Finding and Developing the Unicorn Office Manager

You know what’s worse than not having an office manager? Having the wrong one. We all want that "perfect" hire, but perfect on paper rarely works in practice.

This episode explores what really makes someone the right fit, whether you're promoting from within or hiring from the outside, and how to set them up for success in their new role. You'll learn three important things: the trade-offs of hiring internally vs. externally, what you need to do before handing over the reins, and how to keep your practice running smoothly — with or without a manager.

Topics discussed in this episode:

• Why most outside hires fail
• The #1 onboarding mistake
• How to successfully promote internally vs. externally
• How to interview new office managers
• How to “build your bench"

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

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Chapters

• 0:00 The Office Manager Unicorn Myth
• 1:49 Promoting vs. Hiring: The Core Dilemma
• 4:56 Why Office Managers Fail
• 8:04 Defined Roles and Creating Success
• 12:00 Building Trust and Winning Team Respect
• 18:48 Developing Your Leadership Bench
• 20:41 Final Thoughts on Practice Leadership

Transcript

Paul: 0:43

Every dentist dreams of that magical office manager, the one who steps in, takes everything off your plate, and makes all of your problems disappear. But here's the truth: that unicorn rarely exists. But what if it did? Do you promote from within? Do you hire from outside? And why does it so often go sideways either way? Today, we're gonna unpack the real reason office managers succeed or fail and how to finally get it right. 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. I'm your host, Dr. Paul Etchison, 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. Welcome back to the Dental Practice Heroes Podcast. I am Dr. Paul Edgerson, joined by my DPH coaches, Dr. Steve Markowitz and Dr. Henry Ernst, both large practice owners, managers of large teams, and people with tons of experience in leading and creating uh really great practices. So, you know, in our last episode where we were together, we talked about Henry uh having to make a difficult decision of letting his office manager go, part with this office manager, and going through the transition of developing or finding another office manager to take that position. And I thought it would be a great episode, and Steve's got a lot to say about this too, is I hear this a lot with my coaching clients, is like, where do I find an office manager? Do I bring somebody in? And I have had clients that have brought people in from the outside, and I'm gonna be honest, it has not gone well. I have not seen it work well. So I'm really interested to hear what you guys say because I think you guys got some differing opinions on it. And I think all the listeners could benefit from this because we all and we all want that office manager just to come in and make everything good. Can't we just find that person? But we're looking at the resumes. Oh, they got experience office managing an office. That means I'm gonna hire them and they're gonna come in and make everything, all my problems go away. I'll go to you first, Steve. I mean, you've got six practices, lots of managers, promoting from within versus bringing somebody from the outside.

Steve: 3:12

So I will say, I'm gonna agree with everyone that promoting from within is easier. And the reason why it's easier is because that person already knows who you are and you already have trust with them that they're a good values fit. That doesn't necessarily mean they're gonna be a good manager, and I've seen that. Bringing someone from the outside is also difficult, and the reason why that's difficult is because dentists don't actually know what an office manager does, and neither do people who work on the business team. So someone who's a thing who calls themselves an office manager who will apply to your ad who thinks they're running the entire office, may be just sitting at a front desk answering phones and they think they're gonna go in and do the same thing, and that's what an office manager does. Both can work. Us as dentists, us as the owner, it is our responsibility to provide clarity on what an office manager does for us and to create continued focus for what that office manager does on a it may be daily at first, but at least a weekly basis. Where this goes sideways many times is we have this expectation of this person that comes in from another office, they were the office manager, and they talked about how great they were and how great the office was, and then we expect them to do that for us. But there are intricacies, and it may be something as simple as we use a different practice management software, or we have a scorecard and they never seen a scorecard before. There are intricacies of what makes us us, that it could take months, months, months, months for this manager to even learn who we are, let alone learn how to lead the people that they're in charge of. Mistake number one is we hand over the reins way too quickly. Then we have unclear expectations of what this office manager is responsible for. We say things like, we want to grow revenue by 10%, go do it. And they're like, How do I I don't even I answer the phones or I how do I even navigate that? Mistake number two. What I would recommend is both can work, but it is on us to create clarity and spend a lot of time on understanding what our expectations are of this office manager so that they know where to focus. And then we don't chase shiny things when they come off and up to us. We back this person up, we find opportunities for them to connect, have a ton of early wins, celebrate those wins with them, and then provide support when they are making mistakes because they're going to make a mistake, and someone else on your leadership team or someone in the office is gonna come up and say, I can't believe Kathy did that. And you're gonna the first your instincts to be like, Yeah, Kathy sucks. And then it's over. You're like, that's over before it even started. So as soon as you hear those things, which you're gonna hear, especially from someone from the outside, you cannot react. That is just a data point. Your reaction as the owner, as the doctor, will put this person in a zero chance of success. And that is why outside hires don't work.

Paul: 6:18

Yeah, I could see it, like where somebody brings you something that you said Kathy, Kathy did, and you're like, What? What did she do? Oh, that's not cool. You've got to be so careful. There's so much confirmation bias with the team. And that's something you, Steve, have helped me realize just this past year, just I mean, that's podcasting together, is what I say, even to my like trusted confidant people, what I say, my view on a team member really permeates through that culture. And I gotta be very careful what I say because if people hear me say someone's not good, that confirmation bias, they will find things, they will find evidence for that not being good. What do you think about all that, Henry? I mean, have you had that happen in your experience as well?

Henry: 7:02

I've had lots of the same experiences, and I appreciate the wisdom, Steve. Yeah, you are the man. And some of the stuff you said, I've gotten it written down as you were talking there. I would say that some of this, it depends, is the answer that I would give you. It depends on this current status of the practice. So I'm that practice where we have a large staff member group, and I never want somebody to have a ceiling in their position. If you're an entry-level dental assistant, hey, we've got systems in place where we can ascend you to a DA. We call it 1.5, where you're you know halfway up to a DA2, and we're training you. And then we train you to be a DA2, and maybe you want to be involved in management. We can train. So we always have that, it's part of our culture. We have so many high-level team members that started at the very, very bottom, right? So I think that's usually our MO. And as we talked about in our last podcast, it didn't work. This last one didn't work. We had one for seven years, and we had one for two and a half years, and we just recently had to make a change. Our current status of our practice requires somebody from the outside. We need a new voice, we need a fresh voice, we need somebody who is not buddy buddy. We've been in practice for 10 years in our practice now. We have so many people that have been there eight years, nine years, seven years. Testament to the practice. But I mean, they are so close outside the office, in the office, and that's a great thing, but it's also sometimes a negative thing. So, our current status of our practices, I felt strongly that we needed an outside voice. Now, you mentioned some of these things already, Steve. We need to have defined roles. What I have noticed is a lot of people call somebody a practice manager. Really, all they are is just they're running the front desk. That's it. Right? And so in our current system, we need to have defined roles. Hey, you are gonna be the leader of our L10 meetings, you're gonna be the one who's our integrator, I'm the one who makes the big bold ideas and it filters down to you. I need you to hold people accountable. You know, all this stuff that is the defined role that we have here. We need to have in our system too, we need I need the our business systems tight tightened up a little bit. Someone who's strong with that. I actually just came from a 50-year-old bachelor party this weekend in Miami. Wow. With a bunch of ex-military guys, they all graduate, most of them graduated from West Point. So I love this term that some of them were talking to me about when we were talking about business. There's something called officer's intent. So in the military, if we're, let's say there's 30 of us and we're getting dropped from helicopters and we're supposed to take this mountain. Well, I'm the commander, I'm the officer, and I'm gonna lead you. But what happens if the second we land on the ground, I get shot in the head? Do you guys just quit? No. We understand what the what the goal is. The goal is to take that hill, but you just kind of figure it out. So if our goal is to have this or that 70-75% treatment plan acceptance, hey, let's figure it out the officer's intent. In other words, I want you to figure out what makes it happen. So, in my opinion, whoever this is gonna come in from the outside, they're gonna have the parameters. These are the systems that we have in place, but we're not steadfast. You can tweak them, feel free to tweak them, right? And that's where we are, where we were gonna benefit, in my opinion, from somebody from the outside.

Paul: 10:16

How do you present that to the team? I mean, because now you're transitioning an office manager that was just recently let go or left, but you don't have an office manager anymore. And that was a decision. And now you've got a big team, 35 people, and I'm sure there's some people on that team that's saying, Well, why not me? How do you sell that to the team that you need somebody to come from the outside, or or was that even an issue in your practice?

Henry: 10:41

Well, I basically just made the statement because I think that was kind of like start people starting to think. And I made the big bold statement and I explained to them why this was happening. We're not holding people accountable. Some people were getting preferential treatment. Right now, for the first time in the history of this practice, we're going outside the organization for this position, and this is why. Right. And for example, one of the people that we're interviewing is coming from a large DSO, and she has amazing, amazing business acumen, which is great. And it's kind of like a dentist. My uh sweet spot for an associate dentist is somebody who went to a DSO, hated the fact that they were really pushy on treatment and weren't flexible. Now they've made their mistakes practice-wise, and now they come to us a wounded bird, and now they're gonna see that we're like a great environment. We're gonna basically like give them. I'm not gonna dictate you what to do, just treat people right, do the right thing. And this is uh how I look at this office manager position. We're probably gonna hire this person. I had a detailed conversation with her. Hey, this is what I expect. Are you fine with being John Taffer and holding people accountable? Oh, yes, no problem, you know. And for us, we need somebody from the outside. And it's kind of understood as to the reason why.

Paul: 11:55

How about you, Steve? Like, I mean, you've done both. Yeah. Do you primarily lean towards promoting from within and then going outside? Is there one that you lean to more than the other?

Steve: 12:04

It depends on the situation of why we have that open leadership position. But for any position, we will open it up to anyone who wants to apply. And internally, I may have a thought of where where I think we want to go. But sometimes I've been surprised when people have applied that I didn't think would want that level of responsibility. I also, in the interview process, am not shy about the problems that we're trying to solve. Exactly. And I will be very open and ask, like, okay, when you come in here, the problem that you're here to solve is accountability of the team. Can you walk me through what how you have developed accountability and what that's going to look like when you come here? Like, paint me the most clear vision of what creating an accountable team looks like to you. And then I want to just sit back and have them teach me and show me what that would look like. And if there are things that they say that don't align with how I how I think the answer is, there are two options I have. I can either say, well, that's great, but this person isn't going to be a good fit here. Or I can also share my vision for how I would like to create accountability and push back and give them feedback in that interview process and see how they respond. And if we develop this back and forth as Henry uses the US, it's like integrator visionary. Like if we can develop this back and forth of like, this is how I want it to go, and we're able to come to common ground, what a great understanding and working relationship we're developing. So I I think the take home for bringing someone in from the outside is don't shy away from your problems in the interview process. They are going to find out exactly how shitty everything is very quickly. And I think that it's only going to help you to take it on with them if they're legitimately going to be your right-hand person in the office.

Henry: 13:55

Hoorah. That is exactly what I did, right? I feel really good now that the master Steve has given advice that I already did. Don't shy away from it. I said exactly why, where we are, and why you are here talking to me right now. Right. So, and I think it's important to understand also that conflict is healthy for an organization, right? True. Healthy organizations look at conflict and say, hey, we're gonna not shy away from it. We're gonna talk about it, we're gonna do this and that. Unhealthy organizations ignore conflict, they walk past it, and it just brews up into a crescendo. So thank you for that affirmation, Steve.

Paul: 14:30

Yeah, that's such a good point. And it's that's something that we're kind of struggling with at my practice right now. There's a little bit of conflict. You know, I feel like it's a much better, but there are still conversations that need to be drawn out into the open. And that is our focus with our leadership team right now, and that is our focus that we talked about our last lead meeting, is we have really got to get some conversations out into I can't remember who says it, into the light or something like that. You've got to get the light shine on them. So like don't think you're stronger because of conflict and you're stronger because of discussing them, but it's when you don't do it that's when things get worse. Now, Steve, you mentioned versus bringing somebody in from outside versus promoting from within, you know, setting expectations. When you do bring somebody in from outside, like how do they slowly get the respect to the team? Because like what I've seen in in certain coaching clients I've worked with that have been in really desperate situations where they've lost somebody very critical because they had a very heavy hitter of usually it's an office manager and it's the only person who knows how to do so many things in the office, and that person leaves and they don't have anyone else that knows how to do it, they get in a very desperate situation where they start hiring people very quickly, bringing them in, and then somebody starts just bossing everybody around. They're like, hell no, this is not working. And then that person leaves and there's still that void. And I've seen that happen so many times. And no matter what, it just seems to happen. No matter how much we tell this person, hey, gain the respect of people first. That has been my experience with bringing people from the outside. And that's why at the beginning of this episode, I said, I have not seen that work.

Steve: 15:59

Yeah. We need to create wins for this person. And you don't create wins by implementing change. So a lot of times, especially with inexperienced leaders, they think they have the answers, they are the special sauce. Let me come in and show you how much I know and push my knowledge to fix fix the issue that I'm here to solve. That is not going to get people to believe and trust, trust, and respect you. So, what I want them to do before they even they have a vision, we've talked about it. We need to have one-on-ones with everyone because what I think might be our biggest issue, and what from my perspective, maybe the practice from a bird's eye view may need to work on may not be what everyone's feeling individually. So I need that person to come in and say, I'd love to learn about what you do. I'd love to learn about how you do this, I'd love to learn what works well here. I'd love to learn what an office manager looks like in your eyes. And I'm just going to take notes. I don't know if I'm going to be able to do any of these things or all of these things, but I just want to understand. So that first 30 days on that person checklist is a one-on-one with every single person in the office. We can't celebrate wins or we can't implement change until we have the buy-in of the team and that this person is the right one to make those changes. So that is where we start that. But even before that, we're all going to have a team meeting, like a group meeting, and say, this person is going to be our manager. This is what I expect this to look like for the next 90 days. If it doesn't feel like there's a lot of change, it's because there isn't. So the expectation isn't going to be because this person's here, your life is now everything, all our problems are solved. That's an unfair expectation. This person is here because we need someone to help navigate our challenges, help support us through the tough days, and whatever else we expect our expectations are of that manager. So take the time to let this person integrate to the position. And that could be six plus months before you see any traction in a position of leadership. Don't evaluate them on problems that you created, evaluate them on problems that they are able to solve and then go from there.

Henry: 18:23

I wanted to make an important point that I think is really, really important, especially in a larger practice. Maybe I'm the Neanderthal here. I always have sports analogies. I'm a big sports guy. So it's like in baseball, develop your bullpen or football, have a backup quarterback that's ready to go, ready to go. So for example, in our leadership team, we have a team lead that's a hygienist for hygienists. We have a team lead that's in charge of marketing. You know what? That team lead that's in charge of marketing just also happens to be a hygienist. So we've got a backup. So if the main one that's for ready hygienists isn't there or it has to be out for an extended period of time, boom, we've already got them ready to go. We have another team lead that's our for dental assistants. We have another one that's for sedation. Well, you know what? Same thing. They're both dental assistants. The same thing has happened over time for office manager. Years ago, I had an office manager just write down every single task, like a monthly little thing here. Just write down every single task that you do. And in that case, I was like, you know, the old thing of what are you really good at? What do you like doing? And all this stuff. But hand over as many things as you can, but audit it. And we did that years ago. So that's why right now we're still functioning. We're still cash flowing. We're still doing the same as before. Nothing has changed. Obviously, if we keep on this path, we're gonna have problems, right? But right now we have our bullpen. It's progressing fine. The backup quarterback is leading us through this four or five stretch of games here. We're fine.

Steve: 19:46

Yeah. Henry, I love, I love that you said that talking about the bench. I think that for me will differentiate is this a promote from within or higher from the outside? The strength of the bench is a big determinant of which path that I take. So when when leaders get to a certain point, it is their ability to create the strength in their bench that will allow them to continue to grow. And that again will allow us to know how do we navigate if if we have holes in the starting limit.

Henry: 20:15

And I'm sorry, I forgot to make this point. This is for coaching clients, right? I've seen this. You mentioned this, Paul, is somebody's, oh my God, I lost my practice mentor. She's the only one who knows how to do this. She's the only one that knows how to do this. You have really screwed yourself. And that's the person that's going to hire too quickly in a feverish attempt to get somebody in there. So that's why you develop your bullpen and we're good, right? We're good for a while. We're not going to be forever, but we can mosey along just fine for a while.

Paul: 20:42

Yeah, so true. Something I want to come back to that Steve said is during these one-on-ones, like such a great question for this person's new position to ask their reports. I don't know, their department is in your eyes, what does an OM look like? You know, and I think that's something for us, like to ask our teams as well. You know, as a leader of this practice, what does that look like for you? What is an ideal behavior for me? What is the role that I am trying to serve for you? We talked about servant leadership and stuff. I think that's such a great thing because they're coming into this position blindly, not knowing what the expectations are of them from the team members. So this is a great like way to one, get the you one, you get the respect of the team, but two, like you're also listening for issues, you're validating the concerns of the team, and you're winning people over before you step in and start changing something. And I love that you said setting the expectation that change is not going to happen fast. We don't expect change to happen. It's a slow process. But that is likely why I think I've not seen it work in the people that I've worked with that have done this, and it's exactly what you said, Henry. They're so just front-end loaded on one person that knows how to do everything. They didn't onboard anyone else, they didn't train anyone else, and they lost them, and now they're in a pinch.

Steve: 21:57

I know how hard it is to kind of fill these office manager positions. I think the the take-home is constantly be building your bullpen, just like Henry said. But also and be clear on the expectations for that, for that practice manager. And most importantly, be patient with yourself, be patient with this new hire because it is going to take longer than you think it will. And then you look back in a year or two and you're like, thank God I invested so much in this person. But it takes that long to learn who you are, learn the position, learn all the people they're responsible for, and focus on results. It's a big ask that we ask from this position. And patience will always be your best friend.

Paul: 22:41

Yeah. And I think, you know, if if you're listening to this and you're thinking about the leadership team in your practice, this is one of the things that will literally change your life is having a solid leadership team so you don't have to do it all. And this is the value of working with Steve or working with Henry in helping you with your practice. So if you're looking to take your practice to the next level, you're looking for a coach, my guys, I think you heard it today. These two guys know what they're talking about. And, you know, having a little solid lead at your practice, man, does that take a lot of pressure off you as the owner? So thank you so much for listening, and we'll talk to you next time.