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Welcome to The Health & Wellness Practitioners Podcast! Dr. Danielle and other guest experts talk about everything from getting your practice started, developing your clinical skills, growing your practice YOUR way, and dealing with the real stuff life burnout and work/life balance. Whether you’ve been practicing for decades or just started your journey, you’ll find something here for you!
DR. DANIELLE: Hello everyone. I am here today with Dr. Stephanie Rozenhart from ChirosConnect. She is a chiropractor in Arizona. Dr. Stephanie, I'm going to let you introduce yourself and share a bit more about who you are, and then we're going to talk about getting ready to hire an associate today and having the best possible outcome in that experience.
MEET DR. STEPHANIE
DR. STEPHANIE: Thank you. Thanks so much for having me today. I'm super excited to be on your podcast. My name is Dr. Stephanie Rozenhart, and I have been in practice literally 20 years. I walked the stage yesterday twenty years ago, which is kind of a milestone, I think. And those twenty years have been - well, nineteen of them, I guess - have been in California, and last year we just relocated to Arizona and started from scratch. So opened a brand new practice. I say we because I practice with my sister. We have practiced together for the last thirteen years or so and are just loving it here. About three years ago I started a passion project called ChirosConnect. We have hired multiple associates over the years and I wanted to hire in a different way. I do not love reading resumes. I wanted to see and hear the person's energy and voice, and their personality. So we created ChirosConnect and like I said, it started as a passion project and three years later we are running strong. So I'm super excited to share that with you and talk more about the associate hiring process.
DR. DANIELLE: Practicing with your sister for as long as you have, it's a gem. I don't even know the words to describe what I'm trying to say because I see partnerships oftentimes not working well or husbands and wives practicing together. And it's really challenging for them. Like partners of all kinds working together and having a lot of difficulty, and just trudging along with it because they're partnered and that's what they do. And they stick it out. It's really not awesome for either person. So this is a little off topic, but I'm curious if you have any specific tips that you might share about how you've been able to practice with your sister that long and still have a healthy relationship with her.
DR. STEPHANIE: Yeah, I mean, I honestly couldn't imagine practicing by myself. We always say this, “okay, if you retire one day, I'm going to retire that same day.” It's just, we have developed a system that allows us to work very well together. We don't let our work life interfere with our personal relationship. I think it makes a difference that there's just the two of us in our family and always has been, but we divide and conquer. Not to say that we don't have our hand in the other pieces of the business, but if there's a financial question or an insurance question or anything related to finances, that's my department. If I need input, I will talk to my sister. Her department is more marketing and patient communication type things, and if she has a question or we need to discuss something, then we discuss it. But there's no decisions made without the other person, but we know our departments that we are responsible for. And I think that that clarity has really helped us maintain the relationship that we have.
DR. DANIELLE: It's possibly also for the reason why you have hired associates and had good experiences and you're able to help other people do that as well, because you've learned how to communicate with each other. And so then it just naturally filters into all of your other relationships as well.
DR. STEPHANIE: And I'm not going to say it's always been easy. There have been those days where it's like you want to strangle each other, but at the same time, we both have the mindset that there's always a way to work it out. There's always a solution. And we don't have to argue and fight about it. We just have to talk about it. So I think, yeah, I mean the communication is the bottom line, the key to any successful relationship, whether it's a partnership, a marriage, an associateship - it really is the communication.
YOUR NEW FAVORITE RESOURCE FOR HIRING
DR. DANIELLE: Okay. So you started ChirosConnect as a passion project. Talk a little bit more about what ChirosConnect is for people that are not familiar.
DR. STEPHANIE: We are a company that helps find doctors that are looking for associates. We help them find doctors that are looking for a position or looking for a job out there. So we do that through video ads on our website, it's ChirosConnect.com. You can go there, you can view all of the doctors that are looking for an associate in their practice. We help the associates on the opposite side that contact us that are looking for a position in a certain location or a certain type of practice. We will connect them with a doctor that is of similar mindset that is looking for the same thing. So we do that through the ads on the website, but we also have another outreach where we do post in all the different areas that ads can be posted to take this off of the doctor's plates, because let's be honest, if a doctor is so busy that they need an associate, they don't have time to be figuring out how all these different websites work, how to post it, all these colleges and all of that. So we take that off their plate for them.
DR. DANIELLE: Yeah. When you and I first connected on this two or three years ago, it was, I guess just after you had started it, I was like, this is so brilliant because it's such a needed service. And my hope for ChirosConnect at that time, I think still is true now is that it would become the go-to place. So people say, “I need to hire an associate. Where do I start looking?” that it could be my default or anyone else's default answer - ChirosConnect, go to ChirosConnect. And that essentially you have the resources or the support that they needed to either find an associate or to be matched with a hiring practice.
DR. STEPHANIE: Yes that is my hope too. I think we, as doctors, try to look in all these different places and post in all these other places when there are opportunities to just be that one hub for all that is hiring in the chiropractic field.
DR. DANIELLE: Yeah. And just make it so much more simple. It does feel like sort of a guessing game if you're doing it on your own, if you're trying to figure out where are you going to find the right fit, the right person for a position that you have available. On that note, I guess my first question would be, how does someone know that they are ready for an associate in their practice?
THE RIGHT TIME TO HIRE AN ASSOCIATE, INDEPENDENT CONTRACTOR, OR EMPLOYEE
DR. STEPHANIE: I think it depends on their goals. Doctors hire for different reasons. One is because they are - this is my favorite doctor to hire for - is that they are so busy that they need more hands. They need more boots on the ground to see new people, to adjust, to do rehab, whatever their office does. They just need more help. That to me is the best possible situation. The second situation is a doctor in practice that may also be very busy, that's looking to bring someone else in that can help grow the practice even more. Maybe the doctor coming in wants eventually to have their own practice, but they just don't know the business side. They want to learn how to talk to patients. They want to learn how to build. They have a lot of learning to do, and the doctor needs help still. Maybe not that uber busy office, but they're still looking to grow and they know eventually I'm going to need an extra set of hands. And maybe eventually this new doctor can become a partner. I can help them open another practice. So I think it just depends on what stage that doctor is at. The other stage - and most doctors that are looking for somebody to rent space, they are not necessarily looking for an associate, but they're looking for an independent contractor - so looking for someone to maybe share space with. I have doctors hiring part-time associates. I have doctors hiring full-time associates. I have doctors hiring partners. So there's so many scenarios, and I think it just depends on the doctor.
DR. DANIELLE: The distinction between an employee and associate doctor and an independent contractor is one that's very important, and we could have a whole other conversation about that. I've seen many, many contracts for employees and independent contractors that were really not compliant with the IRS guidelines on what an independent contractor is. And just a side note while we're on this topic. And I've heard from people - I obviously hadn't been in the room when this happened - but I've heard from people who have had these kinds of agreements written that were not really written compliantly say, “but we had an attorney draft this!” and I’m like, I'm sorry that that happened. But it happens very frequently.
DR. STEPHANIE: Well, and I've heard this too. And I think that if we're talking about being ready to hire an associate, one of the things that is key is having a contract. Never hire without a contract, never go into a position as an associate without a contract. And like you said, yes, the attorney can draw it up, but it's also on us as the doctor and as the associate, independent contractor, employee what is legal in that state. Because the other thing Danielle is, it varies from state to state. Certain states now a chiropractor can't be an independent contractor that works with another chiropractor. So you can't even do it, but yet people are still hiring his ICs, you know? So, yeah, I agree. And I think as the hiring doctor, you also need to be very, very, very clear on what you are looking for and why you are looking for that.
DR. DANIELLE: Well, that's a really important point. And I think also a thing where people get stuck where they're like, well, I don't know, I've never done this before. How do they get clear on what it is that they want when they haven't actually worked with an associate in their practice, or maybe even been an associate in the past? What’s the purpose of the associate in the practice? So the person who has a really busy practice and needs more hands on the bodies knows that that's what they need. But for someone that's not quite that busy, but wants to grow and is trying to figure out what does that look like? Maybe you can speak to that a little bit more.
DR. STEPHANIE: Yeah. So if I understand what you're saying, like somebody who almost can't afford to hire, but can't afford not to. So I think the key, first thing is writing it down. Like I always get such clarity when I actually make a list and write things down of the pros and the cons of even hiring. The top reason why you would want to hire and then making that agreement around that. I have a doctor who is so busy right now that he's like, I need two associates. Like, and I don't need them to do day one day twos or new pay or screenings or anything. I just need them to come in and adjust. So for somebody that's growing, it's a different situation. Your agreement may be stating in there too, that you have, okay, I need you to do corporate talks, and I want you to go to BNI and make networking connections. That is part of what you agree upon in the beginning. It's not like you don't know, you have to sit down and figure out what you want this associate to do before you even start looking for an associate.
DR. DANIELLE: Okay. So once you know what the position actually is that you're hiring for, what do you do next?
THE FIRST STEP TO A GREAT HIRING EXPERIENCE
DR. STEPHANIE: Well then I would definitely recommend having a training manual. Figure out, what is it that I do day to day that I want to help someone else learn how to do so can be like a clone of me? Taking notes of everything you do throughout your day for like a week to two weeks and then going step by step, what you do for each of those things. This is not a short process. This is a very thought out process if you want the associateship to be successful. It's not just like you wake up one morning and you're like, you know what? I really need to hire an associate. Okay. Let's put an ad out. It's not like that. It's like you have to sit down and go through, okay, what exactly am I going to train them on? What does a training schedule look like? Where can I fit that into my schedule to train a new associate? Because you have to; you can't just throw them into the fire and expect them to know exactly what you know, there's no possible way. And so I would say there's so many first things, but that's definitely one of them is doing the day to day and making the training manual of everything that they will need to know.
DR. DANIELLE: So one of the things I see people do often is they hire an associate and that person comes in to work in their office and they kind of function more like an independent contractor in a sense that they're kind of making up their own systems and their own procedures. Right? Like when it comes to patient care, a lot of the doctors that I've known in this kind of situation, they don't want to tell someone else what to do or how to do it with their patients. So what are your thoughts about that? Is it okay to do that or more of the downfalls maybe of letting the associate just kind of have their own practice within your practice.
DR. STEPHANIE: Unless they are an independent contractor, that's a downfall. You've hired somebody to help you. What is the point in having them recreate the wheel? As seasoned doctors, we've already done a lot of this stuff. And some of it hasn't been successful. So why wouldn't we share that with the next generation? I think we all need to help the younger doctors and generation become better at business, how to run a practice, how to have things smooth. Why would we leave them on their own to flounder and fail or learn when we already know? Do you think it's because the doctors don't have the time to train them? Or do you think it's just that they're like, well, this is my information, and I've done it this way, but let them figure it out?
DR. DANIELLE: Yes. All of that. And I also think that, especially for women, there's this sense of like, I don't want to tell that person how to do things. I don't want to be bossy, going to be their boss per se. I just want to let them be the doctor. But it's sort of a passive way of not taking responsibility and not taking ownership for helping develop someone in a role in your business.
DR. STEPHANIE: Agreed. And that's the key. They're in your business. So this is what you signed up for. I believe that you are responsible for everything that happens in your business. Whether at the time you think it's your fault, their fault, somebody else's fault - it is your fault. Honestly, you take responsibility for everything. If your CA keeps calling out sick, you are responsible. So bottom line, it's your business, you can choose how you want to run it, but it doesn't set someone else up for success if you cannot help guide them. And you are the boss. Like it doesn't mean you have to be bossy. There's lots of ways to lead a team without being bossy. And I think that going back to my original point, no office runs efficiently without some sort of handbook, procedure, manual, agreements, contracts. It just doesn't. And so why is that different when it comes to an associate doctor? It should be exactly the same. This is the way our offices run. Now I agree that if it's not running the way it could with an associate that you take advice or you take feedback from that associate on how to improve it. In my world, I have been an associate, I've been an employee, I've been an IC, and I've been an owner. So I feel like you learn the systems, and then if you say, okay, I've learned the system the way that it's laid out in this agreement, handbook, contract, whatever you want to call it, and now I think I can go to the doctor and say, I think we can do it this way, what about if we tried this? That's much easier to digest as the doctor, instead of just somebody coming in and being, “I think we should change everything and do it this way.” And as an independent contractor or somebody who's just thrown to the wolves, that's what they're doing.
DR. DANIELLE: I think it kind of would help some people who are thinking about hiring an associate, see that they might actually not be looking for an associate. They might want to have an independent contractor or two or three in their office instead, because if you don't want the responsibility of developing an associate doctor in your practice, have an independent contractor in that role instead, because then they're running their own business inside of your space. They're essentially like a sublessee and you don't have any authority to tell them how to run their business in that case. So if you don't want to be bossy, have an independent contractor.
DR. STEPHANIE: Right. Have somebody rent space. They book their own appointments. They have a separate credit card system. They have their own staff. They're basically just cohabitating with you. They're just sharing space.
KNOWING THE LAW EVEN WITH AN ATTORNEY
DR. DANIELLE: Yeah, so that kind of brings me back to where I started this conversation where highlighting the point that a lot of agreements that are even written by attorneys are not really written the way that is compliant with the IRS guidelines, for example, they're not compliant in every state. And this is a part of the reason why, because these lines between what is an employee and what is an independent contractor have been blurred for so long in offices and clinics like ours that we've just come to think that it's normal when it may not necessarily be correct.
DR. STEPHANIE: Agreed. And I could tell you a story about somebody who hired as independent contractors, but they got paid like an employee. And one of the employees was unhappy. They got sick, they didn't have health insurance. And they went to the labor board and said, “Hey, I don't think that I'm an independent contractor. I think I'm an employee. And I'm entitled to these sick days to the health insurance that they offer their employees. I don't think I'm an IC.” Well, they went back and this person had eight or nine ICs and had to pay them all as employees, and back for multiple years for these multiple employees, they had to pay taxes and the taxes that would've been taken out as a W2. So if there's any question you need to find out from your state. I think that is such a fine line. And I know a lot of doctors like to do it, because they want to avoid payroll tax. They want to avoid the headache of having another person on payroll or taking out taxes or garnishments or anything like that. But trust me, that headache is way better than the headache you may get down the road if it's, if your employee is classified wrong.
DR. DANIELLE: We hear about the possibility of these things, or like you might read about what might be possible if you don't follow these guidelines correctly, but then to hear it actually happened to the extent to which this person had eight or nine employees that they then had to pay back taxes on. I mean, imagine yourself in that scenario, that would be immensely stressful.
DR. STEPHANIE: Oh immensely. And she was extremely stressed and lost pretty much all of her staff because they didn't want to be employees, but she had no choice.
DR. DANIELLE: But she had to pay that money anyway.
DR. STEPHANIE: But if it would've been done right from the beginning, she wouldn't have been in that pickle, right? You asked me what a doctor can do to get prepared. And I probably have a list of eight things here and I know we've only covered really one with the training manual and really figuring out what it is that the new doctor needs to know to help them be successful, to help them be successful in your office. So the contract, the training manual. But also since we just covered something about finances, I would say having your finances in order. So if you are bringing in an associate, just know that they're probably not going to be income producing for the first 60 to 90 days. And so having their salary, having any bonuses, having that saved before you actually hire that associate will save you a lot of stress. And in the beginning, just knowing like, okay, I know I've got them covered during their training period during their ramping up period. I know it's covered. That would be something else that I would say is of utmost importance before you hire.
DR. DANIELLE: Let's keep going on this list. What's next?
GETTING CLEAR ON WHAT YOU HAVE TO OFFER
DR. STEPHANIE: Okay. I have the doctor who is hiring also needs to know what they are offering, which goes back to your first part about why they're hiring. So what they're hiring for and then what they are offering. So we are in a day and age when people want to know what's in it for me? Right? So knowing what you're able to offer upfront, knowing the salary you're going to offer, are there any bonuses, are there any benefits, do you offer 401k, do you offer continuing ed credits, health insurance, do you have a signing bonus, do you have a relocation amount that you're willing to spend? So there's so many factors that when I talk to doctors, I'm like, okay, this is your homework. You need to figure out, is it salary plus bonus? What is the salary? What is the bonus? And then all of the other benefits that that encompasses. And then also having the clear agreements and policies written down and having it signed by all. And again, people don't wake up going, I need to hire an associate, let's put an ad out. They need to think about what this looks like. They're clear. And the negotiations they're not always as easy as like, Hey, let's do a zoom call, let's bring you in and then, and then you’re hired. It's like, here are the agreements, here are the contracts, this is what I expect. And the associate might be like, well, this is what I expect. There's always that negotiation factor that goes into hiring an associate, always. And some things you may think like, I'm not giving up on this one. But you find the right person. And you're like, okay, I thought I was going to pay this, but they've had some experience. Okay. I'm willing to go up to what they're asking. There's a lot of steps.
DR. DANIELLE: This is good though, because my tendency when someone says, I’m thinking about hiring an associate, I'm like, “Cool, go put out an ad, let's see who comes your way!” Just want to go get that person and get to the fun of it, because to me that's the fun. But the hard work is actually in the preparation for that person. And as I'm listening to you talk about this, I'm like no wonder if so many people have just looked at me like, what? When I've said go get an ad, go post some ads, find the person, start drawing that person in. Because they are probably not necessarily consciously aware of it, but they're feeling like there's something else they need to do first before they open up the door to inviting in resumes, for example.
VISUALIZING YOUR DREAM HIRE AND TAKING THE LEAP OF FAITH
DR. STEPHANIE: I'm a believer in really good energy, like a vacuum of energy when we're doing certain tasks. And so when you're sitting there and you're preparing, I always encourage people to think about who is this? What do they look like? What is their vibe? What do they feel like? Where are they from? Do they have a family? Visualizing that person that you are wanting to hire - this does create a vacuum for when you're ready to hire, you have all your ducks in a row and it's going to be so much smoother and so much more successful when you do find that person and you'll know immediately. I often relate it to dating. When you meet a person and you sit down and you know within five minutes whether you want to have a second date; you know within five minutes whether you want that associate to come in and shadow you and see what your office is about, and they know too.
DR. DANIELLE: Yes. I did this with my husband. We grew up in the same small town and we had all the same friends growing up, but we weren't friends with each other. Which was kind of odd, but it just was what it was. His mom worked as a substitute teacher in our school district, and so did my mom. So he probably had my mom in class sometimes and I had his mom in class sometimes. And his oldest sister was my cheerleading coach in middle school and high school. So I got married as I shared with you before we were recording, I got married when I was 23. I got divorced when I was 28. So after I got divorced, I made a list of the qualities that I wanted to have in my next partner. I made this list of 10 things and it was maybe two weeks later that we just connected through social media. We got together to go for a run. It wasn't like a date per se, but we were going to go run at this part together. And then before I knew it, we were a couple and we got married and he was not someone I had ever considered dating ever before that point. But I got really clear on what is it that I want in my next person? And I wrote it down, I made a list and I tucked it away in a special place. And I ended up sharing it with him a few months later, but I was like, okay, there's something to that clarity, that creating that vacuum. Where obviously I had separated from my first husband, and so there was a physical vacuum in my space of not having another person there. And I was definitely not ready for - not mentally at least - for a relationship that quickly, but I had made that list. And then there he was.
DR. STEPHANIE: And it's interesting you say that because you may not have recognized all of those other things had you not sat there and wrote them down. It might have just been like, oh, we're great friends or whatever. That is just, it's a great story. Because it's exactly how it works.
DR. DANIELLE: The thing about it is, I wouldn't have even said we were great friends. We weren't really friends at all. Like this thing that just happened, we decided to go run at the park one day together and then, now we're going to go do this a few days later. And then a couple weeks after that we did this and it was really just, oh, I think we're going to do this thing.
DR. STEPHANIE: Oh, that's a great story, I love it.
DR. DANIELLE: So my last question for you is by the time that someone comes to ChirosConnect and is ready to find that associate, what do they need to have done by that point? How do they know that they're ready to come to ChirosConnect and say I'm ready for an associate?
DR. STEPHANIE: Well, the good news about what we do is that you can come to us at any stage. I have multiple conversations and consultations with doctors who are at different stages in this process. And so I consider what I do part of my job is to help them help guide through this. So I think it's very interesting that you asked me on this topic today because for the new year we have a relaunch of our site and all of this, and it has more learning modules and this is one of them, and it's how to get prepared. And I have it from the doctor's side, but also from the student side, because I think both sides are important. I know we focused on the doctor today. But all stages, I'm happy to have a conversation with whoever needs that next step in guidance. Like I said to you earlier, when people say, okay, I'm ready to hire - how much are you offering? What have you done? What are your benefits? What exactly are you looking for? What does the position look like? What do you expect them to do? These are all the questions that I ask, and then as a connector I want to guide them so they do have a successful relationship with that associate or with that IC or with that soon to be partner. I see that as part of the role of what we actually do. So at any stage they can come to me and I'm happy to have a conversation with them about, okay, what's next? What do we do next? What else do I need to do?
DR. DANIELLE: This is so good because again, I feel like this is a gap that's needed to be filled for a long time, like a long time in chiropractic. And I feel like you're just getting going with becoming the go to place for filling this need that is, it's quite a large need, especially when we, like you said, we only talked about from the hiring doctor's perspective, we haven't even discussed being the potential associate and all that it encompasses too. So there's a lot that goes into both sides and developing a situation and an agreement that works well for everyone - it's possible. And I want people to know that they don't always have to go it alone.
DR. STEPHANIE: They don't, we're not meant to live in this world alone. We're not meant to be in business alone. It is all about relationships. So with my assistant, I always talk about - we're all on the same team. We're all on team Rozenhart. I’m not going to withhold information from you. You're not going to withhold information from you. We're all working towards a common goal. And if more doctors could see that and not withhold information and train and have this open communication, I think that there would be many more successful partnerships and associateships.
DR. DANIELLE: Awesome. So to wrap up, if someone wants to connect with you and/or learn more about ChirosConnect, where is the best place for them to go?
DR. STEPHANIE: You can go to the website. It is ChirosConnect.com. There is a link where you can set up a free consultation with myself and we can get you going if you're on the doctor's side. Also if you're a student and you just want to talk, you want to see what's out there, I'm happy to help you as well. The other place you can connect with me, or you can send an email to info@ChirosConnect.com.
DR. DANIELLE: Awesome. Thank you so much for everything that you've shared today.
DR. STEPHANIE: Well, thanks so much for having me on. It's been fun. I feel like we could talk for hours.
DR. DANIELLE: Oh yes, we could.