Dr. John Meis: Hey everybody, welcome to this edition of The Strategic Thinker. I’m Dr. John Meis and I’m here with Drew Schaefer. How are you doing, Drew?

Drew Schaefer: Great, Dr. John, how are you?

Dr. John Meis: I’m doing fantastic. We’ve had a whirlwind the last few weeks, I think I’ve been in Dallas twice, Houston, Tulsa, Atlanta, and there’s been a lot of great things going. But, there’s one problem that seems to be everywhere in dentistry, and that is that we just don’t find enough team members. So Drew, what are you hearing on the street? What are you hearing in your garage, Drew? (Laughs)

Drew Schaefer: (Laughs) Yes, just ignore the garage door opener. I mean, it doesn’t matter where you are, really even dentistry or other industries, it’s just a very tight labor market right now. With dentistry specifically, there’s been a lot of professionals that left the industry after COVID, and now we’re facing challenges hiring at the more entry level with the different government services. And, with a lot of those positions, we’re competing with the other industries that are upping their recruiting game, so to speak. 

Dr. John Meis: I saw a sign on my way to work this morning that Papa John’s is hiring drivers at $25 and hour, and they’ll give you a free iPhone. 

Drew Schaefer: Wow. And, that’s not to speak of the tips they’re getting too, so…

Dr. John Meis: Right. So, really 4 things driving the lack of available labor force in dentistry. Number one, of course, is the virus itself. And, there are people who are very concerned about the virus. There are people who are concerned about the vaccine and the virus, and they see it as an environment that is higher risk. Now, we all know, a study just released a couple of days ago, that the dental population has a much, much lower percentage of people who’ve had COVID than other professions. And so, it really is a safe place. Dentists have shown to have a lower risk than the general population. So, it’s not risky, but many people have the impression it is. Many people, much more than I would have ever thought, don’t believe in science now. They don’t believe in research. They don’t believe in results. But, even though it is safe, some people don’t think it is. Another thing that’s going on is childcare, right? So, childcare has not returned to normal. And, it’s the same story there. Childcare providers can’t find workers. And so, people don’t have a place to put their children. And, schools are going to be open in the fall most likely, but until then a lot of people have kids that they have no place to put. Another issue is the generous government benefits, which were certainly a godsend for many during the pandemic, but that may be driving down people’s drive to work. And, if you think about it in many of our entry-level jobs, if they have 3 kids that they have to try to find childcare for and pay for childcare, and if they can stay at home and get the generous benefits, they’re probably financially ahead. 

Drew Schaefer: Right.

Dr. John Meis: And, these benefits… there’s now 27 states that are no longer paying those extra benefits. So, I think we’ll see it starting to return. Certainly in the fall, starting to return. In September, those extra benefits are supposed to drop off nationally. So, I think that we’ll be on the mend, but I think it’s going to take a while.

Drew Schaefer: Right. 

Dr. John Meis: So, in the meantime, what do we do? In the meantime, we’re kind of stuck. And, if we think about this and look at a model of how to think about this, at the bottom we’ve got warm bodies. Who can I find that is willing to work? And, the “who” being extremely broad. And, what are the pros and cons of using the warm-body approach, Drew?

Drew Schaefer: Well, you get what you get. Experience is always a variable, whether they’re trainable on your systems, and then ultimately how they fit into the bigger picture long term. Will they be able to ascend to a productive role? And, more importantly, we talk about culture a lot, how will they fit into your culture? To your point, if you’re not getting a whole lot of applications, you can’t be as sticky on some of your criteria as you’ve been in the past. So, this is base-level. Let’s get somebody in here so we can deliver patient care, because otherwise our patients’ access to care is severely limited. 

Dr. John Meis: Yep. And so, if we’re going to get a little pickier, we’re going to find people with the right attitude. I’ve always thought that I’d rather have a person with the right attitude than necessarily a person with a whole lot of training. Because, we can learn dentistry, none of us were born knowing a lot about dentistry. We all learned it. Other people can learn it to, and we can teach it too. So, if you have a team with at least the right attitude, you’re more likely to make progress, right? 

Drew Schaefer: Well, and that one person’s attitude affects everybody else’s attitude. And, especially if you’re already stretched with the team you had, the attitude is going to affect your patient experience. So, it’s pretty significant. 

Dr. John Meis: Yep. So, going up the pyramid here, the next would be having the right attitude and having the skills. So, these are people that want to learn, have some skills, and this is a pretty nice group of people to work with, right Drew?

Drew Schaefer: Yep. 

Dr. John Meis: And then, if we’re going to go to the very pinnacle, and what we all hope to have, we hope to have people that are a good culture fit and have a great attitude and have the skills. And, that’s what our hiring systems should be designed to identify, people in that category. But, if we’re short, we’re going to have to move down the pyramid somewhat in order to have just enough people to function. Drew, we were at a conference in Dallas a week or so ago and there was a practice there that was down how many employees? 

Drew Schaefer: It sounded like at least half their employees. I’m not exaggerating, it was very significant. 

Dr. John Meis: Yeah. So, in one of their locations they had 5 doctors and one dental assistant. Can you imagine trying to practice in that kind of environment? What a very, very tough situation. So, in their case, they might be better just to be looking for maybe some warm bodies, right? And, you hope you can find something better than that, but they have so many positions open, that’s going to be really, really tough. So, when we can at least hire for attitude, we can drive people to skills. But, that does mean that we have to have really good training systems. And, training systems are often not part of the typical dental office. The typical training system is, “Okay Sally, you follow Susie for a few weeks and you’ll catch on.” I mean, that’s really as sophisticated as it gets…

Drew Schaefer: All tribal knowledge, yes.

Dr. John Meis: Yeah, and so the problem with that approach, of course, is that if the person with the tribal knowledge leaves, then we really have a problem. And so, if we have good training systems, then we can get people who have the right attitude, and get them to the point where they have the right skills. But, if we want to get to the pinnacle, we have to have a culture. And, many practices don’t take the time to define what their culture is. So Drew, in your experience, the ones who really have this nailed, how do they define their culture and how do they drive that into their hiring process?

Drew Schaefer: It’s more or less geared around how they treat each other and their patients. The 2 most important groups in any practice are the employees and the patients. I’ve seen them ordered #1 and #2 both ways, but it’s really about a care for each other, a wanting to help each other, a consensus on goals and what you’re working toward with your providers. 

Dr. John Meis: Yep, awesome. 

Drew Schaefer: And, being able to communicate it. 

Dr. John Meis: Yeah, really having it written down and being able to communicate it. And, I always think of it as, “Mission. Vision. Values. And a plan.” And, if you have that written down and in a way that you can communicate it, you’re doing better than most of the practices in the country, so that’s really where you get to have this. So right now, if we’re in warm bodies phase, we may want to allow our payroll to increase in order to get people with at least the right attitude. Because, the warm bodies approach, not in a crisis situation like the practice we talked about, but for most practices, they’re not down half their team, they don’t have one assistant for 5 doctors. Most of them are not in that type of a problem.

Drew Schaefer: And, if you are down that significantly, then I think mentally you have to look at a higher wage in bringing in somebody that’s already skilled, that takes less training. If you’re having to train new people and there’s nobody to train them, or that’s going to take away from patient care, that’s not going to help you. So, don’t look at the entry-level worker, really recruit that higher-level worker, and you might have to overpay for a little while in the hopes that they will continue to ascend and are that culture fit. 

Dr. John Meis: Yeah, so you bring the overpay, and I totally agree with that. So, what are your thoughts about when you’re trying to bring people in and you’re paying them more than the people that are already there. What are your thoughts on that?

Drew Schaefer: (Laughs) I think it’s always a challenge because you always say, “Let’s not talk about payroll.” But, everybody always does anyway. At the end of the day, I think it’s important to, regardless of who you’re bringing in at what level, give everyone a path to earn more money and let them know what their career path looks like to be able to ascend. At then end of the day, if the market has changed, then you need to be flexible and realize that really the pay scale in this area has changed and we might need to bring everybody else up or else you’re just bringing in one person to lose somebody else, and you’re just repeating the cycle. So, it’s very challenging, but you have to have the bigger picture that hopefully this is a temporary labor shortage that we’re facing. And regardless of what the causes of this are, ideally this fall at the latest, we see some relief in this shortage and things become easier and we can be pickier. But, there’s no guarantees on that either. 

Dr. John Meis: That’s right, yep. So, there is somewhat of a squeeze coming, I believe, in that we’re going to see pressures on wages and salaries going up, we’re going to see reimbursement trying to be pushed down by the insurance companies, and then inflationary pressure which raises the cost of supplies and lab and everything, really. 

Drew Schaefer: And, even our team member’s personal expenses. As they’re paying more at the grocery store and at the gas station, especially at those entry-level positions, there’s less disposable money, so that puts more pressure for them to put pressure on you as an employer for pay raises. 

Dr. John Meis: That’s exactly right, yep.

Drew Schaefer: It’s very circular.

Dr. John Meis: Exactly right. So, if we’ve got good training systems, we’ve got our mission, vision, values, and a plan identified and written down and shared with everybody, that’s how we work our way up the pyramid. So Drew, thanks for all of your input. And, thanks everybody for being on this episode of The Strategic Thinker. We’ll see you next time.

‍