Profitable Accountability

Transcript performed by A.I. Please excuse the typos.
00:00
Welcome to Dental All-Stars. I’m Alex Nottingham, founder and CEO of All-Star Dental Academy. And with me is Dr. Paul Etchinson. He’s a dentist and host of Dental Practice Heroes podcast and our topic is accountability. Please welcome Dr. Paul Etchinson. Hey man, thanks for having me. Let’s get accountable today. Yes, hold each other accountable. So accountability, I love it. And it’s a big, it’s a topic that comes up a lot.

00:29
for sure, and I know a lot of dentists report to both of us that we’re having trouble with accountability. So tell me about, let’s start with a problem. What are you seeing for yourself as a dentist through the years you’ve been practicing as well? I know you do coaching as well and speaking. What are you seeing out there? What are the problems of lack of accountability? Let’s start there and then we’ll work into some solutions of what we can do. Well, I think one of the major problems is that if you title this episode,

00:58
and put accountability in the episode, no one’s going to listen to it because it’s not sexy enough for dentists to listen to. Really? You think so? Accountability, leadership, you just got to call it profit. We’re just talking about profit, Alex. That’s all we’re doing. But you know what? It’s like I work with a lot of dentists and I’ll change the title to profitable accountability. Oh, man, that’s going to kill. That’s going to be awesome. So like I work with a lot of dentists and they, we’re always looking for solutions for this problem, that problem, this problem.

01:28
Accountability is one of those things that if we could just nail that at the practice, a lot of the minor issues would just resolve themselves. And what I see in so many of dental practice owners is that there’s no clarity around what we’re holding people accountable to, but then at the same point, they talk about having these difficult conversations and then they put them off, put them off because we’re not capable of having them. They’re uncomfortable and we’re not confident in our ability to have them. So we don’t have them.

01:57
So every time we do have them, we’re set up for failure, which leads us to not having them some more. So I think it’s just one of those things, it’s such a necessary component of running your practice, it would fix so many things if you could hold your team accountable to the standards that you set, but you’ve got to stay on top of it. And it’s really hard to play catch up. And I see this in some offices where they decide, okay, you know what, accountability’s in, we’re doing it, and the team doesn’t like it, and there’s a lot of turnover because of it.

02:27
It’s just been free rein for so long, no hell holding nobody to anything. That makes a lot of sense. Yeah, I mean, like I said, I see this come up a lot that I have an idea, how do I implement it? That’s one of the steps. How do I get started? And then after getting started, how do I make sure it gets done? That’s accountability in many respects. I know it’s part of leadership for sure.

02:55
And it is just understanding the nature. I mean, I do give you all a little bit of a pass being a dentist, because I say this, I get to be full-time business person, right? CEO, but it’s hard when you’re a dentist and you have to be a CEO visionary. You’ve got to run the practice. You got to potentially manage the practice. You can’t do all those necessarily really effectively. So you’re going to have to rely on people. They’re in accountability. We have to lead people.

03:24
and we have to make sure it gets done. And what often happens with practices, and you’ll agree, dentists in particular, because they don’t always love this, is either micromanagement or completely advocating any type of management, and it’s just chaos. And so there’s a middle ground, which is empowerment and accountability, okay, to be able to get the objectives that you want done. Does that make sense?

03:52
Yeah, I think one of the main things that we realize is that when we’re trying to do all the management and leadership in between patients, it’s really hard to do. And as my practice has grown, I’ve been able to pull myself out clinically so that I can spend more time doing the management and leadership functions of my practice. You like the suffering. I like that part. You do enjoy it. I do. You’re sick. But the thing is, when you devote yourself to it, it’s like it’s your job.

04:21
That’s what you’re there to do. And it becomes so much easier to do, but I think a lot of us were trying to do it in between patients and we do it when we feel like it. And the fact of the matter is after seeing patients all day, we just don’t feel like it. So I think that’s critical for dental practice owners, why we need to bring a leadership team in, why you need to have leaders on your team and you need to empower them so that they can do this function for you so that you can focus on your patients or whatever the heck you wanna do. But.

04:49
The premise of the matter is I just think you, we suck at having these conversations. And this is what I see in my clients and I see it in my team members too. I’ve seen it in my own leads and it’s stuff that I have to talk to them about is that there’s this idea of, I’ve heard it explained as a tennis court. So we’ve got two sides of the tennis court and we’ve got the nut. So there’s three components. And in any situation, there’s three components. There’s the behavior.

05:17
There is how it affects me and how it affects you. So what we get in trouble is when we have these conversations with people is we’re playing on the other side of the net. We’re showing up, we’re saying what the behavior was, which is the net, and then we’re telling what other person, what we think it means about their intentions, about their motives, and then that strikes defensiveness. And then it’s just downhill from there. When we really need to be speaking about, this was the behavior.

05:45
this is how it affected me or this is how it affects the team. And coming from a place of curiosity and trying to understand the other person’s perspective. And I think when you approach these accountability conversations in that manner, it doesn’t allow there to be, you know, defensiveness. Now there’s always going to be some defensiveness. And sometimes when you sense that person’s getting defensive, you’ve got to kind of bring it back to safety. You’ve got to, you know, write it back and, Hey, Oh, hold on a second. Then, you know, since you’re getting upset, tell me what you’re feeling.

06:12
And then they’re going to say, well, I feel like you’re doing this. Okay. So then now they’re playing on the other side of the net and you’ve got to come back and say, I am sorry that that it’s coming off that way. These are my intentions. These are my motives. And you restore safety. But once you get better at these conversations, they become a lot easier to have and you’ll start having them earlier when things start going wrong. And eventually I think the, like the big goal of a practice is where you can start getting your team members to have them with each other, you know, rather than.

06:41
coming to get you and tattling on you to help you have you go and talk to everybody because they don’t want to have a one on one pure conversation. Really stuck out in me. This whole idea of safety. It’s very interesting and bringing them back to, uh, cause for me, I, you know, I want to get done. I want to resolve the situation, uh, and just push through. But there’s a certain level of diplomacy, a certain level of listening and understanding.

07:11
Um, and being able to remove what you’re trying to your agenda completely and be able to bring them back. But I like that analogy or even exploit question, especially safety is such a safety is, is one of our key human needs is safety. And what happens is when our, and we have to understand this dentist, you are the one that provides the money. That’s why it’s profitable accountability. And. You.

07:41
Whenever you’re giving feedback to somebody who is not the owner, their livelihood is on the line. They feel. Because criticism hurts our sense of self, but as well, I mean, it’s tied to our safety. And so I think we have to make sure, I like what you’re saying, starting out with creating a level of safety when we’re giving feedback. So accountability, we’re talking about, is a way to give feedback and to make adjustments and to see where we are in things.

08:11
And I think we have to be able to remove some sort of defensiveness. I know our president of coaching, Eric, you met him at our, at our AllStar live program and you were speaking for us. Amazing. And one of the things he talks about leadership is the first thing is you have to make deposits in the bank when you’re talking to somebody, uh, you know, what you did well, we call it feedback sandwich you’ve heard, but I think it’s important that you, I like this idea of deposits before you make a withdrawal.

08:41
So you’re depositing it enough to be able to make a withdrawal. I like what you’re saying is building safety to be able to, for them to be able to internalize that feedback. And I think dentists tend to be more analytical. I’m like, why don’t you understand this? It’s pretty clear, right? Like it’s logical. Why are you getting emotional? Because most people are emotional. They make decisions on emotions. They respond by emotions and that’s just the name of the game.

09:08
And so we have to get better with these soft skills. And I know, like you said before, that’s why I put the term profitable accountability. I get it. Accountability and leadership, especially management, even worse. So it’s not sexy, right? But when you look at a business to be productive, like you have to be able to run a well oiled machine. Okay. Uh, I don’t care how good your dentistry is. I don’t care how good, um, even your people are, if there’s not a level of accountability, the whole train falls apart.

09:38
And so I really like, that was really meaningful that safety has that connotation that we wanna make sure everybody’s safe in the conversation. Yeah, and I’ll bring up a story that just happened this week at my practice is front desk, okay? We are supposed to be filling the schedule. We all know that. Sometimes it’s the last thing to be get done or something, but they all know that. And I have a front desk lead that is in charge of holding the front accountable.

10:08
And the other day I just, I saw we’re open from 7 a.m. to 8 p.m. And our night hours, they don’t go, they don’t, if somebody cancels, we can fill it. Because there’s so many people that wanna come in late night. And I saw a night hour, and it was there when I came in the morning, and it was still there at noon. And I said, man, I find it very hard to believe that we can’t fill this. So I went to the front desk and I said, hey, are you guys, we have four people working at the front desk, right, at this moment.

10:35
I go, hey, are you guys filling, trying to fill this? And they’re like, yeah, we’re doing it. And I’m like, have you called anybody? I haven’t. And I looked at the other one, I said, how about you? No, I haven’t either. And I went through it, no, I haven’t, no, I haven’t. So now I’m kind of upset about it. And I’m like, hey, can you guys please call and fill that? Okay, fine. I come in, maybe another day, and this was the next day, I did the same exact thing and the same exact result is nobody has called. And now I’m verging on micromanaging.

11:05
Now they’re scared of me, you know, and I don’t feel like they have any reason to be, but now I’m like, I’m trying really hard to not make them defensive, but it’s like someone needs to be held accountable. So I go and I talk to my front desk lead and I say, hey, I need this to happen. I don’t know what the best way to make it happen is. Please tell me, let me help you, let me support you. I am happy going to check in at the front desk, but I’m only at this practice maybe one or two days a week if I’m lucky. So I can’t be there every day. Someone else has to do this.

11:35
What do you think? So now her and I are brainstorming things. She said she’s gonna do a better job of it. And we’re gonna check in next week and we’re gonna see. And I’ve got to follow up. Accountability is following up and making sure, if I’m gonna hold this person accountable, I’ve gotta follow up and let them know that I’m checking out this stuff. So often, us as dental practice owners, we delegate to somebody and then we just never check in. And we just hope it’s getting done. And I would, you know, and every practice owner.

12:04
yeah, we’re following up on unscheduled treatment. Yeah, are you? Check, because you’re probably not. You know what I mean? Because that’s always the last thing to get done for the people at the front desk. And if there’s no accountability around that, it just never gets done, because it’s an infinite task that could never have, it never has any ending where you’re, oh, we followed up on all the unscheduled treatment. So I guess like why I bring this up is that it shows that the problem is really that we’re trying to fill our schedule and be profitable.

12:35
But the underlying foundational problem is accountability. And it’s me holding the team accountable. So profitable accountability is really about, yes, profit does come from holding people accountable because if you have a really accountable team, they’re doing all the things that we know we should be doing to make the practice more money. Do you use any tools? Like what is your, so walk me through a little bit of what methods are you

13:04
Are you doing like to be able to hold people accountable? Are there any tools you use to remember to kind of keep the team organized? Like, uh, do you, is it, cause again, you’re helping to manage, but as a dentist, like, like, do you delegate that? So just kind of give me a big picture view of like how this can happen. Where again, the dentist doesn’t end up micromanaging or

13:32
not managing, like, so just kind of give me a big picture view of how this could work. Yeah, I think as owners, we need to create ourselves an owner checklist. And we’ve got to say, hey, checking on these things on a weekly basis. Now, at my practice, large practice, 35 plus employees, I’ve got four people on my leadership team. At a certain point, I had to create a leadership structure, pass those checklists to the leads. And now my responsibility is to meet with each of them for each week.

14:02
So that’s my accountability at this point. But before I had that, I was doing it all. And it was like once a month, meeting with the office manager, and that office manager is accountable to look at the accounts receivable and have this whole list of eight different things that she was gonna check before a meeting. Once a month, meeting with the head hygienist and looking at the hygiene numbers. So it sucks because you don’t get an immediate payoff from doing these things, but they’re so critical to the running of the business. And…

14:30
So much inefficiency when we’re not checking on these little things. I mean, when we just look at case acceptance numbers and we look at how much, I mean, most case acceptance numbers, most offices are running 33, 35% of what the fees that they treat them plan are getting completed. I mean, that’s two thirds of everything we treatment plan doesn’t get completed. I mean, there look at all that opportunity there, even if we could just get a little bit more of that. But that takes the, you know.

14:57
following those details, look at the details and making sure that you’re following up on your team. So to answer your question, my structure is me meeting with four leads and them each meeting with their departments. So hygiene lead, front desk lead, assistant lead, and then I have my office manager. But I think you’ve gotta have a checklist for yourself and that’s the way I used to do it. I used to even go as far as putting, I used to have a little column on my checkbook that said, or on my checklist that said,

15:25
FB for filling buckets. And I would make sure that every two week period, I would give two compliments to every single team member because that was important to show appreciation. And when I started building it into a checklist, man, it’s easy to forget about the people at the front desk because they’re out there and I’m not with you all day. And I would have to go sit up there and find something to compliment them on. I would make myself do it. And if I didn’t have the checklist, I probably would never do it. So it’s…

15:50
They’re important functions for running the business. And if you don’t have checklists and you’re not being intentional about it, it’s hard to do it because you’re going to get busy and you’re going to tend to other things. I really like checklists. I’m thinking, ooh, I’m going to make a note to make more checklists for myself so I don’t forget. Interesting, I believe in the airlines, they have a lot of checklists to make sure. And then once they started implementing checklists, planes were safer. So I think that’s a wonderful tool. In terms of implementation,

16:21
I’ve been on this kick where, and so if you’re listening to the podcast, you’re going to hear me talk about this a bit because I’m excited and I’m actually going to, so I’ve been doing personal training the last few months and I’m going to bring my trainer in and interview her. She’s a bodybuilder. And so she’s like, and I’ve always trained for a while and now I have a coach and I’m like, she’s kicking my arse, you know, like I didn’t know a lot of things and she says, okay, well you’re basically.

16:51
You know, you’re being very inefficient here. And so you’re putting the time, but you’re not gonna get the results. And I’m like, really? And so like, it’s just so interesting getting that support for a number of reasons. The information, as well as the accountability. Oh, here’s that word for being, I wish I should have my, one of our road caster, do you have one of those buttons that makes noises? There you go, I hear it. Mine’s not even.

17:16
Is mine even I didn’t come prepared. Mine’s not ready, but I have those noises, but he was all prepared. It’s the first time I’ve used it. Isn’t that cool? You were ready. I’m happy I was able to pull that out of my pocket. Well done. You get points for better road casting here. So anyways, so I think this would be very interesting because I think anywhere you want to be great, you need coaching and accountability. And if you’re going to provide, hey, you like that if you’re going to provide coaching and accountability.

17:44
That every time I say I won’t use that word anymore. So here’s my point, Paul. You’re a coach. We have, we are a coaching company at All-Star Dental Academy and there’s so much need of good coaching or just coaching in general, yes good, for dentists. What is, tell me about, in terms of the benefits of coaching and why, because also,

18:13
You’re not only the hair club president. I shouldn’t say that you’re also a client, meaning you’ve worked with coaches in the past as a dentist. You are a coach. Um, and, and so why is coaching important? Is coaching for everyone? And then can coaching help this issue, which I will not name because I don’t want that noise again, but tell me.

18:36
Yeah, you know, I’ve always worked with coaches. I have a number of coaches that I’m working with right now. I’m working with a podcasting coach. I’m working with a copywriting coach and you know, I’ve had personal trainers. I’m not right now. I’ve had a life coach in the past. I’ve worked with dental consultants and coaches. I think there’s just, you know, we mentioned like acting emotionally and it’s hard not to get hijacked by your emotions.

19:01
The more I get older, the more I realize how much of my behavior is subconscious and hard to control. And it’s hard just to get a good perspective. I think a coach really brings that outside perspective to an outside perspective and outlook to looking into what your goals are and how you can reach them. And it sounds self-explanatory. When you work with a coach and then you tell somebody else, my coach recommended this and this is what we did.

19:31
your friend’s gonna be like, yeah, no crap. You needed a coach to tell you that, but you do. And you also need somebody to really help you talk through some things so that you can, more or less, just plan out and give your goals the time and attention, the psychic attention that they need. You’ve gotta think about these things and you gotta plan these things out. So, as you asked, is a coach for everybody?

19:58
I think it is for everybody. The only person I could say it’s not for is if like, do you think you’ve got all the answers? You might not be the right person for a coach, but you could use a coach. You would benefit. But I don’t know if it’s going to work for you because you’re so damn stubborn. But you know, yeah, well, you know, it, go ahead. You know, I was gonna say it helps us like, it helps us materialize the goals. You know, what are we looking for? Zoom out big picture. How can we get there? What are the little steps that we’ve got to take?

20:26
And part of what I do is, you know, it’s coaching slash consulting. I mean, I’m, I’m answering dental owners, business questions about what can they do in their practice and the problems that they’re, they’re having, and I’m using my experience from, you know, having my practice practice for 12 years, I managing a large team. So there’s experience that comes from it, but a lot of it’s just talking through, you know, helping people realize the goals that they say they want and holding them, you know, accountable to it. Because.

20:56
We’re promising. Hey, yeah, exactly. We we we’re going to talk in a month and this is what you’re committing to. Don’t let me down. I’m going to hold you to that. And if you don’t do what you committed to, we’re going to have a conversation about how come you didn’t do it. So I think it’s everybody can benefit there’s and there’s no harm in trying it. I think a lot of people poo poo it in the Facebook groups and stuff like that. But ultimately, coaching is a good thing for any aspect of your life in which you’re looking to improve.

21:30
All right. So we did it. We’re being nuts. See, I got, I got mine working. Yay. Okay. Well done. The, I’m thinking our president of coaching here at all star, he said, you know, often the people that need it don’t do it. Right. So part of it is the ones that are not good candidates are the ones that they think they know it all. That’s unfortunate. Uh, and, and, and so I like where you say it’s so true. And I do believe as you.

22:00
mature, you realize your limitations, that other people have insights for sure, that you can learn, but it’s not just the insights. In order for us to use that A word accountability with other people, you got to be held. Who holds the dentist accountable? Usually it’s the coach or other dentist that you work with. And so, and you’re right, we’re emotional beings.

22:27
That’s why life coaching, therapy, all those are, you look at, you’re mentioned in tennis, you look at the great tennis players, they have a horde, a huge team of people around them, and a physio, a mental coach, they have a whole team to be successful. And so again, it is essential in the emotional thing and the timeliness thing and running through those. So coaching is a part

22:56
but also having people around you and listening to great podcasts, Dental All-Stars and Dental Practice Heroes to again, immerse yourself with it. So I appreciate you explaining that. I’m a big fan of this and of course I’ve heard that before, but I want to hear it not just from us insiders here at All-Star, but I wanna hear it from other coaches out there, other dentists that are experienced this because at the end of the day,

23:24
My background, I was a Tony Robbins top coach. And what Tony Robbins always said, his biggest thing was model the best. What are they doing? And sure, Tony Robbins is into coaching. And that’s one of the areas to be able to do. And I think of that finding the information and then putting it into play. So Paul, before we end here, what is it, you do a cute thing in your podcast. I don’t have those million questions that you have at the end. You still doing that?

23:52
All those little questions. I’ve retired that because… Did you? Well, I might bring it back. It was cute. But it was making… People don’t listen to the end of the episode. If I make a 45-minute episode, it’s too long for people. We better wrap it up. So then it’s like I go… I try to get it done and I’m like, I don’t have time for my questions anymore. I should bring it back. Yeah, I do the sexy things. It was cute, but I get the point. You got to watch if… We got to get to the point right there. People want a…

24:18
We try to keep our episodes within 20, 30 minutes because that’s a long time. When you get to a drive, that’s as long as you’re gonna watch and listen to. So you wanna make it appropriate for your audience. Well, Paul, this will, we’ve had you many times before and we’ll have you many times later. We’re gonna be on your podcast soon. We have so much fun together. I’m so happy to have this. If you’re listening,

24:44
watch this also on YouTube because I love our setup. I got the blue, you got the red. We were saying, you’re really gonna appreciate the quality of information and the quality of production when it comes to our podcasts. Because we are obsessive, we’re not gonna talk about it here, but in the green room, we are obsessive of making sure everything is done to a high standard. So thank you, Dr. Paul. You’re my video production coach. Yeah, there you go, we coach each other.

25:11
Because you saw what I had, you bought that, I saw what you had, I bought that. So it’s great. We both got the horn in the applause. This is a very expensive relationship over here. So thank you everybody for joining us and remember to follow us on the podcast, Spotify, YouTube, get the episodes as they are released, share with your friends and until next time, go out there and be an All Star.