Creating a Unique Practice Culture

Transcript performed by A.I. Please excuse the typos.
00:00
What is it about your office that makes you unique? Why should a really good, awesome, high quality candidate choose your practice versus the practice down the street? It’s not the pay, it’s not the benefits, it’s about culture, it’s about fit, it’s about how you treat the employees, how you treat the employees when times are good and when times are bad. Just really what does it feel like to be an employee in your office?

00:26
Welcome to Dental All-Stars. I’m Alex Nottingham, founder and CEO of All-Star Dental Academy. And with me is Alan Twigg, the president of Bet Erickson and Associates, our good friends. Welcome, Alan. Yeah, thank you. It’s great to be back. Happy to see you and happy to talk about HR. Yes. So I love our partnership. We’ve been friends and partners in the dental space for quite some time. And as many of you listeners know, Robin Reese, our director of

00:56
hiring service is a consultant for you predating her leading the hiring division here at All-Star. And we have a good relationship because we hire office team members for dental offices. And I appreciate the referrals from your end. when it comes to HR, we send to the other end. And I think that I like to just check in with you and look at

01:24
one basket, which is a state of hiring and how, you know, we can improve that from an HR perspective, tactical perspective. But I think even more important in our discussion is the joint role that we, we both do where you’re providing HR uh materials, handbooks, support, uh advice. We’re providing in office training or an online training and, and events to build the culture together.

01:54
So Ben Erickson, also General Academy are great to build the team together because what we’re saying in the green room was that once you get them, now how do you keep them? Exactly. Right. And so we have a double whammy is that it’s hard to find good team members. So we want to be able to do that. But then we have them, how do we keep them? Because then we have to go back to that whole process and we see offices that have this revolving door. So let’s just start.

02:24
with the state of hiring, the state of recruiting, from your perspective, what is going on out there that you’re seeing? Yeah, it’s tough still. mean, COVID was tough, and then there was all the great resignation, all the job changes, people asking for giant raises. And I think we’re seeing a little bit more stability now, but we’re not seeing the supply. And that’s really what it all boils down to is there’s just not the supply.

02:51
of people who have dental experience just due to the number of people who got out of the industry, retired, left and didn’t come back, whatever it is. And so it’s a supply problem. so part of that then is everyone is kind of fighting over the remaining workers who are here. And then it’s also about how do we get more people just into the dental profession as a whole? And, know, I’m, I’m a little bit encouraged, you know,

03:20
not happy about this when I see, you know, headlines about giant layoffs at other companies, but I do always then have the thought of, well, now there’s all these people out there who, you know, can potentially could come and work in a dental practice and no, they don’t have all the experience and decades of dental, you know, training and that kind of thing. But if they’ve got the right attitude and they’ve got the right mindset, and if they’re a good fit for our practice values, then we can train them how to do a bunch of aspects of the job.

03:49
And so that’s part of it. And I think one of the biggest things that I would encourage any practice leader who’s listening to really think deeply about is what is it about your office that makes you unique? Why should a really good, awesome, high quality candidate choose your practice versus the practice down the street? And it’s not the pay. It’s not the benefits. It’s about culture. It’s about fit. It’s about how you

04:17
treat the employees, how you treat the employees when times are good and when times are bad. Just really what does it feel like to be an employee in your office and as best you can trying to put some of that into words so that you can communicate that to the All-Star hiring team or if you’re just posting your own ads or even if you’re just out and you meet someone who you think, wow, this person’s got a great attitude, really positive, wonder if they’d be a good fit in my practice.

04:45
having something ready that says, I think you should work for me. And here’s why. I think you the nail on the head. And one of the areas that I resonate, even though I’m a different generation, I mean, my son is like job, that’s a three letter bad word. So, but I know there’s a lot of negativity from the older generation to the newer generation about just work ethic and so on. And his interest, but I, I resonate.

05:15
some to some in this respect. I at all Spinal Academy, I’m the visionary. So I come up with a bunch of ideas and nine out of 10 are bad, but I just need one. But I have a lot of time to, think and, and, and build that. And I have a great business that runs itself. Uh, Shelley, we all know Shelley our COO. She runs the company, right? I’m still, I still create the ideas, but

05:43
Uh, and that’s, that’s cool in the sense that I get to be creative for me. I want to do something because I enjoy it, not to have a job. And maybe I’m ahead of the game because my generation wasn’t necessarily need that, but I resonate with the kids in that, and the newer generation that is like, I don’t just want to get a paycheck. want to be part of something. And visionaries tend to be wacky like that and they’re do that, but

06:10
I think the rest of the world is saying, Hey, I’m spending all this time at work. It’s not just money. I don’t want to be throwing away my life for what? To be old and retire and then have benefits taken away and just, and have this, you know, sucky retirement or whatever. It’s like, I want to live today. And I think that’s a very Buddhist way of living, mindful way of living, living to live in for today. So I think if we stop judging them and say,

06:39
I see the good in what you’re doing, then it becomes marketing to them. And I think everybody, even those in the old generation resonate too, that we have a practice that is, you’re going to be part of something. You’re going to be part of, of, of a movement of, of making a difference. And I find, just did a call with our president of coaching Eric about what are the best dentists doing and

07:07
They are working with, they have coaches, they have Ben Erickson, they have All-Star. They also, go to events, right? You’re uh a fixture at our events, always speaking, it’s always fun learning so much from you, Drake and others, it’s a whole nother conversation. But they invest in their team. And what I say about events uh is that

07:32
that’s a way for the team to grow and learn, have community together. They might not be getting that at their house where they’re have something fun. So that’s one aspect, the outside the office, but in the office, it’s, is it a pleasant place to work? Are you filling my needs up? And if you are, will never leave. Exactly. Yeah. Yeah. And I think you nailed it with this idea of purpose. You know, I was reminded the other day about

08:02
the old fable of it’s, it’s the 1600s and there’s an architect who’s building a cathedral somewhere in Europe, you know, and the architect is going to the work site to kind of inspect progress. And there’s three brick layers there. uh, architect goes to the first brick layer and says, what are you doing? And they say, I’m laying bricks. goes to the next person and says, what are you doing? And they say, I’m building a wall. Okay. So they’re a little bit more kind of vision focused.

08:32
goes to the third bricklayer who’s the most productive bricklayer and says, what are you doing? And that bricklayer says, I’m building a cathedral. And it’s just this idea of what are you building and what is your team focused on? And I could imagine a similar thing of, you know, coming into your practice and I grab, you know, one of your dental assistants and I say, what are you doing? And they say, I just suck spit. It’s like, okay, that’s all they, that’s all they do. I go to one of your hygienists and I say, what are you doing? They say,

09:01
Well, I keep patients healthy. Okay. Well, that’s, that’s a little bit more, you know, big or, or high level. And then maybe I just go to an appointment coordinator, you know, just someone who’s just answering the phone and all that. And I say, what are you doing? And they say, I’m changing people’s lives. And just, you know, to think about, again, this idea of purpose, cause you’re absolutely right. That the, the younger generations, they, they don’t want to just work some.

09:30
grind job for 40 years and then retire to a golf course. They want to enjoy their life today and they want to be able to have meaning and purpose. And that’s easy because I mean, in dentistry, it’s all meaning and purpose all day long. We’re changing people’s lives. We’re making their smile, their health, all of these things better every single day. So it’s not like we’re selling cigarettes and we have to try to figure out how to make that meaningful. I mean, it’s, it’s built in. um

09:58
But it is also about kind of getting your little twist on it. And, know, some practices are more family friendly. Some are more professional. Some are more, you know, the absolute cutting edge of technology. So whatever it is for your office, that’s fine. There’s no right or wrong answer with it, but it’s just about having that sense of it so that you can communicate that to your employees and so that you can tell them this is the cathedral that we’re building in our practice. That’s, that’s beautiful.

10:28
Alan, that really gives a perspective of what you’re looking to build and, what you stand for. And, you know, I think get your head out of the sand really. What can I do to embrace what is and lead into it? And, and like I said, that’s where we’re talking about, like having empathy and in your life, you, everybody, I think everybody in the heart of hearts wants to be part of something, some purpose. Um,

10:57
even those who hate purpose have a purpose, right? Or something, right? So, okay. So we talked about that the state of hiring, changing our perspective and then, right? So when we hire them, we want to keep them. We talked about different methods to do that, really investing in the culture, multiple ways, internal, external, and so on. And it’s a time and what in a lot of the research that you put out,

11:27
And I think it’s bears repeating in every session. The cost of replacing an employee is one to three times the cost or their, their salary based on your research and, and, and also substantiated by other independent sources as well. So we don’t want your dad said this. We don’t want to step over dollars to get pennies. And I love that quote is that keep the big picture. Look, I don’t like spending money.

11:56
But I think that I have to challenge myself to see in what context, right? We’re entrepreneurs. That’s the name of the game. So now that we have these employees, one of the greatest areas that dentists don’t want, the biggest stressors that dentists have is dealing with employees. They’re not conflict trained. They don’t love it. They’re either too aggressive,

12:26
or most of them are anti-feedback and anti-conflict. So how do we, and you’re masterful at this, how do we give feedback? How do we communicate to employees that they may do improve on something? So give me some context and some ideas being around that. Sure. Well, I think the context for this is kind of what we talked about a minute ago, which is we’re in a tight labor market. It’s a short supply and all of that. So we,

12:55
We in a sense have to get this right. can’t just say, Oh, I can fumble my way through this because I’ll have, you know, 25 waiting applicants when I post an ad. So we really need uh to do it right. And as the dentist, as the leader practice manager and so on, we really have to up our game with it. And so I think the first step with it is a little bit of introspection. So let’s say we have an employee who’s not performing very well and

13:24
Our knee jerk reaction is to say, okay, I’m going to have to confront this person. don’t want to confront them. I’m scared of conflict. don’t feel properly trained. And I worry that this person is going to leave or something bad is going to happen. Um, one piece to that is to also kind of turn it around and to think about the fact that the vast majority of the employees in your practice most likely are good employees. may only be one or two bad apples.

13:52
And so we need to keep in mind the rest of the team, because of course, if we ignore problems, because we’re scared of conflict, then the problems get worse. The good employees see that. what we really, the worst case scenario is not that we lose the bad employee. It’s that the bad employee stays and we lose the good employees. So that’s, that’s kind of the real context for embracing this. Now, the first piece of introspection is to kind of say, as the leader,

14:22
Are there things that I could have done better or that maybe I, I, in a sense, didn’t do my part early on. So for example, maybe I rushed the hiring process and I brought someone in who’s not actually a good fit or they’re, you know, the right person, but they’re in the wrong seat on the bus, or maybe their onboarding process was really hurried and rushed because we were short staff. We wanted to just kind of throw them into the deep end.

14:48
So they didn’t really get fully properly on boarded and trained. And so that’s more on us. That’s not really their fault. Um, you know, with, with kind of your overall policies and practices of the leader, have you been consistent? Have you been fair? You know, all of those kinds of things. That’s, think the first step, because if, that’s really what’s going on, then it’s not so much this person is the problem and we need to have a serious uh coaching conversation.

15:16
It’s more, okay, I need to fix my house first and then I’ll address this now. So having done all of that, let’s say we genuinely do have someone who’s just not meeting expectations and there are a million different ways of approaching this. think there’s a lot of methods that have value. know a lot of dentists enjoy a little bit of structure and a little bit of kind of a system with this. So here is a system. This would be used for.

15:47
a, you know, kind of a light to medium coaching conversation. So this is not about, know, if someone shows up intoxicated or they get in a fight with a patient, you wouldn’t use this model. This would be for things like someone is having attendance issues or just their overall job performance isn’t quite up to our standard. Maybe they’re a hygienist and their bedside manner with the patients isn’t very good. You would use this model and we just call it the five step productive feedback models.

16:16
Step number one is about having clarity around what the standard is. What is the expectation? And that can be related to your vision. So for example, with a hygienist in bedside manner, you probably have a vision, mission, values, philosophy statement around amazing patient care and patients having incredible outcomes and good experiences and that kind of thing. So, okay, that’s the vision, that’s the standard.

16:44
Uh, if it’s an attendance thing, certainly we would have a standard that says we expect employees to show up on time and ready to work and, know, not be, you know, excessively absent or late that kind of a thing. So that’s the standard that step one. Step two is to identify the objective facts of this situation. So let’s say we have an employee who has been late six times in the past month. That’s an objective fact.

17:13
Maybe the hygienist, would say, okay, we’ve gotten three patients who have given us feedback that, know, they find you kind of harsh or something like that. That’s the objective thing. That’s step two. Step three is identifying sort of the gap. And that one’s kind of obvious. You know, it’s like our standard is that you show up on time. You’ve been showing up late six times, or our standard is optimal, extremely good patient care.

17:41
we’re getting these complaints. So that’s kind of the gap between where we want this person and where they are. The fourth step is one that people often miss when they’re doing feedback. And the fourth step is really important. It’s where you really talk about the impact that this person’s behavior is having on the bigger picture. A lot of folks will say, Hey, you’re supposed to show up on time. You’re not showing up on time. Fix it.

18:11
This step four though is where you would say you’re not showing up on time and the impact that is having is on the rest of the team, on the workload, on having to cancel patients because you’re not showing up. On the hygienist it’s about, you know, some of these patients have left our practice now we’ve lost the production and the revenue from that. It’s really identifying what is the impact and usually that’s an impact on the rest of the team.

18:39
an impact on the patients, potentially an impact on this employee, if maybe their actions are limiting a bonus or something like that. So it’s, it’s really identifying what that gap is and that’s step four. And then step five is just reiterating what the standard is and asking this employee or kind of re-inviting them to sort of this standard and say, you know, if this employment relationship is going to continue,

19:08
I need you to fix this, meet the standard and so on. So it’s those five steps. And, and again, those five steps can be used for a lot of kind of the light and medium type situations. And so that’s just a suggested model that folks can try out. I feel like, I don’t know if it’s called the law of the herd, but that sounds good. But the idea that as you’re in that latter steps, that what the impact on others, we care what others think.

19:39
we may be a little less offensive and we see that it’s having an impact on those around us. Right. So I thought that was a really clever addition to, to feedback. Okay. So that’s a feedback mechanism. Tell me about compliance. I don’t know. Maybe this is the boring stuff, but this is the important stuff that you guys too, right? No, HR compliance is sexy. Everybody loves HR. Yes. So, so in general kind of cause

20:09
we’ve talked about in the past, but it’s good to be repeated. Like, what is it? uh How do we, we protect for it? Why is it important? So employment compliance is kind of in the same vein as record keeping requirements, OSHA requirements, HIPAA requirements. These are all things that are laws and rules and norms and things that you just, you got to do.

20:36
The employment compliance one is a little bit trickier because employment compliance comes from both the federal level and the state level. It’s not that federal always supersedes state or vice versa. So you need to know your federal rules and you need to know your state’s applicable rules. In addition to that, labor laws also vary based on how many employees you have. So some rules apply to all employers, no matter how many employees you have, other rules apply if you have

21:05
10 or more, five or more, 15 or more. And those also vary state to state. So, uh, for example, a sick leave rule that applies in this state kicks in when you have one or more employees and a sick leave rule in this state, maybe as when you have 11 or more. So it’s not even consistent in that regard. And then of course, the other piece with employment compliance stuff is that it’s always changing. doesn’t stay static forever. There are court cases, there are new laws, there are revisions to existing laws.

21:35
That’s one of the things we do is we track and monitor changes in labor laws. And in the past five years, there have been 250 labor law changes nationwide. And those are brand new laws that have never existed, or those are significant changes to existing laws. And just for a little bit more context, the five years prior to that, it was only 87 changes.

22:02
So we went from 87 changes over five years to 250 changes over the past five years. And so far this year, 2025 is on par with that in terms of number of changes. So, and these are, these are significant rules. It’s things like paid family leave, which works kind of like unemployment where everyone pays into it. And then when the employee is pregnant or has a medical issue or something, they can take time off and get paid for that. And it comes out of the state fund.

22:31
It’s things like mandatory sick leave, which now we’re up to 16 states that have sick leave rules and there are more coming every year. Uh, another really common one is pregnancy accommodation rules. This is where when someone is pregnant, the employer is required to kind of go through what’s called a good faith interactive process and attempt to accommodate this employee and the time off they need for

23:00
You know, accommodations while the employee is working and still pregnant, the actual leave of absence itself, and then nursing and breastfeeding when the employee comes back to work. And we’re now up to 26 states that have passed that at the federal level, it kicks in when you have 15 or more. The bottom line is just that it’s, it’s a big complicated piece with this compliance thing. The

23:27
The thing that people really need to know and understand is that keeping up to date with this stuff is incredibly time consuming because you have to find out about these laws or find out about these changes. You have to research it. You have to write your own policy or potentially modify your existing policy. And it’s just a lot of work and it takes a lot of time. the, the pressure I think on employers is you really need to get this right.

23:57
And the reason is that employment compliance in a, a way that’s different from OSHA and HIPAA a little bit is that employment compliance really, really directly impacts your employees. You know, if, the OSHA and HIPAA compliance is a little bit off or a little bit outdated, the employees might care, but it’s very different from you’re not paying them correctly, or they should be getting overtime and you’re not giving overtime.

24:26
or they should be getting paid for when they’re sick and you’re not doing that. That kind of stuff will really, really impact your employees and more and more with chat GPT and even just, you know, more state labor boards putting all of their laws on the internet. It’s really easy to find this information. Um, to be clear, chat GPT and AI gets things wrong a lot. So please do not.

24:52
Do not use chat GPT for all of your HR compliance. It’s so I’m getting very nervous and anxious about this on behalf of the dentist. How can I, I want things simple. think most scientists do. I assume Ben Erickson, and I’m just kind of playing with that, but I know you handle a lot of this stuff. So please tell me because I don’t want to know all of it. I just want it in a handbook and I want you to tell me what to do. And I want to go do dentistry.

25:22
Well, not me, but the dentist. So what, what do I get and who do I talk to and where should I go to get this help with that stuff? Sure. Yeah. We have a really simple and robust and easy to use package. call it the HR director package and it entails five main elements. And, and these five elements are really all about giving you all the tools and materials and resources.

25:49
so that the HR management and the HR compliance is just off your plate. And you can focus on leading the practice and creating your vision and all the big goals that you have with your office. So part number one with the HR director package is the policy manual or the employee handbook. We create that for you. It’s state specific, federal specific, takes into account your number of employees.

26:14
It has all of your benefits in there. It has all of the required state and federal policies. And then it has all the management policies, everything you need around appearance, uniform, smoking, cell phone usage, all of that is laid out, customized for your practice. And it’s really good and comprehensive. So again, we create that for you so you don’t have to do it. You just need to, you know, skim through it. It’s good. Part number two is job descriptions. We haven’t talked about job descriptions yet, but

26:43
The job description is so important in the hiring process, training, a performance reviews and goal setting. It’s also really important when you do have someone who’s pregnant or is claiming any sort of medical uh need or leave of absence. So we provide templates for all the normal positions, really easy to put those in place. Number three is paperwork because again, the old adage of if it’s not written down, didn’t happen.

27:09
So we have about 85 different forms that you use for the whole employee life cycle. Again, you don’t have to reinvent the wheel. We just provide all of them to you and you can use them as needed. And then number four is what we talked about earlier, the ongoing updates. So anytime there’s a change in federal rule or state rules, we just draft new language, send you an alert. You log in, you can accept it and generate a new handbook from there.

27:35
And then the last piece is what we call HR specialist support. And we have a whole team of folks here who are available via phone and email. And their job is just to walk through, uh, HR issues and challenges with Dennis all day, every day. And that’s what they do. It’s phone and email support. And it is incredibly helpful because there’s so many different, you know, situations where

28:01
It’s not just pregnancy, it’s pregnancy with complications, or it’s not just, you know, a difficult employee, it’s a difficult employee who just did this and they also are on a workers comp claim. There’s all these nuances to it. And those nuances can really trip you up and it makes it really hard to know which path you should take. What are the risks? What should you do? What can you do? And so the HR specialist support is a really big part of what we do.

28:29
And we, it’s unlimited support. There’s no cap. There’s no maximum. There’s no extra fee for it. We really encourage clients to call us and, and don’t hesitate because HR is one of those things where if you can get ahead of it early on, it really keeps it from getting more serious and more expensive. And so, um, yeah, that HR support is a big part of what we do. We really hang our hat on that. And, uh, you know, every

28:59
company that does HR is a little bit different. And in our case, it’s that it’s that real human to human support. And we are there when our clients need us. And that’s, that’s really what we get excited about. That’s so beautifully spoken. Thank you, Alan. So where, where can people, and I’ll put this in the show notes, but for those that want to learn more about the HR director and Ben Erickson, they’ll go where?

29:24
Yeah, I would say just head to our website. It’s been ericsson.com and on there, there’s a contact form. So if you’d like to set up a complimentary consultation where we can just kind of talk about, you know, the state of your HR and what you got, what you don’t have and what your goals are, where you’re headed, we can just talk through all of that. It’s a complimentary consultation and folks can reach out to us on the website and schedule that and be happy to talk to you. Well, thank you, Alan twig as always.

29:54
And we look forward to having you again and again, and we’ll see you at the, we’re to be with us at the May, the May, uh, growth summit over in Fort Lauderdale. So for those who are interested, that’s on the website, also dental academy.com. have our practice growth summit every year and we cover four pillars. I should have that handy, right? Uh, there’s communication, there’s case acceptance, there’s phone skills, there’s, there’s culture, right? So that’s part where you’re going to be talking about. So it’s always learning every year on.

30:24
the four pillars of practice growth. And, and so it’s nice to hear your lecture and be able to speak to you and talk to you as well. Uh, it’s it’s a very nice, uh, group that we, we have. it’s, it’s a, it’s a nice size event, not too big, not too small, just right. Right. Uh, and, and so to learn more about that event and enjoy sunny Fort Lauderdale in May, uh, you can go to also dental academy.com click on events. All right. Well, yes. So.

30:54
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