372: Filling This Impossible-to-Fill Role

Hiring is hard in general, but right now, there seems to be a hygienist drought. In this crossover episode, Kiera talks with Grace Rizza of the Dentistry’s Growing with Grace podcast about how dental practices can face hiring shortages, perfect the dynamics of your practice’s culture, and what the future of dental hygiene looks like.

Other topics Grace and Kiera chat about:

• How long it takes for practices working with the Dental A-Team to see positive effects

• The one service DAT provides that doctors don’t think they need

Episode resources:

Listen to Dentistry’s Growing with Grace

Connect with Grace

Listen to episode #347, Common Dental Marketing Mistakes

Reach out to Kiera

Subscribe to The Dental A-Team podcast

Visit The Dental A-Team website

Review the podcast on iTunes

Podcast Transcript

Kiera Dent:

Hello, Dental A Team listeners. This is Kiera and all right. I was doing a podcast with Grace. She was on our podcast just recently and she does marketing and with identity dental. And so Grace Rizza and I were talking, and it was funny because a lot of times I will record on our side and then we'll double post for them. And I did it on this one and I wish I would have because we actually started out and she was asking me if Dent was really my last name. And I told her, yes, it is. And then we started just chatting through it and it was hilarious. And so I always tend to hit record just a few minutes into the podcast. So I wanted to share this podcast because I think what her and I talk about a hygiene drought and ways to overcome are just some really good tangible that I wanted to make sure if you guys are not listening to Growing with Grace, which is her podcast that you pop on over there and listen to it.

            But also I wanted to bring it on over here to The Dental A Team as well, so you guys can hear it. You guys can listen to it. Sometimes it's fun when I'm on other people's podcasts. You guys just get a different side of me that I really want to share. So I hope you guys love it and enjoy it. And as always, thank you guys for listening and I'll catch you next time on The Dental A Team podcast. So my background started out in high school. I wanted to wear scrubs and there was an ROP program at the high school. And I could either become a nurse or a dental assistant. I thought fastest, easiest way to get there, learn the mouth, not the whole body, definitely going dental assistant route. I didn't have a passion for teeth. I had nice teeth my whole life. I didn't really have to have ortho or anything like that. So just one of those things that I didn't really realize how great I had it.

Grace Rizza:

Oh, that's annoying.

Kiera Dent:

It's super annoying. I know I was just that person. And so, I went into dental assisting ortho. I was a terrible dentist assistant. I will tell people when I first started out, it did not come natural for me. I hit the dentist in the head with the overhead light. I shot air into an open socket, like blood in the face. I did all the things like x-ray status. Holy moly. I became a really good person to taking x-rays, but because it was so hard for me to do it. And so I felt like I had to put a lot of love and attention into dental assisting, and then I fell in love with it.

            So of course that's how it happened. So I was a dental assistant for quite a while, then a treatment coordinator, a scheduler, a biller and office manager. And then I've always been a little entrepreneurial spirit over here. So when my husband was applying for pharmacy school, after the long debate that I lost of him being a dentist and he won that he wouldn't be a pharmacist. So we got into pharmacy school and he applied to several schools because we were not going to not get in. And then I did a little research on all the places he got accepted to and Midwestern University in Arizona was one of the few schools that actually did a spouse reimbursement. So if I worked at the school, we would get a discount on his tuition. So that was actually one of the reasons we chose Midwestern. It wasn't because we wanted to, we wanted to go there and I would be able to get a discount, but then I had to try and get a job there.

            So I feel dislike really, truly... It was not my path. I feel like there was a higher power that was involved and I was able to get a job at the dental college at Midwestern. So I worked there for three years, got a discount on my husband's tuition, but more importantly, I got access to so many doctors and I just felt like that was a great way that I could help give back more to the dental community is bringing my passion and love for the profession to all these future dentists. So I worked with them for three years, and then when my husband graduated, he did a residency and I actually went and helped a student from Midwestern. We went and started a practice in Colorado and that practice we took from 500,000 to 2.4 million in nine months. It was crazy. And I'm like, I don't know what the heck we're doing.

            That was insane growth. I felt like we were drinking from a fire hose, making a ton of mistakes, learning a lot of things. I just feel like we were playing dental house. I didn't know what the heck we were doing. And we're just like, "Well, we're doing this." And then I realized we had insane growth and I thought, "Hold on. I just helped one dentist. What about all those other students that I knew?" How could I help them? So I went and practice on a friend's office just to see if I consulted. I didn't know what a consultant did. I'd never done it before. And so I went and helped him. And in one month, I was out there for a couple of days and he went from a $75,000 producing practice on average to 125,000 a month. And then we caught the eye of Mark Costes and DSI because my friend happened to be one of his clients, Mark and I became great friends.

            I worked with DSI for about four years, working with hundreds of their offices, traveling all across the nation. I tend to average about all 50 states every year is what we tend to hit, we haul. And then we've now just grown into The Dental A Team. We've grown into the podcast. We have our own podcast and it was really just to give back to all those students is how it started out. And then it's morphed into how can we help the profession of dentistry in the largest way possible? This is our avenue and this is what we love to do.

Grace Rizza:

That's awesome. That's fine. I love hearing how people get into dentistry and then how they just fall in love with it and stay with it and evolve. And we all have a story. It's always fun to get to share that.

Kiera Dent:

For sure.

Grace Rizza:

Okay. I always like to share something in the podcast that's going to help people like immediately, or at least connect with people with where they're at right now. When I'm talking to our clients on a regular basis, I'm hearing a lot of their growth challenges circulating around not having enough team members or not having the right team members. What role right now is the hardest to fill in the dental practice. And why do you think that is?

Kiera Dent:

Hello Dental A Team listeners. All right. One of my absolute favorite quotes is, "You are always one decision away from a totally different life." So what life do you want to have? Do you want more accountability? Do you want a team that's trained? Do you want to have somebody who thinks outside the box and create just for you? Do you want to have a coach? Do you want to have team training? Do you just need somebody to kick you in the rear and get you going? Okay. Don't worry.

            I'm in every single one of those boxes and that's why we created Dental A Team silver, gold, and platinum. It's going to be customized team training for you on the terms you want. So silver. Silver is more for accountability. Gold. Gold include all of our online training plus the accountability. And platinum includes all of that and in office. You guys, I would strongly suggest you go join Dental A Team gold today because you're always one decision away from a totally different life. So what are you waiting for? Hop on over to the dentalateam.com today. You guys, we only have so many spaces. So get over there today and sign up for Dental A Team, silver, gold, or platinum.

            I love this question and I became a serial entrepreneur and we actually had a company called Dental Placement Pros for a hot minute. And it was about a year run and I realized hiring was a hard thing to do, especially when I had several hundreds of clients that we were working for. But I love this question because I feel like I can actually talk about it and I can help give those tangibles. So hiring is hard. It is challenging. And I would say, I think it's ebbed and flowed over the course of time based on statistics and what's going on in the world. So right now I think the hardest position to fill has been hygiene and it's due to a lack of hygienists out there. So we got the COVID that hit. And then we had a ton, a lot of those hygienists were actually moms.

            And then there was nowhere to put their kids for school. So a lot of hygienists actually just left the profession, or we had some older hygienists that had just been doing it because they love it. But now there's a health concern, fear. So they pulled out of the profession and knowing that the bulk of hygienists are females, it actually took a huge chunk of those hygienists out of there. And now we have a hygiene shortage. There's not enough hygienists to be circulating throughout. So now it's this, what do we do? Can we share hygienists? Can we run assisted hygiene? And so I think right now that tends to be one of the hardest positions to hire. And I've just seen it all over. So offices are needing to get scrappy. They're needing to think differently. How could we actually see the same amount of patients or change up our marketing strategy?

            So we're bringing in more of our ideal patients. So we're not having to have as many hygienists, could we share with another office? Can we like wow and dazzle hygienists in school? Can we send some of our assistants to school? Yes, I know that's a two-year play, but at least we'd get them back. Can some doctors start doing hygiene? So I think right now that's been the hardest piece. However, I will say that I think writing ads and doing your ads differently, we have a whole hiring course that we put together because like, "Hey, let me just take all the knowledge we've got and give it to you guys."

            But I think that by doing so kind of if you write really good ads, you have certain titles you zig when other companies are zagging. I post three ads simultaneously for the exact same position, just with different titles. Grace, I'm sure you know, our podcasts, it doesn't matter the content, it matters title that we put on there as to how many downloads it will get same thing with your ads. So if your ad has a really sexy title, you're going to actually get more candidates to apply.

Grace Rizza:

But yeah, I should title this one. What's Kiera's real last name?

Kiera Dent:

Yep. There you go. You'll get download clicks and it's not because of the content. I could talk about whatever we wanted to, but it's all about that title and same thing for your ad. So that's a tangible that you guys can take is like, how do you write your ad? What time are you posting your ad? What's the title you're placing on your ad? And then also some of the things to do at hygiene. I've had some offices where they'll just do assisted hygiene, maybe for the last two or three hours of the day. It's the most prime spot anywhere for hygiene appointments, doctors then have two or three hours where they're just doing hygiene checks. Maybe you run that for one or two days a week, but it's not hard. It's not exhausting on your team. We're not compromising our patient care, but that's thinking outside the box when we're in a shortage of hygienists and then any of those hygienists that want to come back to work, like just let us know. We'll happily take all of you.

Grace Rizza:

Yeah, it's been such an interesting conversation to have with people because there's this desperation and it's so unfortunate and it's such an important role. Do you think the dynamics of a dental practice... I mean, I worked in a practice prior to starting my company for a couple of years. I was always in the marketing side, but I was able to see the dynamics of a dental team. Do you think that the dynamics of a dental team put a unique kind of stress on the hygiene department? It's kind of different. It's unique. It's like they're providers, they're still a part of the team. There's a little bit of maybe isolation because they're not as connected with the doctor. What advice could you give to a team that's having a hard time, not only just finding a hygienist but being able to assimilate their hygienists into their team and making sure that they're there to stay? Because I think that's the goal, right?

Kiera Dent:

I love that question a lot. I think hygienists, oftentimes you're right. They kind of are put on a pedestal. They're not a doctor, but they are a provider. So their clinical team, but oftentimes there's mutiny between the hygienists and the dental assistants. And then there's mutiny sometimes between hygiene and front office. And so what I've found is first and foremost, let's set our company goals as a team. What is the office achieving? And then have each department set their own individual departmental goals and then personal goals and realize... I'm not huge, crazy fan of individual bonuses in a practice. I like it to be a team bonus. The reason being is I remember when I was having our practicing, I had my dental assistant say, "Kiera, I don't think our hygienist should get bonus the same as we do. They don't even do anything for us.

            They're just sitting there cleaning teeth, but they get our same bonus?" And I said, "Hold up. Who goes and gets your patients numb for you and so that way you can stay on track? Who's the one who's teeing up all the treatments so that way we can get treatment into doctor schedule? Who's the one who's got a strong relationship with our patients?" A lot of times patients will stay with a practice solely because of the hygienist. And so helping the whole team realize that every single position within the practice is valuable. And then I think all of us working together. So instead of it being hygiene, dental assistant office manager, treatment coordinator, everybody being a siloed, let's incorporate them all in. And I also think as much as you can, have each other help each other. So getting each person there and then a really big way to help the hygienists that I've seen in a lot of the offices that we consult across the nation is what I call, what would doctor do?

            So you actually get the hygiene team with the doctor. They look at FMXs and intraorals, they post it up there and hygienists really start to learn how to co-diagnosis. Of course, they're not diagnosing but they're co diagnosing with the doctor. They can tee up treatment. They can make those exams so much quicker and more efficient. And I aim for the hygienist should be able to co-diagnosis like 90, 98% exact of what the doctor will say, then it becomes fun. And then your hygiene team can actually train your future doctors coming in, exams are consistent, treatments consistent, diagnoses consistent, and you really incorporate that whole hygiene team in together.

            So they're a super integral part on all the levels and also notch it up. I have the hygiene and dental assistants work together, or they're actually flip flops. So hygienists will go see the dental assistant world, dental assistants will see the hygiene world and they give each other feedback on how they could make it more efficient. And also if you're really struggling with it, have a high five jar where every morning huddle, everybody gets a random name and they write a shout out or a kudos to somebody that way it becomes a whole team focus of positivity versus that negativity that can sometimes exist.

Grace Rizza:

Awesome. I love when we share information that people can use right away, that they can apply in their practice and be like, "Oh, good idea." So I know so many people listening right now are going to say, "Oh, we're doing that. That's a great idea." So thank you for sharing that.

Kiera Dent:

Good. You're welcome.

Grace Rizza:

Of all of the creative ways that we've kind of talked about navigating that you've talked about navigating this hygienist shortage. What do you anticipate to be the future of the hygiene department? Do you think it will go back to what it was or do you think it will morph into a more efficient model? Or do you think doctors are just going to be doing hygiene now?

Kiera Dent:

I definitely don't think doctors will do hygiene. I don't know if you've ever seen a doctor do hygiene. They did not go to school to be hygienists or [crosstalk 00:14:42]

Grace Rizza:

I have as a patient and I needed another [crosstalk 00:14:45] I needed to schedule my next appointment for tomorrow.

Kiera Dent:

Yep. Exactly. So most doctors don't make great hygienists. So I don't see that being the future. I think it might be a small interim if we need to. I think it's going to be similar to a lot of things. I don't know if you guys know, I didn't know this till recently, but there's a bike shortage. They called it a bike drought. My husband and I decided we live in Reno, Nevada. We decided we're going to jump all in and get into biking. And so we went on Saturday. We were like, "Okay, we know how much we're going to spend. We've researched mountain bikes. We were ready to go." We show up to the place. And the guy's like, "So we actually don't have bikes." I was like, "What?" And he's like, "Yes, we're in a bike drought." We went to so many different bike places and they said, "You literally have to buy the bike that comes because if you want to bike, it's either get this bike.

            If it works for you or you're going to be waiting like 10 to 12 months, if you're lucky, because there's going to be a whole wait list." I was like, "I'm sorry, what? Don't we live in the United States? How does this happen? Like Amazon, I get two day delivery on anything I want." So I feel like similarly, I think what's going to happen is it's just kind of a hygiene drought right now. However, a lot of people are going to school for hygiene school. I think the hygiene schools will start to produce more hygienists. I actually think if hygiene schools are smart, they would figure out how to create different curriculums, to be able to get more hygienists in because it's a huge need that I then think that we will probably over produce enough hygienists, but to get them in there. So I think it'll probably be maybe a one to two year drought, penny upon how quickly we can get hygienists through dental hygiene school and then back in the field.

            So I think it will probably settle out. I do think offices will have to be a little bit more savvy while we're waiting for that hygiene drought to end. But I really do see hygiene's a strong profession. It's a great profession. Like I said, a lot of moms, a lot of parents love hygiene for the fact it's very flexible with little kiddos. Processing people go back to school. So schools are opening back up, which means more people are available and wanting to go back to work. I think people are getting bored. So I really do think it's a short drought that we'll be in. And whether it's six months a year or two years, because it's usually a two year cycle for hygiene school. But I think we'll see it come back just like I'm hoping bikes will catch up on manufacturing and we'll all be able to go biking again. But like, Hey-

Grace Rizza:

There's a lot of weird shortages right now. There's like a wood shortage if you want to build a house, you're going to have a hard time with that. We did buy a jet ski, we found one out in the country to buy. But we couldn't get a jet ski easily, there wasn't a lot of like... I don't know why that it's so weird. It's so weird.

Kiera Dent:

I think we all got bored. We all started sitting at home. We all started getting like more outdoorsy and active. We were like, "Hey, let's build our house." But you have a mass huge population that all decides to do similar things at the same time. And then we also shut down our production manufacturers because we can't do inter global trading if you will. And so here we are like, wow. But it just makes me realize how grateful I am that we do rely on so many other people and how grateful I am that there are people that will build these things because it's just a part of life that I don't think any of us are used to like, "Wait, what? We can't get this right away?" I mean, there was a fridge and a freezer shortage through COVID when everybody was like... I mean, we had a toilet paper shortage. I never would have thought I'd see the day-

Grace Rizza:

Baking flour.

Kiera Dent:

And yeast was on a shortage for a while because everyone was making bread. It was crazy.

Grace Rizza:

Yeah. It was kind of cool though. It was kind of neat. I mean, it was not cool, but that's the wrong word to use to describe a pandemic, but it was different. And that experience definitely changed [inaudible 00:18:19] some ways, hopefully for the better. If a practice is looking to bring you on, looking to work with your team, let's say I'm just an average I know it's going to vary substantially based on how much they do with you. How long typically does it take for a practice to see a tangible change in their culture and operations, the things that they're looking to tweak? What can they expect there?

Kiera Dent:

I'm glad you asked this question because I'm hoping that the listeners realize Kiera Dent is a quick implementer. So every time I'm on a podcast, on our podcast, I don't like fluff. I like for you guys to get a tangible, actionable item that you can go implement today that will make a difference. So it's the exact same in consulting. So most of our offices, we work with most offices for about a year. However, I'm really big on them seeing a quick ROI because everybody wins at that stage and then everybody's bought in. So most of the time our offices see between a 10 and a 30% increase in revenue within their first 30 to 90 days working with us. And I purposely do that. And it's all simple. Nothing we implement is hard. We've been coined the Dr. Seuss of systems. So everything is really simple, really easy.

            And I'm not big on cookie cutter. It's not like, "Hey, here we go, you're going to start with A, B and C." It's where are you at? What are your pain points? Because that's how I know you're actually going to implement because that's a pain point and we're going to solve that quickly, easily and efficiently. So I tend to work with offices for about a year because we'll put that in. You guys will see growth, but then it's that human nature. I mean, how many times do we say on January 1st, I'm going to work out and by January 30th, we've missed seven workouts and we're just over it. And we're back to having whatever lifestyle we want

Grace Rizza:

Every year.

Kiera Dent:

Hey, me too. I'm glad there's someone else out there. But if I get consistent like last year through the pandemic, I said, "That's it. I'm going to hire a personal trainer." And I did, and I got my freaking results and it was amazing. But then just like in anything else, I had worked with her for about six to eight months. And then I was getting really just kind of bored. And so I try really hard with our clients to make sure that we don't hit that growth, growth, growth, and then we plateau. So it's always an evolution like, "Okay, great. We've got our systems in place. We've got these basic things in play. Now we're going to move on to leadership." And then that becomes this whole world of, instead of it being systems, it's people now and leadership teams that still built on a system.

            So in case any of them ever leave, we're still going to have it to where it's a plug and play, but we then start to morph leadership and changing as people. And so I kind of worked that and we dovetail all the way through that. But most of our clients, I don't know, we've been in business for the last four years. And I always thought we had a two year lifespan of clients, I thought, "Okay, great." Year one's systems, year two's leadership and then we'll just do on your own. The goal is to teach you how to fish.

            I have clients who have stayed with me for four years. I've had some clients who within a year, I'm like, "You guys are great. You've grown. I'm like rock on, continue on." I will say most of our clients, so usually average between a year to two years. And then they tend to do maintenance of just coaching calls, just to keep that accountability rolling. And also to have a consultant in their back pocket that at any moment you can text and say, "Hey, what do I do with this?" And we've got the solution and the answer customized to your practice.

Grace Rizza:

I love that. I see a lot of people really hating on consultants and coaches in the dental field. And same thing with marketing is it's not so much about you've had a bad experiences. So all consultants and coaches are bad. You've got to keep working in and networking and find the right advisors for your team. Otherwise, you're missing this huge opportunity because you can only see so much as the owner. And I'm kind of speaking to myself too and to you as well, is that as the owner, we can only see so much. It's having that fresh pair of eyes come in and kind of evaluate and give feedback. And sometimes as the consultant, you're going to see areas of opportunity that the doctor didn't even know existed. So what is the one service you provide that you think most dentists don't realize they need?

Kiera Dent:

That's a good question. Grace and I'm glad you brought up the hating on consultants. It happens all the time. I know I walk in there and I know people have had bad experiences, but I think hopefully we're a young, innovative company and I'm hoping just like dentistry, we're changing the vibe of consulting. We do it in a really fun way. We do it in a very innovative way. We're really young, we're savvy, we're tech savvy. We can help you guys with it. But I would say the number one thing that doctors do that they're missing or they see is literally what you say. We come in from a bird's eye view and we can see your blind spots because we've literally been in your shoes and we've done every position in the practice except for being a dentist.

            So like right now I have an office and they just called me because they have an office manager and a treatment coordinator with no dental background. Sweet. I think that's something we can definitely help with because we don't just understand that position. We actually have been that position and we can give tangible tools directly to you and your team. So I'd say that it's also being able to get the whole team on board and headed in the exact same direction in a really simple way. So I have another client, he was on the fence, do I bring on a consultant? Do I need consultant? He is like my penny pinching doctor. And he will tell you today is that, "Kiera, I just don't know if I want to bring in that [dance row 00:23:52] chair, because it's so much..." And I'm like, "Oh my gosh. Okay, here's the deal. I'll buy your chair.

            And for every dollar that you produce out of that chair over the next six months, I get a keep." Because I know it's that good of an investment. And he's like, "I know I'll just do it." So he's that doctor that he knows that he is very tight on funds and wants to invest them in the smartest way possible. He told me, he said, "Kiera, when you came in, I was real skeptical." And he said, "Within 10 minutes, you'd already paid for yourself." He said, "You had figured out who my team was, you knew exactly their personalities and you knew how to fix this." And I just had a wrap-up call with them. I've been with them about two, two and a half months. I was out there in January. So I guess we're at three months now. And they've already had their best months that they've ever had in the history of their entire practice.

            And he's been in practice for at least 10 years. So it's been quite a while. And he said, "Kiera, what you did is you were able to get my whole team on the same page. And then you figured out what each person needed in their own individual strengths. And then you're able to push us with enough push, but in a simple enough way that everybody won." And he's like, "I've never seen my team do this." And so that's what I think we bring in consistently is wherever your team's at, we meet them where they are. We give that little spin or a push of where you guys need to go to hit your goals of what you're looking for.

            And really getting everybody aligned, I think is what we do. And that's why people got it. I'm like, "We're the A team. We fly in the A team for a reason. We come, we help get your whole team to be A team players, but then all on system. So in case one of them leaves, you still have your A team system that any person can come in and join and you'll still be successful."

Grace Rizza:

That's awesome. And just to kind of recap, the doctors don't think they need certain things because they think it's fluffy and they think it's not tangible. And those seemingly small intangible things are the things that make all the difference in everything else that you do. It's really your foundation. And without that, you're just always going to be chasing more new patients which isn't ideal. We want the new patients to feed a functioning, cohesive, healthy team. And it's great that you can help them achieve that. So if anyone out there is listening and they're interested in learning more about what you do, how can they get in touch with you?

Kiera Dent:

Yeah, thank you for that Grace. So we have our Dental A Team summit, which is May 14 and 15 that's virtual. We did it that way on purpose because we wanted to be able to bring our coaching and consulting to your team and get the whole team on board versus, "Hey docs, you got to go learn this and then try and implement it." So May 14th and 15th, you guys are welcome to join us @summit.thedentalateam.com. And if you use the coupon code podcast because we're on Grace's podcasts you guys will get a discount. So we'd love to see you guys there. Also, if you're interested in consulting or you want to just see if you're even a good candidate, what our services are and if we can help find those blind spots and just make your life a little easier, [email protected] or cool like the Facebook and the Home Depot. So it's [email protected].

Grace Rizza:

Awesome. Well, thank you so much for being here with me today and for those of you listening, thank you for joining. I look forward to sharing more useful information with you. If you're listening on our podcast, join our Facebook group, Dentistry's Growing with Grace and if you're on our Facebook group, listen to our podcast. Thanks guys. And I will see you next time.

Kiera Dent:

Thanks. Grace. And that wraps it up for another episode of The Dental A Team podcast. Thank you so much for listening and we'll talk to you next time.