Episode 46: Building Better Systems to Work Fewer Hours

Dr. Ruth Mannschreck is a dentist, business owner, and founder of Shoreline Strategies LLC, focusing on helping practice owners become more efficient and streamlined. 

She’s a wealth of experience and expertise on practical things that clinicians and/ or business owners can do to improve their processes and build a healthy culture. 

Here are my takeaways from this incredible episode-

• Asking for help and relying on your team are not only possible, but are critical. Dr. Ruth’s personal story magnifies how important it is to realize that you can’t do everything on your own.
• While we may think we have to improve our time management, the real key is improving our communication, operations, and business processes, which requires an intentional shift in our thinking and behaviors. We actually gain more time in the end when we take these actions.
• Core values and leadership are at the foundation - when these are aligned and clear, everything flows much more easily.

Click here for a resource Dr. Ruth created, complete with a checklist you can use to start using these tips today.

For a practical guide to managing your time and energy in a way that brings you joy, click here to purchase my book (available in print, digital, and audio).

Connect with Dr. Ruth here-

Website:  www.ShorelineStrategies.com 

LinkedIn:  https://www.linkedin.com/in/ruthmannschreck/ 

Transcript

0:09

Welcome to Designing Healthcare That Cares the show where we explore how to build healthcare systems where people and performance thrive. I'm your host, Dr. Laura Suttin, a physician coach and healthcare leader who believes that human flourishing and organizational excellence go hand in hand. Each week I talk with leaders, change makers and innovators about how to shift culture, lead with purpose, and tackle the root causes of burnout. Because when healthcare works for the people in it, everyone wins. Welcome to the podcast. I'm super excited to have my guest on today, Dr. Ruth Mannschreck, welcome to the show. Ruth, it's good to have you. Thank you, Laura. I'm very excited. This is a great audience to speak to. I can't wait. Thank you. So yeah, let me introduce you and read your bio. So Dr. Ruth Mannschreck is a dentist, a business strategist and founder of Shoreline Strategies, LLC. Has over 30 years of experience in private practice after a life altering experience with her daughter's NICU stay. She reimagined her business, reducing her hours while boosting revenue. We definitely wanna hear about all of that. Uh, this shift inspired her to develop a streamlined business model centered on efficient systems, high performing teams, and a thriving company culture. Now through her transformative programs, business, lifestyle by design and prep it to sell, Dr. Ruth helps entrepreneurs build scalable businesses and unlock their full potential, ensuring they sell for maximum value, maximum value, when the time is right. So awesome to talk about all those things. Yay. Yeah. So, so it wasn't, go ahead. Being a coach wasn't actually something that I aspired to in the beginning. Um, I'm a dentist. I started my practice from scratch. We had two little boys. Um, I was practicing full-time five days a week, and then my daughter was born. She had a very traumatic birth and she was in NICU for almost six weeks. When she came home, she had to see eight different doctors every week, and. Even with my husband helping, uh, there was no way, uh, to make that work. So I went to my team and, uh, said We have to shrink what we do in five days down to two and a half. Uh, and we did it. And I, and I always want to, and. Give my team a huge amount of credit. For what, for what happened. Um, they were phenomenal. Um, so it, it's not like Dr. Ruth knew exactly what to do. Um, it took us almost a year. Um, but we together figured out how to make everything run. We got back up to our revenue level in a year. Um, and then we grew it after that, but we never went back to five days a week. Uh, we always stayed at the two and a half.'cause once you, once you can do that, it's just like why? Um, so, uh, that's how, that's how we got started. The, um, my building where my practice was, uh, is all full of docs of different sorts. And the fellow next door was a dentist and he stopped me in a hall and he said, Ruth, what are you doing? He said, you're never here, but your practice is running. Your team is handling everything so well. What are you doing in there? And he actually became my first coaching client and I taught him all the things. We have this little, uh, list of five different areas in your practice, um, that need to be addressed in order to have a business owner not work so many hours. Um, and it's not like everybody wants to cut their hours in half, but boy, you could get yourself an extra day away from the office, uh, and not take a hit on productivity or, um. Your team satisfaction that it's been very, very helpful for people. So I'm thrilled to share this information. Yeah, I can tell, I can, I can just sense that energy from you. I can, I, I can see it and feel it. Something that's so interesting to me that you said, and I know you work with a lot of physicians. Um, so I'm curious this kind of contrasting physicians and dentists a little bit. I just. I wanna get your thoughts. Sure. So you, you had this traumatic, uh, you know, this life event happen where you, it required so much time for you, from you, and you realized, I can't work five, can't work 40, 50, 60 hours a week any longer. Right? So you went to your team and said, we've gotta make this happen. What I hear in that is, or I guess what I don't hear, what I hear in a lot of physicians is, oh, I could never do that, or That'll never work, or. I, I, I don't have the right team or I don't have the right people, or nobody's done that. I can't do it. Who am I? You know, all these doubts Yeah. That we tell ourselves. And so I'm curious, did, is that something that you glossed over in telling the story? Did that come up for you? You know, back, um, actually, I think. That I'm not a courageous person, and I would never have attempted this if I hadn't been up against the wall. You know, I think I didn't have time to be afraid or, or to have the doubts of, oh, my team's not gonna wanna do this. Nobody's done this before. I didn't have time for any of that. This had to work. Yeah. Um, so one of the little details is I had just taken out, um, a loan to, um, redo the inside of my office. So it wasn't like I could just set my practice down and walk away because I had big responsibilities. Uh, timing is everything. And uh, so it was like, it was just this incentive. There was no question of all those doubts that you listed, I had no choice. We had to make this work. Yeah. You know, and that's, it's a whole different incentive, um, than just worrying about what's my team gonna think if I, if I try to do the, what are my patients gonna think, you know? Um, we just did it. Yeah, we just had to do it. You had to, you're, you were forced into this and, yeah. The other thing that I, that I didn't hear is this, again, I'm making a generalization, but as physicians, a lot of times we struggle with asking for help. Oh, and you gave so much credit to your team and you went to your team, and what it sounded like was this team approach, how do I make this happen? How, how can we do this together rather than Right. Feeling like, oh, how am I gonna do this? Or feeling like you have to do it all yourself. Mm-hmm. So did that, was that coming out for you a lot too? That that was a. A huge thing for me because I'm really old and I was, when I was learning how to be a leader, it was very much a top down way of leadership. Yeah. Um, I'm the boss because I have knowledge. I know how to do things, I know how it has to be done. Um, and you will do exactly as I tell you. And the more you do it well, the more I'm gonna like you and help you, you know? And. Today's people, young people are not interested in that at all. And I could see immediately that that was not gonna work. That was not, um, I didn't know how to do it. I had some ideas, um, I had seen many practices and how they work, how they run. Um, but I knew that I couldn't come from a top down position. And that was one of the best leadership decisions I ever did was the. The authenticity of just saying, I don't know how to do this. We're gonna figure it out together. Yeah. If you wanna play in that sandbox, please stay. If you don't, I understand. And I'll, you know, I'll help you go wherever you wanna go. But this is, the rules have all changed in our practice, you know? Yeah. Are you still seeing that mentality in physicians today or any practice owners, whether that's physician, dentists, physical therapists, whatever that looks like. Is that mentality still there of like, I have to do it all myself? Yes, very much so. In fact, um, I'm doing research for, uh, a new program that I'm, I'm launching, and so I've been surveying hundreds of, uh, practice owners and, and saying, uh, asking about. Um, do you feel like you have to work too many hours? And across the board, I hear people say, but I'm always gonna have to work too many hours. I, I said, have you ever read a book on how to not work so many hours? And I had some owners tell me, well, no, I'm always gonna have to work. I mean, it's just a given. Yeah, that as professionals we have to run the ship. We have to be there until the cows come home and. It's, it's like in our brains, um, that that's what's supposed to happen. Um, and I'm so grateful that, uh, we came up with a way to not live like that anymore, you know? Yeah. Yeah. And again, I mean, this was, this was a decision that you, like you said you had to make it. Um, um, I just, I hear from so many practice owners and physicians I, that it makes me wonder, like if they had to sit and wrestle with it, if the decision wasn't made for them Sure. How would it take them to, to come to that realization? Like, oh, I can ask for help or I can, yeah. I, I don't have to do everything myself. And so, um, and it's interesting because I have had, um, the people that reach out to me from a practice are actually the team members and say, our doc needs what you are doing. Please help us figure out how to talk her into doing this, or talk him into, you know, it's, even team members realize that we have it just a little bit wrong. Or not maybe the most helpful. Mm-hmm. Um, that it, it's so easy to get into burnout and overwhelm and all those things that make life less joyful. I love the way you speak of joyful, uh, in your, in a podcast that I've listened to, um, and a lot of people don't even think of that as being part of what they get to do as a practice owner. Right. Yeah. It's like, at least I know I felt like this for a long time and I've seen this in my clients and colleagues, is we, we, at least, again, I'll speak for me. Sure. I didn't feel like I could, that I deserved it as much as Yeah. I saw other people doing. Mm-hmm. And so. Um, yeah, and I do, I hear that from some people. It's, it's like, well, other people get to do that, but, but I don't, I have to put my nose to the grindstone and work 60, 80 hours a week and mm-hmm. Um, and yeah, it's a very, very pervasive. Yep. Um, dentistry is coming out of an era of being a good old boys club and there still is very much, um. A, a feeling of this is what I did to, to get to the top of my practice and my, where I am in my community. Mm-hmm. Um, and so that's what you're gonna do too. Yeah. Yeah. The, the model of dentistry of a lot of independent practices versus huge health systems is, yeah, it's just, it's, it's very different. I mean, we, we we're trained, uh, in a clinical way that's very similar hands-on and then very book learning and, and all that. Mm-hmm. But then the practice model, when we, when we. When we diverge in that way is so, is so different. So I love mm-hmm. I don't see a lot of dentists in this space and so I love, I love what you're doing. It's very, very cool. I think it's very transferable to so many, uh, professionals in private practice. So I have clients that are attorneys and veterinarians, um, and chiropractors. We all are in the professional space and, and we have these, um, aspirations that have been shaped by our colleagues in our communities. Um, and it doesn't always give us the opportunity to choose, I wanna do it this way because this is what success looks like to me. Yes. Yeah. So tell us about that journey, what that was, what that was like for you. And then we definitely want to spend a lot of time giving some tips and advice Sure. To folks about Sure. How to work fewer hours, I think. Mm-hmm. Anyone, any of us would sign up for that. Yeah. Um. Because one of my, what what I learned from this whole journey is that, um, most of us, when we get overworked, when we're working too many hours, uh, we immediately think I'm not good at time management. And so we, we jump into that world of I need to manage my time better and. I, I have this opinion that there is no such thing as time management. Time is this ethereal thing that we created to help us talk. Um, but we don't manage it. It we have no control over time. What we want to manage and we just don't realize is our behavior. Mm-hmm. Our team's behavior, our patient's behavior. So it, what I, what I help people do is learn to manage behavior. Um, and we have like five different areas in, in the practice, uh, that need to be looked at from that point of view of, um, for example, the, probably the biggest thing, um, that we have people practices look at is your operating systems. Mm-hmm. You know, Anytime you want your business to run more smoothly, you're gonna need to look at your systems. You know, and I, the first system I encourage people to look at is what I call your patient journey. So it's what happens from the first time someone answers the phone. How does that conversation go? What are the goals of that conversation? Not just, you need to get this information and this information, but how do you want your patient to feel when they're in that, in that phone call. What, what do you want them to experience? How can you create a winsome experience for a patient? That very first phone call, so that they say, whoa, I, this is where I, I belong. I, I wanna be right here. Yeah. And then, so what happens after that initial intake? You get information, then there's scheduling, then there's, you know, all the steps that go into, um. All the diagnostic stuff, all the treatment plan, design, all of those things until in dentistry we get to the final step is um, what we call recall. Getting people into a system where they come in every so often. So each profession has their own version of that. Um, but to document that whole process and, um, have really, uh, great tasks listed for each thing. That's the, it's a very organizing kind of, um, exercise to do with your team. Mm-hmm. Um, and that's where we always start because usually it's the systems that are sort of in place. They're not always used, and some people are better at this and other people are not so good at that. And nobody really wants to do collection phone calls and all those things, but we have it all spread out. Um, and that's the first place we have people look, um, when you're trying to make things more efficient, is to look at the systems you have in place or don't Yeah. Have in place. Yeah. You know? I definitely wanna dive into that, but just to go back to what you said about time management, so Uhhuh, um, my, my book, purposeful MD that came out last year is very focused on this. I started. I started out writing the book, thinking I was gonna write a book about time management. Mm-hmm. And as it started to come together, and I was working with clients who came to me and said, I really need help with time management. That's not what they need help with because I'm, I'm working with professionals. And you didn't get to be a professional without learning how to manage, manage your time, quote unquote. Right. So it's about, and I love what you said about managing behavior and other people's behavior, the, which, that's so brilliant, and I hadn't thought about that. What, one of the things that I say in my, in the book is it's really about managing your energy because um mm-hmm. How do we, you know, we all have, we all have this, we do all have the same 24 hours in, in a day. We don't all have the same resources and lifestyle and, and all those types of things. Mm-hmm. How we ch how we spend that time is a reflection of our values. It's a reflection of our priorities. Mm-hmm. It's a reflection of, um, how much energy we have. And so it's not about like, oh, well I've, you know, I wanna, I want to create another 30 minutes in my day so I can go work out or cook dinner. It's like, okay, we, let's, sounds like that's what you do is we gotta back this way, way, way up to. Mm-hmm. It's not about creating that time for you to, to work out or cook dinner, that might be the end goal, but what's everything that's underlying that? What are, what are the beliefs that you're telling yourself or that you, again, that you don't deserve it or mm-hmm. Or that you have to live up to the standard that's unrealistic and all of these things behind that, so. Mm-hmm. Um, I, you, you speak in my language there, that's, that's so, uh, so powerful and, and so much of that. The mindset of how, you know, all that belief system that you have that's part of the support system that allows you to be flexible. Um, because what works when you have, like, we have four kids, so at one point the three of'em were in diapers. And what worked for me when there were three in diapers, it's not anything like when we have four teenagers, you know? Yeah, yeah. So you can't just say. I'm gonna do the Mel Robbins thing and, and get up at, you know, at this hour I'm gonna get outta bed right away. It you need something that works for you and is flexible Yes. Based on where you are in your life at that moment. Yes. You know? Absolutely. Yeah. Yeah. Couldn't agree with that more. so when you start, just again, to go back into the, so you start with the, the system like mm-hmm. Um, and it sounds very patient centered what you're talking about, what's the patient's point of history? Absolutely. When they pick up the phone, what do they, what do they experience, how do they feel? And then what's their journey along the way? Mm-hmm. And because that's, that's really what the practice is there for, is to take care of the patients. But they probably, and I've seen this so many times, I've been involved in so many process improvement projects. Were doing process mapping and mm-hmm. And all of this and, um. Just realizing how disparate a lot of systems are and processes and tasks. Mm-hmm. And well, why do, why do we do this? Well, it's because I was taught this way and the person who trained me is no longer here. Sure. And all of these things that get passed down and really, let's just get it all out and let's understand what's the, what's the object of this task? Where does it fit in to the bigger picture? And so that, again, it sounds like that's a lot of, of, a lot of what you do with getting into the operations. So, so you start with bare bones operations, but, um, adding the patient experience right at the beginning mm-hmm. Um, while you're designing your systems, keeps you from having to, because if, if you only teach your team. The technical tasks that they have to accomp without saying, here's how I want them to feel. Right. Here's what I want them. You're gonna have to do that for the rest of their time as your team member, you're gonna, they're gonna do the task perfectly, but they didn't think about the patient. They didn't, you know, so I just front load all of that and say. Otherwise they're gonna, they're gonna run it to you with a question about how do I handle Mrs. Jones because she can't pay her. Do you know what I mean? Right. So to avoid further the doc being the bottleneck, because everyone is lined out, up outside my office. Mm-hmm. Um, we build those expectations right into the process right at the beginning. And actually our next step is in this, these five things is communication, because that's also a piece that people forget when they set up this beautiful system, but they haven't plugged in. Where does one piece connect to another? How do people talk? Um, in the, in the business world, we call'em silos. You have a marketing silo and a sales silo and a delivery silo, and they don't talk to each other. If you've ever seen a silo on a farm, they connect up at the top. Mm-hmm. Um, but in a business you want, you don't want silos. But when you have those departments, you want them connecting and communicating all the way up and down. Yeah. Um, so the next big step of this is to build communication into, so we'll go back to the client or the patient journey. When you're done with that, that initial intake, where does all that information go? And who gets it next? Like who is the handoff? For this, where do I store the information so anybody can reach it without asking me questions? It's all there somewhere. Mm-hmm. Um, so the communication piece, uh, is hugely important and something else that's baked into the operations. Um. Now, a lot of people say to me, uh, gee, does this mean we have to have more meetings? You know, if you're gonna have, you know, and I'm here to say I don't like meetings. I try to have as few meetings as possible. Yeah. We have a few that, uh, a good team really needs. Uh, for example, uh, in the dental world, every morning we have what I call a standing huddle, a morning huddle. Mm-hmm. Uh, and everybody stands up. It's only gonna be 10. 15 minutes. Um, and as we look at today's schedule, do we have all the lab work? Are there any holes that we need to fill in the schedule? Um, are there any, uh. Patients coming in who need extra help, who might be, uh, more apprehensive, uh, might need financial assistance. You know, we discuss these things with the team before we get started, and then we look at the next day and say, what holes are there in a schedule that need to be filled? Um, because while your patients are in the office is the best time to rearrange your schedule. Uh, and just so those. Those two days, um, all the communication is handled in 10 minutes. Yeah. In the morning. And everybody is, oh, I know what everybody's doing. I know who might need an extra hand because Mrs. Smith is terrified to get her crown done. You know? Yeah. Um, so there's always, everyone knows what other people are, are anticipating in their day. Uh, it really helps build, um, a team approach to. Just because Mrs. Jones is in my operatory doesn't mean somebody else can't come in and, and be of assistance because they know Mrs. Jones really likes it when somebody comes in and talks to her and distracts her so she doesn't know what I'm doing. Yeah. You know? Yeah. Uh, things like that, that's what really makes your team, uh, much more cohesive. Yeah. Much more supportive of each other. Yeah. I love that so much that the, a morning huddle is something that in the organization I worked with for a long time, a lot of our clinics did that and it, it works so well. It sounds so simple and it mm-hmm. It doesn't take much time. It would be, no, yeah. It would be like five, 10 minutes and mm-hmm. Just like you said, everybody stands up. Um,'cause that kind of gets the blood flowing and energy going mm-hmm. In the morning and make sure that it doesn't run long. Right. But that's, yes. That's really, that's really all you need. And so, yeah. I love what you said about, it doesn't necessarily mean more meetings, I mean, busy practices don't have time to take meetings. We don't during the day anyway, and so mm-hmm. How can you, what, what I hear about communication is like, does that mean more emails are more, more meetings, but mm-hmm. How can you make sure that the information is communicated upfront? And people are given guardrails and expectations. Mm-hmm. So that they don't have to, like, like you said, come to you every time Mrs. Smith can't pay her bill. What do we do? Well, if they, if they're have a good understanding of that process mm-hmm. At the very beginning, then they don't have to come to you. And that's communication too, that they, and, and that is because so much of what keeps the doc working too many hours. Is the thousand questions that the team comes to us with. Yes. During the day. And it's like, I need two minutes. You just have to tell me this one thing. And that's what kills us. Yeah. We, we you get interrupted and then you can't get back to what you're, what you're trying to design. It's, it's crazy. Um, so as much as possible to get all this communication somewhere, and nowadays it's so much fun, you can, you can have different modes of communication for different things. So you're. Some practices have rules. If you're communicating with a patient, it's gonna be a phone call or an email. If you're gonna communicate with Dr. Ruth, it's gonna be on a Slack channel. If you're gonna communicate with one of the team, it's gonna be our, our, uh, scheduling software has these little boxes where you can, you can talk to anybody on the team, and they're right there in the operatory. So no matter where they are, they can see mm-hmm. It pops up for them to see. So then I, it's so much easier. I go to one place to find all the things that I'm supposed to address, and the team knows they only have to go to this one place. Yeah. Um, so technology's made this a whole lot more fun. Yeah. You know? Yeah. Yeah. So. Um, I, I encourage people to figure out what works best for your team. Yeah. When they're communicating with each other.'cause it's three different arenas. Mm-hmm. It's communicate with me as a doc or with each other as a team or with patients. Those are the three big areas you have to figure out. The level of professionalism, the kind of language that you can use, uh, the format that you're gonna use so that everybody is singing the same song. It makes your practice look very cohesive. Mm-hmm. To your patients, which patient confidence in their doc is so important. Yeah. All the research shows that that is vital. That is vital for them to get the best results no matter what it is you're doing with them. What kind of treatment? Uh, you're working through, um, their confidence in you and your team is a huge, uh, impact on their results. Yeah. Which I love. I think that's awesome. You know? Yeah. I mean, how often, at least from the patient perspective, it's like when they feel that the one hand doesn't know what the other hand's doing, it's, it's tough. Mm-hmm. It's really tough. Mm-hmm. Yeah. And I, um. I take it on as part of the doc's responsibility. So if I want, if I want patients to have great confidence in the skill and, and, uh, care of my team, I need to create that world for my patient. So I say things like, Mrs. Jones, I'd be happy to, um, take care of this question for you, but I just want you to know. If I give it to my team, it's gonna get done faster. If you have to wait for me to figure this out, it's gonna take longer. Mm-hmm. So my team is awesome at this if, is it all right with you If I hand it off to them and they'll, they'll carry this through and they'll do a much better job than I would. Mm-hmm. Patients think that the doc does everything the best. You know, so we have to, I try to create an expectation of my practice is a team experience. Mm-hmm. Or I don't do everything in the patient flow. The, the patient journey. I'm not every step of that. Um, and I tell the patients that right at the beginning. So they are not shocked by like, why isn't the doc explaining financial arrangements to me? Mm-hmm. You know?'cause I'm not good at that. Yeah. You know? Um, and I don't want to Yeah. So, um, but all of that, that we need to create the expectation that our team is wonderful. Mm-hmm. And they're better at than the doc is in their various areas. Mm-hmm. You know? Yeah. Um, and I think if we don't, we. We handicap our team members because there isn't that setup from the doc. Yeah. You know, I think that's very important, um, that we support our team verbally. Loud and long, all along the patient journey. Yeah. Yeah. And that's empowering for the team too, when they hear Yeah, when they hear that. Um, yep. Yeah. I worked in, uh, with the, the Studer group for a while, and that's part of their, their AIDET, you know, the, the, the tool that they train on is, um, really talking up the. The, the people right. On that team and, and making sure that they are aware how, just how magical the team is and how mm-hmm. Skilled they are and competent they are. Right. Yeah. And, um, so the next phase in our Yes, I was gonna ask you in our, in our pros is actually to have a very high performing team. So, um. That means, uh, we, when we were fixing our practice, we had to come up with a whole different hiring process. Um, we had to have self-directed people. We focused, we switched from, uh, in dentistry there's a big, uh, lack of talent as far as it's hard to find chairside assistants. It's hard to find hygienists, and so therefore, dentists spend all their time looking for chairside assistants who have the technical skills that they need, and we had to flip that completely on its head. Um, we started looking for the personality and the core values mm-hmm. That were important to us because I can teach anybody how to make a temporary crown, but I can't teach them how to be compassionate. Yeah. How to be soft spoken, how to be caring, how to listen. They have to come with that package. Do you know what I mean? Yeah. So we completely changed how we hired people. Um, and yes, we did test testings for skills and all that, but that was way down the road. Right? We had to start with what kind of personality would fit with the rest of the team, with our, um, our practice. Culture. Mm-hmm. Um, so all of that was a big flip for us. Uh, and, and we lost some, we lost some, uh, team members when we did that, you know?'cause we said there's, we have to make changes. Yeah. You know, I, yes, I know you're, you're wonderful at this, but. You can't be a prickly pear. Yeah. You know, it, it was sort of annoying before. Now it's absolutely essential that you not do that. Yeah. You know? Yeah. So, oh, so important. How, how do you, and I know you work with a lot of practice owners, but I think a, there's a, a good number of our, uh, our listeners in our audience who have various levels of influence over who they work with and who they're mm-hmm. Because they're in a large health system or academic setting. And so how, how do you, what advice would you have for, uh, for a physician or any clinician in that type of role where you don't get to pick your own team members, you mean? Yeah. Yeah. So, um, I did a lot of the training, uh, uh, chairside. Chairside assistance is the, uh, probably the best example for me. And I would, um, while I'm working on a patient, so there's a patient and then there's the patient's head is like eight inches from me, and then assistant is on the other side. And while we're working, I talk constantly to, um, to the new chair side. And it's all about expectations and. I know that I have an audience of two'cause the patient is listening mm-hmm. Hugely to how I'm training this new person. Mm-hmm. Um, and it's all, none of it is about the technical part. The technical part we've always said, you go in the back, you go in the, in the kitchen or in the, the op, the. Utility room, and that's where we'll teach you how to do technical stuff. All the training that we do chairside is, um, about our culture, about how to talk to people, about what's the best way to present this idea and how to listen to people. So I, if, if someone is not a good match, they're gonna get really tired of listening to me, explain all of that, and they self-select to not work with me. So if you have to, because you just have to define where your boundaries are. Yeah. Even if you are working for a large, uh,'cause now we have big box groups. Mm-hmm. Uh, you know, in dental practices too. Mm-hmm. It's not as bad, not as bad as the medical mm-hmm. Uh, world. Um, but there has to be a way for you to set the stage. Um, and of the, the MDs that I've worked with, no one, no one has been told that, you know, you can't, you can't be selecting that way. Hmm. Um, there isn't anything harmful. There isn't anything, um, outrageous in having these conversations. Yeah. But it's. You're just teaching that person what you expect when they're with you in front of a, you know? Yeah. And it, if you're consistent and, and you, you can carve out your little kingdom within the big Yeah. You know? Um, and what I found is that it's very winsome to other docs. Mm-hmm. You know, they're like, oh, how do we do this? Yeah. I want, I want that kind of relationship. Um, the prickly pear on the other side of the room is no fun, and I don't want them. So how do, how are you doing this? You know? Yeah. How are you getting them to behave? It's all about those behaviors. Yeah. You know, so yes, it can be done. It's not near as easy when you are not, when you don't have control over. Yeah. All of that, you know? Yeah. Yeah. So operations, communication. Hiring, onboarding and training process, right? So what's number, what are numbers four, five? Number number four is to have, um, an irresistible business culture. So when you have good systems, a great team, you have to support them. You have to make it irresistible to, to work in your office. Yeah, so, so we take our core values. People, people have really bad, bad ideas about core values, because a lot of times, uh, business owners will pick five good sounding words, big words, and put'em on a plaque and say, those are our core values, and they never talk about'em. They never mm-hmm. Look at them again. So we, I still love core values. I love core values that, that makes my heart sing. And we have turned our core values into behaviors so that I can, I can look at a, at a, a team member and say. You did a great job today because I watched you demonstrate integrity with Mrs. Jones when you did this. Yeah. In fact, we have, we have, uh, we have contests in our office, um, for team members to catch each other, living out our core values in behaviors, and they catch each other. So the, we have two awards, one for the person that that demonstrated the behavior, uh, and another award for the person that caught him doing it so that, um, it just, it. The problem with core values is nobody knows what does integrity look like. Mm-hmm. Besides being nice and fair, what, what does it look like? Yeah. So you put four or five of those words together and then you break it down with your team and say, this is what, um, working smarter, not harder, looks like in my practice. Yeah. You know, and help them. We do have teammate meetings. This is, I have three kinds of meetings, um, and a team meeting once a month or whatever, uh, regularity you want. Um, but a time to continually review- these are the core values and this, this is what the behavior looks like. You don't have to go through all of'em, but if you pick one core value, go over it once a month and say, so where, where could we plug this in? What's another way to demonstrate our core value, um, of being efficient or being, uh, frugal, whatever they are. People have all kinds of core values, um, and that's wonderful. I love. I love how, how, uh, owners put their, their heart into their practice. Yeah. Um, and core values is a great way to describe that to your team, and it helps your team self-select like, yes, I wanna live in a world where that's important, you know? Um, and, and they can decide, um, no, that's not how I wanna go to work. I just wanna show up and do as little as possible and go home. Yeah. Um, but it, you, you just need to engage your team members, uh, in a supportive environment, culture, uh, that makes them want to come and work, you know? Yeah. So important. Huge, hugely important. Yes. Um, and the, the culture also teaches them how to communicate with each other. Mm-hmm. So those, when we went, we're talking about the communication. So. Our team, I want them to, to look, it's like a triangle of mm-hmm. The, the doc, the team, and the patient. And right in the middle are your core values. So before they come to me and say, Mrs. Smith has a problem, I want you to sit down and think about the core values. How, how could you answer the question you have based on our core values? Mm-hmm. So it's another way to keep people from lining up outside my door. Yeah. Yeah. And it, and it gives people permission, your team members permission to use their brains to think, to solve problems. You know, it's not, it's not all about what does Dr. Ruth want. It's what's the best thing for this patient based on our core values on how we do things. Um, so now you really have engaged team members and that is so good for retention. Yeah. You know, um, retention is tough in my industry. It's very hard to get, uh, hygienists to work more than 10 hours a week and to keep'em longer than when their kids are in elementary school. So, yeah. Um, it's, it's a challenge. So you really have to create something that people want to be part of. Yeah. That's so cool. You know? Yeah. Yeah. I love that. Um, and definitely, uh, I know we're coming up on our time, but we've got one more, so I wanna hear it. Okay. Okay. So the last one is, you need great leadership. Mm. Yeah. You need, you really need to step in, step up and grow your team members. Um, this is where I get the biggest pushback from my own colleagues, um, because I feel a huge responsibility to these people who are promoting my goals, my, my success. They're the ones that are helping to get, get, helping us get there. Um. I want to help them grow. I wanna help'em grow as a person. I wanna help them grow as a chairside assistant. Uh, and I wanna help'em grow. Like what do they wanna do with the rest of their lives? We have trained people, we've sent them to courses that are helping them leave my practice because they're gonna go on to something bigger and better. And I love that. It, it's so helpful to your team members to see that we truly do want people to grow because while they're working for me, I'm gonna have a better employee because they've grown. Um, and sometimes it's so simple. Um, sometimes like one, uh, one, one fellow, we just taught him how to balance this checkbook. You know, the training that you provide for your team. Yeah. Doesn't have to be, doesn't have to be dental, it doesn't have to be medical. It could just be daily living. Yeah. Things that, you know, that's helping them grow as a whole person, you know. Um, so, uh, and I already talked about how I was raised on the top down kind of leadership. Mm-hmm. Um, and I think the best thing that helped me see that that doesn't work is my four millennial kids, who want absolutely nothing to do with that top down stuff. But they love being able to problem solve and be creative and use their brains at work and all the other things we talked about, allow them to do that. Yeah. If they're given the right guidance, you know? Yes. Like, so you have to get really good at, um, designing like the end result. Like this is what I want you to get. Um, you come up with a way to get there. Um, and here are the parameters. Here are the guardrails. Mm-hmm. So that you don't get in trouble. Um, but it's so fascinating to see, um, you've engaged them, you've given them permission to be creative, to use their brains. Great things happen when you, when you actually let your team members make decisions. Yeah. And move forward. Yeah. That's so beautiful. Thank you for sharing all of that. It's, it's incredible work that you do. And, um, I know you've just made an impact on so many practices and, and clinicians and patients too. They're the ones getting the, the ultimate benefit at the, the downstream. So It is, it is, it's so fun. Um, yeah, we're, I enjoy it and I, um, really have this mission to share it with more and more practices. Yes. You know? Yes. I can tell for sure. So where can folks find you? You mentioned before we started recording, that you had a resource that you wanted to share. Oh, yes. So, um, my, I have a, if they go to, um. workfewerhours.com. Okay. There's a, there's a checklist there that, that covers a lot of the material that we talked about today in much more organized fashion. Um, they also can go to our website is shorelinestrategies.com. Awesome. And if they wanna reach out to chat, um, I'm on LinkedIn. Um, so any of those ways. Yeah. Perfect. Um, I'll, uh, we'll put all those links in the show notes. So, great. Thank you so much for being here. This is a great conversation and I know it's gonna be so helpful to our listeners. Oh, thank you. Great, Laura, I've really enjoyed it. Thank you so much. Thanks for listening to Designing Healthcare that Cares. If today's conversation gave you a new idea or inspired you to see things differently. Share this episode with a colleague and keep the conversation going. And if you're ready to take the next step in building a thriving healthcare culture, you can find resources and ways to connect with me at drlaurasuttin.com. This podcast is for educational and informational purposes only. It is not medical advice and it should not replace care from a qualified healthcare provider. Always seek the guidance of your physician or other qualified professional for any medical questions or decisions.