentists don't have an HR manual. Can they buy one? Do they have to create it? How do you get a HR manual for four out of five dentists?

 

Ann Marie:

There are three references I can give you. My personal reference that I use in northern California is Human Resource Advisors, Barbara Freet, located in Lafayette, California. She writes my HR manual. She and I have met for the last twenty years, every year, to update that manual. It has to be updated because the laws change.

 

Howard:

Does she only do dental in California, or does she do ...

 

Ann Marie:

She does the whole country. She does the whole country.

 

Howard:

For dental or for any business, any sector?

 

Ann Marie:

For dental or medical. I'm not sure if she does every business.

 

Howard:

Do you think that would be a good podcast?

 

Ann Marie:

Oh, she'd be fantastic. She is fantastic.

 

Howard:

Would you serve her up?

 

Ann Marie:

Definitely. Definitely. She's one reference. Another reference, you, Howard Farran, actually put me in touch with. That is Paul Edwards, down there in Arizona, at Cedar HR. He could do an HR manual for you. The third reference is HR for Health, attorney Ali Oromchian and his assistant, Andrew Llama. They have theirs in electronic format, where they have it on the computer that you buy a program that you put in your computer, but they could also do an HR manual for you.

 

Howard:

Could you send me all those contacts again?

 

Ann Marie:

Yeah. Yeah.

 

Howard:

By the way, I want to tell my podcast homies out there, you might not know the story about me and Ann Marie, but you have served me up more podcast leads by some of the most amazing people, like the orthognathic surgery lady, the most amazing expert in the world.

 

Ann Marie:

Oh, she's fantastic.

 

Howard:

You do so much for me behind the scenes, I feel like a ... I'm so grateful to you. I'm serious.

 

Ann Marie:

I'm happy to keep doing it. Now, Howard, can I tell you what you have done for me?

 

Howard:

Now, you don't make bald jokes anymore.

 

Ann Marie:

Okay, but I am studying comedy. I am studying comedy and I'm getting my set together for you.

 

Howard:

Are you really?

 

Ann Marie:

If you ever invite me to a townie meeting to speak, I will perform my set for you.

 

Howard:

Oh my God. Consider it done.

 

Ann Marie:

The title of my set is Men-tal Dental. My jokes are all about men.

 

Howard:

Oh, that is awesome. In all seriousness, I have always thought that the problem with dentists is that they were accepted because they got As in math and chemistry and physics, and then they're successful on how they relate to people. The dentist that had a part-time job during dental school, like as a bartender or a waiter, learned more skills as a bartender and a waiter than they did sitting in the library learning math. I love stand-up comedy because you have no props, you have no PowerPoint. You have nothing but just you and a mic, and it's a brutal art form.

 

Ann Marie:

And you're trying to make people happy. You're on the spot and you're trying to make people happy. One of my case studies in my book, my book has fifty-two case studies. Except for two, which are fabricated, fifty of those fifty-two are true scenarios of things that happened to either me, a friend of mine, someone in the Dental Society, some colleague, or they were stories related to me by dental consultants or HR consultants. One of the stories I tell is about, I forget the exact title, but it's about the stressed out dentist.

 

 

It is the most costly HR mistake you can make is for the dentist to be stressed out, to reprimand his assistant in front of a patient. Then he emotionally in turmoil, he goes to do the procedure, he doesn't perform it as well as he could. The assistant is silent. She walks the patient to the front desk. The patient knows something is wrong. Another patient witnesses the whole event. She's thinking, "Wow. Something must be wrong around here," and a third patient sitting in the waiting room says, "I'm going to cancel my appointment and I'm leaving."

 

 

It is the most costly HR mistake to be stressed out in the office. I write in my book, rather than being stressed out, tell a joke. Clear the air. Whatever's done is done. Say you're sorry if you ever do anything to upset your assistant. Tell your assistant, if she makes a mistake, say she's sorry and move on from there, but the worst thing you can do is hold onto it, be stressed out.

 

 

Just like comedy, you've got to be in the moment and you've got to keep moving on. You've got to put the patient first and always be serving the patient, making the patient happy. That's a lesson for all of us, but I have to tell you, Howard, I worked on this book for two years, and through our friendship on social media, you helped me so much put this book together. It's an interesting story, because it started, Howard, with HR, with you ... Hello?

 

Howard:

I was just grabbing the book. It's an amazing book. I'm just holding it up now.

 

Ann Marie:

You're so sweet. Let me tell you this, because this is a story about synchronicity. It happened one day, the first time ever I heard your voice was on a podcast. You were talking about HR, and it was the first time I ever heard you. I knew nothing about you. I didn't even know your name, but I was listening to you and I was thinking, "Oh, my gosh. This guy really knows what he's talking about." I'm listening, I'm going, "Yes. Yes. Yes. Yes. Yes. You're right. Yes." Then you start talking about salaries, and this word comes out, and I won't say the word, okay?

 

 

But you had passion in your voice. That's how I first met you, talking about HR. I started following you on Facebook, and one day I noticed you made a post that you were on a flight from Poland back to the United States, and you sat next to an HR manager of a Fortune 500 company, and you posted that you asked him, "What are the two best HR books ever written?" He said, "The first book is First Break All the Rules, by Buckingham, HR and all, and the second book was It's Okay to be the Boss." Do you remember that, Howard?

 

Howard:

I do.

 

Ann Marie:

By Bruce Tulgan. I'm like, "Great. I'm going to get these books." I get these books, I read these books. I reference both of them in my book. They are the two best books ever written. I start going on Twitter and I'm tweeting some of Bruce Tulgan's quotes that I think are really good. Next thing I know, his CEO sends me a response. "Ann Marie, do you really think that managers need to be as specific as possible?" I said, "Yes, of course. They need to be as specific as possible. Not only that, they need to repeat themselves, like twice or three times to get the job done." The next thing I know, Bruce Tulgan says would I like to proofread his next book, The 25 Mistakes of Managers. I'm like, "Oh my gosh. I can't believe it."

 

 

He said, "I'll email you the book." I was in heaven. I'm like, "I cannot believe it." I proofread that book, I read the book, I write a review, and then I say, "Well, could you do me a favor? Could you write the forward to my new book that I'm working on?" He said, "Sure. I'll be happy to do that." But an even more remarkable thing happened, Howard. My husband and I were on vacation. We went to Massachusetts. We went to Tanglewood, summer home of the Boston Symphony, and we're in a hotel, and we're in the restaurant. We're sitting down there and I look up and I say, "Oh my gosh. There's Bruce Tulgan," sitting right next to us.

 

 

My husband's like, "Ann Marie, you're starting to really worry me a little bit." I said, "No, seriously. That is him. I know that's him. I recognize his nose." I go up to him, and seriously, he is sitting right at the table next to us. If that isn't synchronicity of something coming together, and this book really came together for me. I had incredible input by two attorneys, Art Curley and Ali Oromchian.

 

 

I had great feedback from three HR managers, Paul Edwards, Barbara Freet, and Andrew Llama. I had David Harris help me quite a bit with the embezzlement and sabotage chapters, and you were kind enough to endorse the book as well, so I really want to thank you. I really felt like I learned so much writing this book, and it has so much information that is so crucial to dentists, that can make their lives so much easier in the office, and make them happier, just make them happier in their day to day dealings with the team.

 

Howard:

Those are the only two things I ask my homies to be. I just want them to be happy and healthy, because when they're not happy, then they start to be unhealthy, whether it be drinking or whatever the hell. They're miserable and they're burned out and all they watch is their 401K and count down the days until they can retire. Then when I look at the really happy dentists, they're healthy, and their retirement is so much more because they can work an extra ten years. People do things they like to do. Imagine how much more money you're worth if you didn't have to retire at fifty-five because you hate it so much. You know what I mean? You work on to be ...

 

Ann Marie:

Every dentist should be happy in their practice. I see no reason why a dentist should not be happy in their practice. It's like me saying, "Are you happy in your home?" Your dental practice is your home. That's your home. Would you invite a guest back to your home if every day, or every time you saw them, they made you unhappy? No. You tell them, "I'm never inviting you for dinner again." It's the same way in your dental office. You have free choice. When something is not right, either you correct the problem, you correct it, you talk about it and you correct it, or you eliminate it, and that's exactly what you talked about with Tony Robbins.

 

 

What is the psychology of success? You are working toward your own state of happiness, and you're making adjustments, eliminating things that are not successful for you, or pulling you down, or making you unhappy, whatever, or not making you successful, and you're increasing the things that make you happy and make you successful. Every dentist has the choice to be able to do that every single day. Now, I'll say, Howard, I am not a fan of having an office manager. Studies have shown, from Harvard Business School, that if you have fewer than ten employees, there is absolutely no reason for you to have an office manager, because there's not much to manage.

 

 

You are in a small space. You can have direct communication, as the leader of your practice, with your team, so you don't need a middle man. If you have a huge office, where once you get to the number ten, beyond that people start to segregate into smaller groups, so if you have a huge office with twenty people, then maybe you might have ten front desk, you might have ten back office, then you would need an office manager, but you don't need an office manager for less than ten people.

 

 

Maybe that's some of the frustration, because maybe the dentist is not a hundred percent happy with their office manager, or maybe there's a roadblock there, or maybe the office manager is not truly a liaison between the owner and the team. Maybe they're part of the team and causing problems. That's another layer of complexity if you have an office manager. Think about it, Howard. In business, here we are. We go to college for four years. We go to dental school. Some of us have graduate degrees in health management or MBAs, or you go and you do a residency, and you're highly skilled.

 

 

Who are you going to hire to be your office manager? If I hire an office manager, they better be pretty darn good, because I would expect them to know more than I know, or be more capable than I'm capable. Otherwise, I'm better off doing it myself and saving myself the extra step of inefficiency because every step decreases efficiency. If you want to be efficient in communication, the doctor needs to be a leader, they need to be a transformational leader to be able to inspire their team, pull the team member aside, talk to them immediately, and correct what needs to be corrected.

 

Howard:

Are they born transformation leaders, or can it be developed? If you saw some kid walk out of dental school, you see some are just natural born. They were president in their dentals, this, that, they were in ASDA, all this stuff. What if someone's not a strong leader? What advice would you give them?

 

Ann Marie:

Well, I'll say it again. To be the HR director or to be the office manager, it takes courage, it takes communication and it takes candor. Candor is addressing the truth, the truth, not sugarcoating things. Whatever it is that needs to be addressed, it needs to be talked about right away. That's the key to being an efficient team. Even, I know in your book you reference basketball a lot. I like that reference also. My favorite team workbook is Coach K on teamwork. One of the things he says in his book is, "Whatever it is, we need to address it immediately and we need to have an honor code that always the truth will be spoken."

 

 

Always the truth will be spoken, whether it's good or bad, everyone needs to know about it. If a patient's upset, the doctor needs to know immediately. If one team member is letting the other team members down, maybe someone is cutting out early or they're not doing their fair share of work, you need to talk about it immediately. You don't let it go days or weeks or a month, or whatever. I think that's really the key to success is nipping it in the bud, and speaking about it immediately. Let me mention insubordination. What do you do when a team member says to the doctor, blatantly, right to the doctor's face, "I won't do it?" How do you handle that?

 

 

Well, you say, "Well, Sally, I hired you to put this smiley face sticker on your jacket today and participate in Smiley Face Day, so if you're not willing to do what I hired you to do, I'm going to need to hire someone else to do the job that I've hired you to do." When you say that, that smiley face sticker, in one minute, it goes on the jacket. If you just say, "Okay, Sally. All right. You don't really have to participate. Maybe it's not your thing," right at that moment, you are letting the tail wag the dog. You've lost authority and you have diminished your office culture. You have to nip these things in the bud, especially with the new generation.

 

 

The young people, maybe it's their first job. Maybe they don't know how to act. Maybe they don't know how to dress. It is your job, as the leader of your office, to develop that talent, to teach them. Teach them how to be professional. You might have to buy them clothes. You might have to teach them how to be polite, how to speak, teach them before they leave every night. Ask every team member, "Does anybody need help? We're a team. You don't just walk out on your teammates." All of those things need to be developed, and it's a team effort.

 

Howard:

I've always thought that successful people were the ones willing to have the most number of uncomfortable conversations, and I always thought success was counter-intuitive because as a social animal we want to see each other and be nice to each other, and pet and groom each other. It's just uncomfortable to sit there and not do that, and be a leader and say, "Okay, you need to do this and this." You know what I mean? I think the easiest thing for a dentist to do is what you always see them do. Whenever there's a problem they go back in their office and close the door.

 

Ann Marie:

Yeah. Well, Jack Welch calls this superficial congeniality, that if the dentist is thinking, "Sally, I don't think you're performing. I don't feel you're giving a hundred percent," then he goes to Sally and says, "Thank you, Sally. See you tomorrow," without saying anything, the dentist suffers at their own peril. I say in my talks that why is it we do this? Is it that we don't have the courage?

 

 

Is it that we have been in the ivory tower too long? Is it that we're just too nice? We're too nice. Dr. Nice Guy or Miss Sugar Sweet or whatever. This is a business, and business is challenging, and you have to be honest about what's going on. Yeah, another thing is, and Tony Robbins mentioned this in your podcast, which was, by the way, Howard, the best podcast you've ever done in the history of your podcasting career.

 

Howard:

Oh, you're too sweet. I think this one is.

 

Ann Marie:

No, no, no, but Tony Robbins hit the nail on the head with you, saying people who want to be happy, want to be successful, you've got to address your pain. You've got to take care of what needs to be taken care of, the business you need to take care of. Once you do that, you're going to feel great. You're going to be totally happy.

 

Howard:

I want to give you some other things. We talked about dress. I see these dentists on Dentaltown, they're wigged out because the young assistant comes in with a pin or a bar in her nose or whatever. Another one is the work-life balance you talk about.

 

Ann Marie:

Yes.

 

Howard:

Talk about that a little bit, because they get upset that their assistant has a personal phone call and the other side of that coin is well, she's sharing responsibility with a six-year old kid, with a husband. How do you determine that work-life balance at work?

 

Ann Marie:

Okay, well first of all, for a dentist, and I write this in my book, your happiness is not reflected by how big your dental office is. In fact, it may be an inverse relationship in some cases. Your happiness is by your work-life balance. How happy are you at work? How happy are you at home? For me, personally, I work three days a week. I work one Friday a month, half a day. I am a hundred percent happy with that schedule. I start at nine-thirty in the morning. My entire team, we have the luxury of dropping our kids off at school.

 

 

That to me is huge, because I don't get home until late. I don't get home until six or seven o'clock at night, sometimes eight o'clock at night, so for me to be able to study in the morning, drive my son to school, that means a lot to me. That right there is already work-life balance. A lot of people went into dentistry because they felt the hours were good and the balance was good, but then what happens is once they get in their practice, they get so pulled in, and the work will never be done.

 

 

It will never be completely done. Every night on my desk, I'm sure it's the same with you, you have work that you could still do. You could stay there until ten or eleven o'clock every night, but you just have to get in the habit of, "Okay, whatever time, five o'clock, six o'clock, I'm done for the day and I'm going home." Now, for the team, you want the team to also be happy and have work-life balance. One thing great HR managers know is to be flexible.

 

 

One thing you can be flexible on is vacations. In our office, if someone wants to take a vacation, we have a sheet that they fill out, Vacation Request. All I request is that they give me six weeks notice. If you give me six weeks notice, you can have a vacation. We will block out your column and you can take it. Your team members need a vacation, too. They can't just keep going. They're going to burn out, especially if they're at the front desk. That's another important aspect of work-life balance.

 

Howard:

What about the personal phone calls?

 

Ann Marie:

Personal phone calls, we ask that they be made to the office, not on someone's cellphone. We ask that they call the back line, not the front office line. In my office I have a back office number that is only for personal phone calls. We ask that they don't have too many personal phone calls during the day, but I can understand if someone has a child who's getting home from school and they have to report to their mom, "Mom, I got home from school at three-thirty." I understand they might need to take a personal phone call at three-thirty to make sure their child got home on time.

 

Howard:

Yeah, I always come back to that, you know, treat other people like you want to be treated. I've walked out of my dental office three times in twenty-eight years because my kid was on the way to the ER, because they're falling off bikes, doing whatever. I just think it's crazy when the dentist is taking those personal phone calls about their children and they get mad when the assistant does. You know what I mean? It's just not fair.

 

Ann Marie:

Right. No, it's the same for everyone, and same for me too. I try not to take personal phone calls ever, but if I do, it's on the back line and same as my ... The leader leads by example. Whatever you want, you lead by example, and you need to reward the behavior that you want. I'm a big believer in awards. Whatever it is that you want, let's say someone goes the extra mile and they do nice things for your patients.

 

 

I would get a small token of financial gift card or something like that, and at the team meeting I would acknowledge that person and say, "You know, I really have to thank this person. They stayed late with me. We saw two emergency patients, and I really appreciate that and I would like to give you this token of appreciation." When you reward the behavior that you want, suddenly everyone on the team tries to aspire to that behavior, and then everyone's doing it, not just one person.

 

Howard:

How often should the dental office staff have a meeting, where you're not seeing patients, and have a meeting? Then the flip-side of that is how often should you review an employee's performance?

 

Ann Marie:

Well, in my office I have an hour and a half meeting once a month. Now, I spoke to a consultant recently. She recommended two meetings a month, one hour each, one mid-month and one at the end of the month, so it's up to you, but you should have a minimum of one a month. What I do is I have each team member responsible for a certain report. The report could be collections, it could be conversion rate. It could be starts, it could be the budget, it could be public relations in the community, it could be referrals, but every person at the team meeting gives their own report and reports on the progress of their project.

 

 

One thing I write in my book, and studies have shown this, that people who work on their own project are much more efficient and put out a much higher productivity than people that work in a group. By putting your team member in charge of something, you're pretty much ensuring that that job gets done, that that report gets done, that they give the report, and then everybody's going to look at the report. There's no higher achievement inspiration than peer pressure, you know? You can't let your team down, so the team meeting is really, really vital.

 

Howard:

You said at the very beginning of this podcast, fifty-three minutes ago, that HR's really half psychology, half law. Talk about law. I think you're talking to so many dentists right now that they knew they could get sued if they did this or that, but they don't really think about law in HR.

 

Ann Marie:

Okay, I heard a consultant recently, and she was talking about HR, and she was saying, "Document, document, document." Well, if you are documenting discrimination, if you are documenting that you let someone go for an illegal reason, you are in big trouble. I would never, ever say that HR is about document, document, document. HR is about knowing the laws and how to be fair, how not to discriminate, how to pay overtime, all of these things which govern us. After four hours you have to give a break by law. We have to know the laws and all the laws are written in my book, Howard, so if they want to know the laws, the laws are there, but one of the things that inspired me to write the book is in the state of California, every two years we have to do California state law, employment law.

 

 

I sat there for twenty-five years listening, over and over and over, California state law, law, law, law, and I said to myself, "I just want the laws. Just give me the laws so I can read them." In my book are listed all the employment laws. For example, in the book we have all the questions. What are legal questions to ask when you hire someone? What are illegal questions? Anything not related to the job, anything: someone's family, what they do in their free time, their religion, where do they live. All of those things are illegal questions to ask when you hire someone. We have employment at will. Yes, certainly, we do, but there are reasons you cannot fire someone.

 

 

Let's say for example, you're doing something illegal in your office. Let's say you're, I don't know what it would be, but let's say you're giving drugs to a patient that doesn't need drugs for their dental procedure, and your assistant sees you do it, and they come up to you and say, "That's illegal what you're doing. You can't be doing that in your dental office." The doctor says, "I don't like what you're saying to me. I'm firing you." Well, that person was fired in retaliation, and that is illegal to fire that person, so you will be brought to court for that. Let me give you another example.

 

 

This is a little sticky thing, but by law, when you terminate someone, they need to have a separate vacation paycheck from their regular paycheck. This is such a small thing, but a friend of mine actually got brought to court for this, that instead of having two separate paychecks, he just said, "Okay, well here's your paycheck. It's the full amount in one check," and got a call from the husband that night and said, "You didn't give my wife her vacation paycheck." The dentist said, "Yes, I did." The husband said, "No, you didn't." Well, he got brought to court, and the judge said, "Yes, you are ... Legally, you did not do it correctly, and here's an additional fine of six thousand dollars." Dentists need to know that law, and they need to know how to be a good employer and follow the laws of employment.

 

Howard:

When you talk about discrimination, can you give a discrimination example? What do people discriminate against?

 

Ann Marie:

Well, discrimination is for sex, age, nationality, religion, or disability. If someone could prove that you fired them because you discriminate against older workers, that could be a problem for you. You cannot discriminate.

 

Howard:

You know what the most common discrimination is that I see in dentistry routinely? People talk about it openly, and I always wonder, it's illegal, they could get busted, is they'll be interviewing for an associate, and someone will apply and they'll say they're left-handed. The dentist is like, "I don't want to deal with all that," because it's really tough if you've got two doctors in an office and one's right-handed and one's left-handed, and all the chaos with that, a lot of people ... But would that be illegal?

 

Ann Marie:

I don't ... Well, if the chairs were set up that they are right-handed chairs, I think that if you're looking for a right-handed dentist, and you're hiring a right-handed dentist, I don't think that would be discrimination.

 

Howard:

Really?

 

Ann Marie:

But don't quote me on it. Well, you can hire for whatever you want. It's your freedom of choice. I know one of my dentist friends, I was hiring someone, I was interviewing, and I said, "We're interviewing today." He goes, "I know who I'd hire. I'd hire the blonde." Everyone in his office is a blonde. Every single assistant he has is a blonde. Well, that's his choice. You have a choice of who you hire. It's when you fire someone, that's when you get in trouble. If someone can say, "You discriminated against me." That's why when you lay someone off, let's say you lay someone off for financial reasons.

 

 

The best thing ... What you need to do is you need to grade every single person in your office. Actually have categories of things you're grading. Give them a number grade and then dismiss the person with the lowest score. Then take that report and put it in every single person's personnel file, because that way you can say, "I had to let one person go for financial reasons. I graded all ten of my team members on performance, attendance, skills, whatever they know, and this person had the lowest score. It was totally done legitimately and that's the person I let go." But if the person happens to be the fattest person or the oldest person, or the only person of color, well then you might get in trouble, so you need to document how you made that decision.

 

Howard:

I think our office practices discrimination, because I notice nothing ever goes bad with the short, fat, bald guy. I think we're ... But hey, we are out of time. Once again, how do they get your book?

 

Ann Marie:

Well, my book is on Amazon. Once again, the title is Beyond the Morning Huddle: Human Resource Management for a Successful Dental Practice. Howard, it was an honor to speak with you today. Thank you so much for your invitation.

 

Howard:

Ann Marie, you are my idol and role model in so many ways. Thank you for all that you do for dentistry, your patients, and that you've done for me personally. You're an amazing person, and it's an honor to know you.

 

Ann Marie:

Well, thank you, Howard. I feel the same way about you, Howard. Thank you so much.

 

Howard:

All right. Have a rocking great day.

 

Ann Marie:

Okay, bye.

 

Howard:

Bye-bye.

 


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