Dental Practice Heroes

When the Wrong Leader Wrecks Your Culture (And How to Fix It)

• Dr. Paul Etchison • Episode 606

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Not everyone should be a leader. Not even your star employee. The DPH Coaches learned this lesson the hard way, and this episode unpacks what can happen when you put the wrong person in charge. You'll hear how to be proactive and get the right people in the right roles, the signs you may have promoted the wrong person, and why an outside hire might be the best move. Leadership is too important to get wrong, so don’t miss this one!

Topics discussed in this episode:

  • Early signs Dr. Henry’s new manager wasn't a leader
  • What actually makes a good leader
  • Internal hires vs. external hires
  • Why internal promotions don’t always work
  • How respect is earned in a practice

This episode was produced by Podcast Boutique https://www.podcastboutique.com


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Paul Etchison:

Have you ever noticed how one wrong person in a leadership role in your office can derail the entire culture? Recently, dph coach Dr Henry Ernst had to make one of the toughest calls as a practice owner. He had to let his office manager go and while it was painful and it was difficult, it reminded him of a powerful truth Leadership is much too important to get wrong. Today, we're going to talk to how to make sure the right people are in the right seats, how to train and build up your leadership team, and why the success of your practice depends on it. Stay tuned. You are listening to the Dental Practice Heroes podcast, where we teach dentists how to step back from the chair, empower their team and build a practice that gives them their life back.

Paul Etchison:

I'm your host, dr Paul Etcheson, dental coach, author of two books on dental practice management and owner of a large four-doctor practice that runs with ease while I work just one clinical day a week. If you're ready for a practice that supports your life instead of consuming it, you're in the right place. My team of legendary dental coaches and I are here to guide you on your path from overwhelmed owner to dental practice hero. Let's get started. Hey, welcome back to the Dental Practice Heroes podcast.

Paul Etchison:

I'm your host, dr Paul Etchison, and I'm joined by my DPH coaches, dr Henry Ernst and Dr Stephen Markowitz Dr Henry's got a large practice in the Carolinas 18 ops and Dr Paul Atchison and I'm joined by my DPH coaches, dr Henry Ernst and Dr Stephen Markowitz. Dr Henry's got a large practice in the Carolinas 18 ops and Dr Steve has got six practices on the East Coast. So some very experienced owners here that we're going to talk about. A really good topic today and this is something that I hear with my coaching clients is that they will work with me and then they'll say I can't believe you've got problems at your practice with all the systems that you got. How do you have problems at your practice still? And I think there's this glorified notion that once you start systematizing your practice, the problems go away. And it's just not the case. I mean, things continue to happen and I'm going to pass the mic to Dr Henry right now, but he had some pretty big it's a pretty big turmoil recently. Tell us about it, henry.

Henry Ernst:

Yeah, thanks for that introduction, Paul. I think that the way that you said it is great. We can have systems in place, we can have everything, everything the way that we feel like is going great, but stuff hits the fan. And the best way I could describe it is if I'm taking an implant course and somebody's telling me like, oh, they're showing me all these great things, show me your failures, show me where you screwed up. And I think it's great on this podcast for us to put our guard down and say, hey, we have stuff that happens in our practice too.

Henry Ernst:

So in our practice, you know, we're always really big on promoting from within, having a great work environment. We have EOS in place and our most recent practice manager and maybe I'll give you a really quick history we had a practice manager from the two-month inception of the practice till about seven years and she was great. Everybody knew where they stood with her. She wasn't super, super warm and fuzzy, but if I came in late I knew that she was going to hold me accountable. She was great in the business aspect the front end of the house there, which is great because it complements me, and being great with the back end of the house and stuff like that. She left to start a family a couple years ago and we promoted from within. We promoted from somebody who started at the very entry level entry level hygiene assistant, worked their way up, worked their way up, got coached into being assistant, practice manager and eventually practice manager.

Henry Ernst:

So, long story short, there were times in the last six to eight months where I would get somebody from my leadership team telling me listen, we've got problems, people are not getting held accountable, being late, which never happens in our practice. You know, people being late, people kind of slacking off a little bit and nobody's holding them accountable. And I use the example of a child, a child that wants to go to sleep oh, your bedtime is 8 pm. Next thing you know, parents slacks off, it's 8.15 and nothing said. Okay. Next thing you know that's the new normal.

Henry Ernst:

So that's what was happening in our practice. We have all these great core values and next thing, you know, everybody's like slacking off just a little bit, a little bit here, a little bit there. And that was the weakness of this practice manager is she didn't want to have those uncomfortable conversations, right. And eventually somebody's five minutes late. Next you know it turns a 15. So we're creating a bad environment there and, on the other end, we're alienating the great team members. The great team members are like dude, they're slacking off. They're in the break room and I'm doing my job. I always have to find them. They're 10 minutes late for the morning huddle and that's. It just sets a really bad, and this has happened a few different times and it would just really aggravate the heck out of me. You know, we always talk about creating that practice where we can work two days a week, which is what I have, and so I need to be able to trust that integrator, my right hand, and always defend them.

Henry Ernst:

So I had a very difficult decision to make and I actually there was one of your podcast episodes. I had a guest from California, dr Kalasho. Yeah, she had a great little snippet that actually played for my team that she mentioned. For example, if your office manager is not holding people accountable, it's not the owner's responsibility, it's the practice manager's responsibility to talk to the dental assistants, because we can never run a business like that and set the tone. Right now we've got kind of interim One of my leadership teams kind of running the show for now, and right now we're in the process of interviewing and that was the first thing that I said to this new person.

Henry Ernst:

I said I told them exactly what's been happening. We have great systems, we have a great reputation. We just kind of went off the rails a little bit. And if I'm supposed to fly from here to Chicago and I've got this pathway, that's directly pathway and for the first 10 minutes of the flight I'm going just a little bit off course. It's not a big deal because we can just correct it, boom. But if you let that 10 minute span go for 30 minutes, 40 minutes, next thing, you know, I'm headed to freaking California or something like that.

Henry Ernst:

So that was what I mentioned to the team. We got off course and I basically said you know, these are our principles. We are on time, we do our job, we have respect for everybody. If you want to be here, great, you're here, we're on the same bus rowing together. If not, you need to go somewhere else. And when this was announced, there was another team member or two that was getting preferential treatment by this practice manager that decided to leave also. And that was great, perfect, right, we're clearing the deck and now we're moving forward. So you know, just being humble, this stuff happens. Nobody's perfect. I'm sure both of you have stories just like this here, and I think the important thing is to look back, take a step back and see how did this happen? How could we, of course, correct it a little earlier, but we ultimately make the challenging decisions to move forward, to correct the course.

Paul Etchison:

But I think it's hard because it's such a disruptive decision. It's like you're between these things where like, oh well, I don't really like how that's going, I don't really like that. It's like all these like minor, like little paper cuts that you're just like, ah, that's kind of irritating, but it's not so big. I mean, what eventually brought this to a head? Was there a situation that just happened recently where you're like that's it, that is it, we are done?

Henry Ernst:

Yeah, so we had a couple of highly trusted leadership team members come, and this is a hard hierarchy, right, because we have our accountability chart. So this is going outside the accountability chart. For those of you guys have EOS in your practices, you know you have the visionary, which is all of us, the owner, and then the integrator, and then everybody is team leads and down. So basically this kind of skirted the pathway and they came directly to me, which should never happen, but it was that important that they had to come up to me and tell me listen, we need to talk you know, the dreaded words we always love to hear.

Henry Ernst:

As owners, we need to talk, and I would get detailed things that were going on. I verified again, wasted my time, verified from looking at cameras, footage and yes, these people are late, nothing's happening. People are goofing off in the break room, nothing's happening. And then it was corrective action on my part to say listen. I used a John Taffer example of the show Bar Rescue he always talks about. If I'm walking down the halls of the business and I see somebody doing something wrong, if I decide to just I don't have the energy for this right now and just keep walking, you know we have that right If somebody's doing something wrong. Paul's like dude, I just want to go sit at my desk and have one of those cold hot dogs that he eats or whatever.

Paul Etchison:

Oh, I thought you were saying you didn't have the energy to do a Jon Taffer impression right now. I thought you were being like. I thought you were really getting the character here for us. Okay, all right.

Henry Ernst:

Yeah, that would be interesting. Don't have the energy to do this conversation right now, this difficult conversation. I'm just going to walk past it. The second that I do, that, in that employee's eyes it's saying to them oh, I'm goofing off here and he just walked by. That means it's as good, this is the new normal. So I had that conversation with her and telling her that when you see something wrong, you need to call it out right then and there, in a respectful way. Right, always give them the why. This is why we're not, we don't goof off, because other people have to take, do your job and do this, you know. So there was some action like that and then it just didn't happen. I guess, looking back on it and trying to do like a how did this happen? This person just didn't have that ability to correct people, and it takes a special type of person to be a leader ability to correct people and it takes a special type of person to be a leader.

Paul Etchison:

And not everybody's made to be a leader. Yeah, that's what I've noticed too is that it's like with working with so many practices is it's you kind of don't always know what you're going to get with leadership, and you've got to put people in those situations, you've got to give them the opportunity to prove themselves and you've got to give them training and help them through and hopefully you've modeled good leadership. But sometimes it's like there's that it and it's like how do you, how do you correct? I mean, steve, what are you thinking over here?

Steve Markowitz:

There have been times where we have had really strong business team members and then we put them in a leadership position and they were like no bullshit at collecting AR and doing and supposedly having difficult conversations that I thought were difficult because they were in charge of billing or having handling patient complaints. And then as soon as we put them into a leadership position of other people, they would go and do the job for them, as opposed to having a difficult conversation. So I can totally understand how that happens, understand how that happens, and I think for us it's like how do we evaluate if someone is capable of leading and influencing others to do their job, not just being really good at specific tasks? But then to Henry, thank you for sharing that.

Steve Markowitz:

I'm sure it's kind of been a lot for you over the past little bit, but how did you know that you weren't able to correct the behavior? Like, at what point in this you're like I'm hearing this, all this information, it doesn't sound good, but this person's been with you for a long time. I'm sure that there were times throughout that 10 years where you're like I need to correct this behavior. I feel like I'm strong enough to do it, but you didn't have that feeling this time? What was different for you and why? How did those conversations go?

Henry Ernst:

Yeah. So I'll give you a little background. This person I never had to correct ever. And all this asked you know, hygiene assistant, dental assistant. In all this, you know, hygiene assistant, dental assistant, da1, da2, assistant practice manager, never, ever, ever. And I would look, use the analogy of, let's say, we're in a boat, the darn boat has got a hole in it, it's leaking and I'm able to plug it. Actually, you know, it's leaking some more and I'm just, I just can't stop the leak and eventually I'm just drowning and I just I had to do something about it.

Henry Ernst:

And in this specific example this is a specific challenging example you have somebody who've never had to correct before, is perfect core values for the practice and as they got promoted to practice manager, they just didn't have that John Taffer right, that ability to correct people and hold people accountable.

Henry Ernst:

So then you know, what do you do? Do you demote them, do you terminate them and just tell them why and start afresh. So I made the decision to start afresh and when I told this to the practice, everybody and I said this is why this is happening. We have to get on board. Either get on board or I'll shake your hand and 95% of the practice is like appreciative and grateful because they were the good ones that were upset because others were goofing off, so you kind of like strength in numbers. So that was how I came to that decision and that's where we are now and I feel like definitely could tell there's a different vibe right now. There's a vibe of, okay, we need a course correct and I'm on the boat with you, dr Ernst, I'm going to go with you.

Steve Markowitz:

There is that law I don't know, it's some business law that says we're going to promote people to a level of incompetence. So that's clearly an example of that. But also our practices are living organisms and the manager that's going to be the best leader when we're in super hyper growth mode may not be the best manager when we're in mature maintenance mode. And I think that, from the owner seat or the visionary seat or whatever we are calling ourselves, we need to understand that. What is this person's strengths and is that fitting with what the practice needs right now?

Henry Ernst:

so to create maybe a learning aspect for the, the listener out there right now, we just decide to go a different route where, for the first time in the history of the practice, we're hiring a practice manager from outside the organization, somebody to come in brand new. So I kind of equate it to sports. We've all had our teams that we've, you know, root for and stuff like that, and once in a while maybe the coach leaves or the coach retires or gets fired. And next thing, you know, maybe they bring in what's called a player's coach. Oh, we're bringing in a new coach, new idea, and all of a sudden a year or two goes by and it's like, dude, this player's coach is not working, man, they don't have any discipline, they're getting penalties. Next thing, you know, you go back to the disciplinarian coach and all of a sudden, boom, it works, and sometimes you're right. Like a team, there's cycles. So where I'm going with this is right now we're going with somebody outside your organization.

Paul Etchison:

Nobody knows, and I was going to follow up and ask you, henry, do you feel like, in retrospect, that you could have saved this had you intervened earlier? Or do you think this was just the top out of this person's leadership ability?

Henry Ernst:

I think sometimes you either have it innately or don't. As far as this goes, you have to be able to be comfortable to call out people and I think some people just want to be a little too much buddy. Buddy, you know, and it's like I always tell some of the team like my team respects me, right, and they'll come by my office and shoot the breeze with me. They did this this weekend, that weekend, but at some point in their mind there's like a time clock when they're like, okay, this is good, so they respect me, but they don't have to. I hope they all like me, and I think they do, but they have to respect you.

Henry Ernst:

I like your head. Well, that means a lot to me, Steve, but you have to respect and respect has come from you know, when you do, you're always going to hold people accountable and they know where you stand. Like I said, the previous practice manager was not warm and fuzzy, but when you were late, you knew she was going to come up to you and tell you that you were late and we can't do this anymore. That's what we need, yeah.

Paul Etchison:

I think that's you know, it's interesting. I and it said something like as a leader, we like respect and as a leader, like even fake respect, like leaders still appreciated it. Like, even if they knew the person was like brown nosing a little bit and it was somewhat ingenuine, the leader still appreciated that because it showed some level of respect. Steve, you know what do you think? I mean you develop tons of leaders. You got six practices. How do you know if this is somebody that can learn more or somebody who's topped out in their leadership? How do we not make these mistakes? Sure?

Steve Markowitz:

A couple thoughts. One is are we trying to find what this looks like from bringing someone in from the outside, because that's a whole podcast? I'd love to unpack like bringing in a leader from the from the outside, because that is a? Yeah, there's a ton to unpack there, but for most dental practices they are like this person left now we're going to promote from within. How do we know if that person's capable? The greatest success I've ever had is not providing positional power, for that respect occurs.

Steve Markowitz:

I will never forget the time when we announced Karen our regional manager was the manager of the practice that she started as assistant, as and I was all excited. I brought in a freaking cake, maybe balloons, and I made this announcement and I was like guys, I'm announcing Karen as the OM and it was like silence. It's like what? Why is no one excited? I thought Karen was the om. Oh, that was the response. Everyone was like, oh, she's already. I thought she already did that, she already had that level of respect. We already had those conversations.

Steve Markowitz:

I was to plant seeds, not with the team, both karen of like all right, do you want to take off these responsibilities? What does it mean? Clearly to hold someone accountable. What are our non-negotiables For Henry? It sounds like if you're showing up late, that's a non-negotiable. If you're not going to hold someone accountable, that's a non-negotiable.

Steve Markowitz:

So before we give the title, we have a ton of conversation around what does this look like? And I almost want to talk him out of the position, because if I'm doing a job telling them how hard this is and how much leadership, responsibility, leadership is, how much this sucks, and they still say that that's something they want to do, then they're going to be able to do the hard shit. If they're like just thinking like this is the next step in my career and I deserve this position because I was so good at this, I'm going to be great at that. And they're more concerned with the positional power and that's their motivation.

Steve Markowitz:

Most of the time they aren't willing to have that level of difficult conversations, and what happens in most dental practices is we're not proactive enough. So we have this opening. We want to fill it as quickly as possible because I don't want to do more shit myself. So then we look around and say you're the best person for this here. I guess You'd be awesome. Let me tell you how great this is. Let me sell you on the position as opposed to having you understand truly what the responsibilities are of leadership.

Paul Etchison:

So you're saying that because this is interesting, because I do this with my clients a lot and we talk about how, when we put somebody in a leadership position, I always feel like, as the leader, you need to give that person the blessing and like you need to grant them the authority of being in a position in charge. But you're saying you show me that before I grant you the authority.

Steve Markowitz:

So we were just talking about respect. Respect doesn't happen because you're in a position of power. Respect happens because you are actually influencing and earning that respect. That's interesting. So what I'm telling this leader, or future leader, is earn respect of your team. They will fight through walls for you, the same way that your team loves you, Paul, and your team loves you. They don't love you because you're the owner of the practice. They may like you and respect you. Part of it because you signed the checks, but mostly it's because how you serve them and how you treated them and how you made them feel and how you're able to help them. All of the things that we do for our team is what I would expect someone to do in a position of leadership. The owners that struggle the most and have the most HR problems and have the most turnover are the people that say you're fucking here to work for me.

Paul Etchison:

Yeah, and.

Steve Markowitz:

I'm the owner, show me some respect. And I'm the owner, show me some respect. And I'm like you got this wrong, babe. It's backwards. I'm here for you and if I can serve you and give you what you need, alongside with what the practice needs, then I will have all the respect in the world. And this team will go through walls for me and they'll make sure they show up on time. And they'll make sure they show up on time and they'll make sure they do their job and they make sure they're focusing on results. So I need to make sure that person is fully understanding that level of responsibility and I almost want to talk them out of it because it is heavy and it's not fair to them to put them in a position that they don't know if they want to succeed in.

Paul Etchison:

You know, what's interesting about you saying that is that I was going back through the six years of coaching and I wanted to say, okay, what are the stats and collection increases, what are the amount of clients? I have been able to double, triple their collection, like things like that. And what I saw is I had some stats that were lowered by certain coaching clients and what's funny is I don't work with these people anymore. It is that leader. It is that exact leader. When I'm having a strategy call with somebody and I sense that that that person is like you work for me. I'm the boss, because I said so. These people are stupid. I can't find the right people. Nobody does what I tell them to do. Those are the type of leaders that you sense it?

Henry Ernst:

I say I can't help this person, I cannot change the way this person leads, and I think now going forward, my stats are going to be even better because I'm not taking those people as clients. Yeah, I think what's really important is servant leadership right, no matter what position we're in to this day. I mean, I walk down the hall. I see a piece of paper on the floor. I'm not above doing that, right. You know, the garbage needs to be taken out. I'm not above doing that. It's all about respecting leadership, because we can do anything right, and I love this quote that I saw recently by a football coach you know, if you want to make everyone happy, don't be a leader. Sell ice cream, because as a leader, you're going to be respected, but some people may just not. They may be nervous around you or this or that. It's a lonely sometimes. Being a leader is a lonely life sometimes, and you just have to be able to accept that. I'll sell ice cream and I'll make everybody happy, unless they're going to complain about the prices.

Paul Etchison:

You can sell those WWF shortbread like cookie, those shortbread things, with the WWF people.

Henry Ernst:

Those are my favorite. I think you're showing your age. I think those are pretty old Paul.

Paul Etchison:

Shut up, those are pretty old.

Steve Markowitz:

Paul, shut up. They still have them. Really, I haven't seen those in, honestly, years.

Paul Etchison:

I don't think that they exist anymore. You're right, I don't think they have those anymore.

Henry Ernst:

I think back in my day it was like a Roddy, Roddy Piper one.

Paul Etchison:

I like some Cracker Jacks here. They're only a nickel.

Steve Markowitz:

Paul's eating scale cookies. He probably gets like the. You know those old baseball cards that had the gum in them. It would be the best tasting thing for like two bites, and then you would immediately get like some carcinoma of the tongue.

Paul Etchison:

Yeah, yeah, no, my baseball cards are digital now, so whatever, okay cool. Yeah, you're pretty cool.

Henry Ernst:

So I'll kind of summarize too. I know this is a good topic, for you know an episode and stuff like that, but it may sound more of a problem than it really really is, because essentially, out of our 35 team members, you know, the practice manager is not there anymore and one other person decided to leave. Another person we had to have a heart to heart, so everybody else on the entire team was wanting this to happen, believe it or not, like they wanted change. They wanted their work environment to be an accountable work environment. So that's actually a really good thing.

Henry Ernst:

And another beta testing that happened and maybe this is another idea for large practices is right now we've kind of got a hybrid system. Right now We've got one person that's the director of operations, kind of like, taking care of all the business aspects of things, and we have one person right now that we're calling the director of people. So any people problem, whether it's a patient, an employee that has a problem, that's their person. So it's actually worked kind of well. I mean, it's not what we're going to keep doing, but that's another hybrid model that I kind of thought of, because sometimes you mentioned it, steve if you have people that are really strong in this, but maybe not good in this, and that could be another hybrid model for a large practice that could work also.

Steve Markowitz:

I love that. Yeah, that I do not want to apply for the director of people position. That sounds heavy.

Henry Ernst:

That takes a special person, because your main job is to have uncomfortable conversations. You're basically being the John Taffer. Shut it down, john Taffer.

Steve Markowitz:

There it was. We had energy for that, paul, we did it. We got the. We got him to do the. John Taffer, it only took 26 minutes.

Paul Etchison:

He had to get all amped up. Dude, he's pumped up. Man, he's raging. Yeah, dude, great.

Paul Etchison:

I'm so glad that we were able to share this and it's such a good topic for people and I think the next time we do an episode, I think we should do promote from within or bring it from the outside, because I think that happens to a lot of us and we're always looking well, you know what We'll do it the next one. But yeah, henry, thanks so much for sharing that. And Steve, you have some great wisdom there. This is a tough situation. This goes to show you, I mean, no matter what level of practice you get to, you will still have issues and you still will have problems to solve, and that's totally okay. That's not a failure of leadership on your part, it is just.

Paul Etchison:

I think, like Henry mentioned, this is a tough decisions have to be made and sometimes they're not the most popular. Luckily for Henry, for this one, it sounds like it was in a democracy. You've had a majority at least. But yeah, I want to get an update in like maybe a month or so and see how that's going. But yeah, thank you so much for listening. Everybody, we'll talk to you next time, take care.

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Dr. Paul Etchison

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