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This Dental Specific Podcast is dedicated to the Dental "Entrepreneur" Michael Dinsio, Founder of Next Level Consultants, delivers #TRUTH when starting up a dental practice. From the very first step to getting the keys of a dental practice, Michael shares his raw & unscripted playbook with you. Not only does this podcast provide you with "What To Do" but more importantly "What Not To Do". With over over 15 years of experience & over 150 past clients, Michael delivers an educational and informative program in a real and genuine way. Start w/ Episode 01 - as we go through a STEP by STEP process.
00:03
That question is so low to John, I don't even know where to start with that question. guess the problem is, and by the way, I love that question. Interesting, interesting. This is an interesting topic. What's the solution here? Show up, understand your part, and just crush it. Pay per click, social media, we can talk about all this stuff, but what really matters is patient experience, that wow factor.
00:34
Startup unscripted, the questions you have with the truths you need to hear. Now your hosts, Michael Dinsio and Jon Bertagni.
00:49
All right, everybody. Welcome, welcome. We are back in action. This is Startup Unscripted. We got a special guest today. I'm a big fan of this guy. as we're working through the startup process, HR is such an important piece to the whole puzzle. And we needed an HR expert. But I know you, John, specifically, when you ran your practices, you had a lot of
01:17
HR issues. So I know a particular topic, it probably hits you right, right in the nose a little bit. It might even give me diarrhea. not even sure. Remember these things. Mike, good to see you. This this is a topic that is probably what dentists don't really think about when they start their practice. And it's
01:43
probably what keeps them up at night. It's not getting nitrile gloves. It's not that crown that it's seat correctly. It's actually staffing and making certain that they are protected. And the coolest thing about Ali is as I reflect on who this guy actually is and, you know, Mike brought up a point of all these letters behind his name, very impressive, but more importantly, you know, he brings a legal mind.
02:13
to the fact of a company that's gonna help people understand how to protect themselves, how to protect their employees, patients. I couldn't be more humble to have Ali from HR for Health on board. Ali, thanks so much for joining us today. Hey, John, thanks a lot for inviting me. Mike, thanks for inviting me. It's fun to be here with you guys. And so you're right, HR is...
02:40
It's not one of those sexy topics. It's not like marketing, right? But it's such an important part of what every dental practice needs to do. It really is. It really is. Well, let's get into it. We try to get right into it because listeners don't like to hear John and I just ramble on about nonsense. So, you know, let's get right into it. Ali, like, in your opinion, I mean, you set up HR for Health for a reason, a purpose.
03:09
Why did you feel like there was a need to fill this gap in the world of dentistry? Because it's an extra expense. In a startup, it's very expensive and you're trying to earmark all of these categories that you're trying to put all this money in. Startups don't have a ton of cash flow, as we all know, right out of the gate. And so, just big picture, this is very important service. So why is it that important, I guess?
03:37
Yeah, no, it's a good question. And it goes back to sort of why we even went down this road of creating the software, as you know, as you guys both know, I'm a dental attorney. And so we do hundreds and hundreds of transactions every year. And what I saw was whether it was an acquisition or startup, what was happening was that these young dentists were getting into practice and doing everything they need to do, everything that you guys teach them to do from A to Z. And then
04:05
as they were getting into practice ownership, they were starting to deal with their employees and the things that they never ever teach you anywhere. Right? I mean, forget not teaching you in dental school. They don't teach it to you anywhere. They have to suddenly deal with it's like, Oh, I have to deal with overtime. have to deal with, you know, breaks and lunches and I have to do this and I have to do that. And where do you learn that? It's impossible, right? To get that information. And so
04:33
What happened in my law practice was that I saw a huge number of our clients coming to us because they were getting sued or they were getting in trouble for these tic-tac violations. If you're going to commit sexual harassment, you should get sued. You're going to do child labor, you're going to get sued. You can't cover yourself in a manual for that.
04:57
It was crazy. was these tic-tac violations that just broke my heart because they know, I know that they were working so hard on getting their practices off the ground. And you're right, Mike. Look, whether it was my own wife who opened her pedo practice in the middle of the recession or any one of your clients or any one of our clients,
05:25
They're putting their heart and soul into this thing, right? They're trying to build this so that they get to financial independence for their families, for themselves, paying off their student debts. You know, they want to live the life that they were promised and they were hopeful for. so... yeah, finish that point. And by the way, we interrupt people on this show. Yeah, go ahead. Yeah, yeah, yeah. I get so excited about this stuff, so...
05:52
So, but Ali, I guess what it comes down to is this, right? There's a lot of things that this comes down to. It's, you know, people don't think about the systems that they have to have in place. They don't think about the manuals. They don't think about the hiring process, the firing process, even the warning process and the documentation and how you have to take that file and put it in a locked drawer so no one else can see it. Tell me about how you could help people understand
06:20
some of the five, six things that they need to definitely do. And I think that's what you guys do at HR for Health. Just give them a roadmap. And that's what we are doing at Startup Unscripted, giving roadmaps. Same thing. We want people to have a roadmap of predictability of, hey, I'm covered. Or at least have an assemblance of, hey, I'm covered.
06:47
Yeah, no, absolutely. it does break down into a couple of things. And that's why we set up the system the way we did. It comes down to really a couple of really core items to stay compliant. And that's the whole gist of why you created it. we talk about risk profile, right? If you have a high risk profile, that means you're not doing any of the things we're going to talk about in a second. But if you have a low risk profile, then you're less likely to get in trouble. So what do need to do?
07:16
Right off the bat, you need to have all of the new hire documents in your state. So those average anywhere from 12 to 17 different documents that you need to have for every single employee, right? For every single employee. And so, and you're right, they need to be in a locked cabinet or, you know, I mean, that's the old fashioned way, right? That's like the rotary phone of HR. You know, these days, right, what you do is you put it on HR for help, you have it on a system.
07:46
that electronic, that secure, that people only can access with their own usernames and passwords. But the first thing is those new hire documents, Then the second thing is the employment manual. Now, you could go to a dental attorney or an HR attorney and spend thousands and thousands of dollars putting one together. And guess what, John? Next year, it's out of date. And guess what? Are you going to go get another one and spend another three, four grand? Of course not.
08:16
these employment manuals get stale and that's a problem. what we did at HR for Health, you know, to my own detriment, because we were doing those manuals for doctors at the law firm, we customize a manual for each person and then we updated for them every year if things change. so they always- For instance, I just got one today from Belmont Equipment. This year's-
08:44
with COVID guidelines, different. So you're right. Every year a new one comes out. Yeah. And Belmont is a multimillion dollar company. what is the... of millions. Yeah. What does the, you know, what does the, you know, the dental practice do? Can they spend four or five grand doing it every year? No, man. I would rather they spend that five grand on a chair, right? I'd rather them put it on a marketing budget with, you know, with Michael. I'd rather them do a thousand different things with that. But that's one of the reasons we give it to them.
09:13
So there's really no excuse not to have that. that's the second piece that's really, really vital. And then the third piece, which, you know, it's kind of a combination of a lot of things, but it's really about documentation, right? Documentation, documentation. Now people, you know, when they hear documentation, they go, oh my gosh, I don't have time to document. Well, yeah, of course you don't. That's why HR for Health does it for you, right? So whether it's performance reviews, violations,
09:43
know, vacations, any of that stuff, you know, the system helps them do it so that it's automated and easy, right? It's automated and easy. And tied to that is a second piece of the automation, the documentation that because of COVID is hugely important, you guys. And this goes, nobody talks about this in the HR world because their systems can't do it, right? Our system can't, but nobody else talks about it because they know it's a big, big, you know, weak spot for them.
10:12
which is combining their time clock system with benefits, right? And everything else tied to that. And so our time clock, right? Where people clock in and clock out is tied directly into their benefits. they accrue vacation and sick leave and all those things. It's tied into their PPP loans because they need all that documentation. It's tied into all the COVID regulations with FFCRA. So now
10:40
They've got one system that keeps them totally safe. so, so those three buckets are really the three buckets that, you know, need to be kind of filled, you know, as, they kind of think about HR. Well, let me ask you one quick question on that. Just sorry, Mike. Um, because it's, does that mean they have to time clock themselves in their, you know, their software, whether it's an Eagle soft, you know, dentrics, whatever it might be. Um, and this or.
11:09
Do those, is there an API to that? No, no. So, so we know, so most of those systems are closed systems, you know, as you know, and so they don't give access. And so we kind of, you know, we created our own and so they don't do it in those systems anymore. I mean, they do it in our system and only our system because it's tied into their payroll to benefit and whatnot. The reality is, I mean, you guys know this, you know, none of those softwares, right? Whether it's Dentrix, Eagle Soft, Open Dental, they're not made as a clock in clock out tool.
11:38
Right? They're a practice management software for patient records. They just kind of throw that in because in the history of dentistry, there hasn't been an HR platform like ours. Now that we've got this, people are moving away from those systems because quite honestly, they don't do their job the way it needs to be done. They move to Mars. are. They're a little antiquated. And there's so many third party softwares like HR for Health that plug into those practice management software.
12:08
that there's some awesome tools out there, real quick, pivoting on this topic. So since we're talking about startups, we're talking about HR and concerns and keeping in compliance. What are, John and I were talking about this before this episode, on a daily basis as a dental consultant, I get HR questions, like nonstop. And I wanna just say,
12:37
here talk to the attorney, but I've been getting so many of them, it's like I field them now instead of sending them because otherwise all the attorneys would hate me because I'm sending them HR questions all day long and you guys aren't able to bill for it. So, as a startup though, what are some of the biggest pitfalls someone can do when hiring their team right out of the gate? Because, know,
13:05
As an acquisition, there's some systems already in place. There's employees there. Sometimes there's an old manual. Of course, we would want all that to be cleaned up before they transition. But that's kind of the benefit of an acquisition is you just kind of plug and play. Might not be perfect, but at least everybody's hired already. Startup, you're hiring the whole entire team. So on these startups, Ali, what are some of the biggest pitfalls?
13:33
that you can think of when you're onboarding a brand new team. I mean, you mentioned onboarding documents and whatnot, but maybe performance reviews or whatever, Okay, so it's funny you say that because the acquisition side is actually more risky than the startup side because here's the thing, a lot of people go into acquisitions thinking that they can just do whatever the seller was doing, but nine out of 10 times the seller's doing things wrong, right? Or they're using...
14:01
the old manual and you're right, those employees have been hired by the seller but they need to be fired by the seller and rehired by the buyer. And so when you talk about biggest pitfalls, what I would say is the biggest pitfall of the three are, you know, letting go of someone who's pregnant, right? Letting go of someone who's older, which happens a lot in acquisitions, right? It happens a lot in acquisitions. And then third is letting go of someone who
14:31
you know, has been injured or, you know, complains about something, you know, having to do with their rights, you know, whether it's FFCRA or, you know, anything else really. You know, those things, or they're injured at all, you know, those things are the things that I see most commonly, right, most commonly. And, you know, the thing, Mike, is you're right, you get a lot of questions. We all get a lot of questions. The reason people are getting questions is because they're not guided through HR for health, right? You know,
14:59
If they're going through the system and they've gotten set up properly, they've got an employment manual, and they've got their HR representative that they're working with, they wouldn't have these questions. And if they do have questions, they're getting it answered quickly through our reps because it's all part of the service. So the issue is, we talked about the documentation and those things, but in practice early on, it's those three things. I can't tell you how many young dentists fire
15:28
you know, an older employee that they've taken on in an acquisition and almost immediately get sued. And it sucks, right? Because they've spent so much buying something and now suddenly, you know, they have to deal with a lot. Yeah. So here's a question that I have, you know, at one point in time, there was 48 employees that were part of the practices that we had. so we hired and fired not only doctors, but staff members, hygienists, I mean, and
15:58
that hiring process, everyone comes across pretty much as a rock star, right? Like they can, I mean, it's, it's absolute bullshit. Hey, I just moved here from Tuscaloosa strangely enough, like everyone's moving from Tuscaloosa to come and work at my dental practices, you know, with my business partners. So, so here's my question. What is the best way to vet these people out? Is it through background checks?
16:25
Is it through disc profiling? And is it legal potentially to go through those steps? And does that weed people out? Or are you still gonna have people that slimed their way through and needed a fireman in three weeks? Yeah, John, this is a great question and a million dollar question because people know- I'm sorry, again. You always get the million dollar.
16:51
question. You get like the penny stocks. Two dollar questions. So here's the reality, right? In dentistry, we have a hundred percent employment almost everywhere in the country. And what I mean by that is, is if someone's in dentistry, they can get a job. There's no hygienist looking for a job. There's no RDA like who
17:18
can't find a job, a DA, like it's just there. At any point in time, if there's 4 % unemployment, it's zero. I always say this, it's 0 % in dental. It is. is. It's probably, exactly. And so, so, you know, finding the right person is tough enough, but finding a person, you know, is its own problem, right? Right. Just finding a person, let alone like the right person. What I think is, you know, a lot of states are
17:47
are kind of really hunkering down on background checks and questions you can ask in interviews. But here's what I would say, right? From a legal perspective, and then I'm gonna give you sort of one of my secrets on the show. So, so listen up. So, from a legal perspective, if you're gonna do a background check, you wanna do it after you've given an offer to someone.
18:16
but you make it contingent on the background check. you say, hey, I'm going to hire Michael. I'm going to give him $16 an hour, but it's contingent on a background check. And then you do the most basic background check, right? Like you don't start asking, don't look into who their third grade teacher was, right? Like you just want to know, is there a felony, right? Have they been arrested? like, what was the reason if they have? And that's basically it, right?
18:45
But here's the secret, right? The thing that we really only tell our clients to do. And it's one of my most favorite questions to ask because I think it gets to the result that everybody wants, which is wanting a hardworking team member, right? Who is going to give it their all. Okay. And the question that I like to ask is,
19:14
How old were you when you got your first job? That's magic. Not how old are you now? That will get you clued. So let's make sure about that. It's how old were you when you got your first job? Because
19:31
I don't know about you, but I was probably 11 when I was throwing newspapers and walking around the neighborhood and then I was selling gumballs at school for a quarter. I was always hustling and doing stuff because that's just how I was. I think other people who I think we enjoy working with sometimes have that same background. Now, does that mean that asking that question will
19:59
Is the end all be all? Of course not, right? Like you got to make sure they're intelligent. You got to make sure they're a team player. You know, you got to make sure all these other things. But I love that question and it has always sort of served us really, really well. So that actually makes me think of something that we always do it on the, next level side. that's, um, you give people a 90 day kind of test tryout. Um, how do you suggest doing that? Because
20:28
Like kind of John said, everybody's a rock star in the beginning, everybody. But then they start missing work and they're horrible and they're doing ridiculous things. And so how quickly can you get rid of the bad employee and how do you structure that in the front end? So what you're describing is like a 90 day trial or probationary period. That is really was created by HR people.
20:58
to help evaluate employees. My goal, not to necessarily let them go any easier because as soon as they become an employee, they're an employee. Whether it's like a day or a week or nine months or three months, it doesn't matter. So I think what you've got to do is if you've got your HR house in order, you've got the new hire documents, you've got the employment manual, you've got all the things we were just talking about, then if this person doesn't turn out to be a rock star, they turn out to be sort of a dud.
21:25
then you can still let them go because you've done everything right up front. But if you don't do stuff correctly up front, then yeah, it's gonna be trouble. I just had a situation just on Friday where a doctor called me and she had hired an employee, given her the documents we recommended, the employee refused to give it back, right? So she goes three weeks.
21:50
without giving back the documents that the doctor was asking for and the doctor kept letting her come to work. Well, guess what? Payroll happened and she didn't get paid because she didn't have the documents in, right? And then she quits, the employee quits and sues the doctor or files a claim against the doctor, right? And so, was the doctor at fault? Yes. Was the employee at fault? Yes. But, you know, it doesn't matter.
22:16
In the United States, in most states, at the end of the day, the onus falls on the employer to get stuff done. And so the documents are the employer's responsibility. So there are strategies for this sort of trial period that we were just talking about that you can do to minimize your chance of getting in trouble. But yeah, I think a trial period is great. So did you say that you could
22:45
Did you say that you could fire them or not as long as as long as you set them up correctly? that what you ultimately said? Yeah, as long as you set them up correctly and you've got all the right documentation and then you're reviewing them at the 30, 60, 90 day mark. If something goes wrong and they're not a rock star anymore, yeah, you can let them go. That's not a problem. So, but as I say to everyone and I'll make sure everyone who's listening hears this too, you know,
23:13
Please, when you're looking to fire someone, pick up the phone and call me, right? Or call one of our HR people. We don't charge for it, but we're happy to do it as a service to our community. Like, talk to us before you let somebody go, right? And if you're a next level client or you're a client of John's, just let us know and pick up the phone and let's talk. Because I'd rather you do it right than to get sued, right?
23:39
So you're telling me having a police officer in a 7-Eleven parking lot alongside myself with the final check and paperwork is maybe the right thing to do or not the right thing to I need more that story, I think. By the way, the police officer was for my safety, actually. Yeah, I bet. And her name was Yolanda.
24:09
But I, you know, that paperwork I think is, you know, covering your tracks because what people don't understand also is, you work comp, I mean, start, things start adding up as you start having, you know, rollover of employees and you start paying for this stuff on an ongoing basis and it's hard to get that off of that payment schedule, correct? Exactly, exactly. And, know, and the- What I'm trying to say is,
24:37
don't go on a firing spree and a hiring spree just to find the right one. These things start adding up and start, you know, taking against you. And now there's websites that say this guy's a jerk or this guy has a world environment. So tell me about that, Ali. Yeah, yeah, 100%. There are law firms that we see, you know, you know, every other week, you know, who are attracting employees to contact them if anything goes wrong. And you're right.
25:07
It's kind of like driving on the freeway, John. You you could get away with not wearing your seatbelt once and probably be okay. You don't wear it every single time you get on the freeway. It increases your likelihood of something really bad happening. And the same thing is true in a dental practice, right? You could fire one person and get away with it and feel like, I'm good. But you keep hiring and firing the wrong people at some point.
25:33
it'll come and catch up to you. And honestly, the cost of getting HR for Health is so low, at $200 and change a month, that it's a no-brainer, right? I mean, we don't have anybody who talks to us about pricing as a problem because we've priced it so low. We wanted the burden to be so low that the value is like astronomical because at the end of the day, like you said,
26:00
You just don't want to go through this sort of rat race and turnstile of employees because at some point it's going to come and catch up with you. Well, one second, Mike, I want to say something to this because I would suspect most most staff members for, you know, a lot of general dentists that are out there or oral surgeons, there might be three or four staff members there and they might have been there for a long time. And it's just show up for work and you leave work.
26:28
And there's not a system necessarily in place. There's not a portal. There's not a place to go and look and see where your PTO falls in and to see your documents or, go on here, change this for your payroll or whatever it might be. This ideology or this mindset potentially could also change the persona of staff members because there is a responsible party, there's responsibility, and there's systems. They're not used to that.
26:58
It might actually vet people out because they're afraid of this kind of stuff, which is great in some instances. But I've got to believe it might actually escalate some employees to say, hey, these guys have their act together because they have systems. John, you hit it on the head. Like we have so many office managers and team members who say, look, I'm so glad my doctor's finally doing this because I've always wondered what my vacation was, what my
27:26
you know, benefits were, and now it's all in front of me. Like, like with our system, the doctor doesn't ever have to answer about how many days off somebody has, right? Because the employee logs in and say, Oh, oh, I see. Okay. I have three days off. Great. Uh, I'm going to put a request in right now. And then the doctor approves or denies it. And I mean, just those things make everyone's life easier because it just takes this burden off of their shoulder, right? You know, they don't need to ask about
27:53
Leave they don't have to ask about vacation or sick leave. It's all documented for them Well this we talked about last question and and I think it's a good one because we talked about There's no unemployment percentage in dental, right? In fact, next level is gonna open up a front office school soon this year This hey, this could be the rollout because we're finding that there's so many front office people that have no idea what they're doing
28:21
and it's such an underserved part of the dental office, just like hygienists and dental assistants, but the front office has their own roles. the point that I'm getting at is there's such a lack of professionals in the clinic. What it's creating is it's creating a fear factor from our clients that they don't want to fire, they don't know how to hold people accountable.
28:48
because the dental assistant, the front office, whoever can say, hey, I'm not showing up today. What are you gonna do about it? And if you fire me, I'll get a job right down the street. And so maybe this is just a conversation between the three of us, but I'm wondering, these HR systems, it all helps probably to mitigate some of that fear factor against, not against, but kind of to manage
29:18
the craziness of the HR. Well, but see, Michael, you're right. I mean, it's a peace of mind tool, right? It's an insurance. It's a peace of mind of knowing you're doing things right. But at the end of the day, it's a human relationship, right? And that's what it's all about, right? It's about respect. It's about love. It's about listening. It's about working with your team to make sure they understand what
29:45
your needs are and you understanding what their needs are and then making it all happen. Those things are really what allow human interactions to be really strong in a dental practice, that respect that people have for one another. Yeah, HR for Health is not going to by itself create a great team for you. I mean, that's not what it is. If you're going to throw a handpiece at someone, you're going to lose your team regardless of the HR system you have.
30:15
But it's gonna be that peace of mind, it's gonna be that safety net, it's gonna make sure you're okay if, God forbid, something really bad happens or you get a bad apple in terms of a team member. But yeah, the human side, that's on you, right? That's on, it goes. It does force more, maybe not more communication, but it forces more interaction, more expectations. I find that dentists in general, and I'll pick on them just a little bit,
30:44
they'll be texting their employees because they don't want to have a conversation. Nobody loves confrontation. so just big picture. Managing people is difficult because you have to have that interaction. And by maybe having better, tighter systems, that's going to reduce the stress and the fear factor of managing people on this other. 100%. confidence. It's to come out.
31:13
Well, I mean, we could probably talk for hours. I love these shows because we just really get into it and I have a lot of fun. But final thoughts, John, before we leave Ali with his. Yeah, no, I mean, this is this was an important key because people don't like, you know, taking this head on and it's they shelter themselves from conflict. And so.
31:41
This is having a system, whether it's homemade, home-baked, great, whether it's Olly, the biggest and best. I look at this as you need to have it and you need a structure and you need to follow it to a T. And unfortunately, doing it on your own sometimes does not allow you to follow things to a T. You need that personal trainer, if you will, to show up to the gym.
32:09
And that's what maybe Ali and his team can do for you guys. Yeah. Yeah, absolutely. Ali, thank you, man, for giving us your knowledge as always. Dude, you always bring it. We always get something from you. Final words on, we're going to have descriptions of HR for Health below. For the podcasters, it'll be all in quick links. But Ali, thanks so much, man, for being on. Oh, my pleasure, guys. This has been a lot of fun. You guys are awesome. And thanks for
32:39
letting me preach what I really feel strongly about because it's... every one of us, and John you know it because you've owned practices, Michael you know it because you see so many practices and everyone works just too hard to let HR problems derail your goals and your aspirations. So whatever we can do to fix that we do. So I appreciate you guys and hope to talk to anybody who has questions.
33:08
Beautiful. Alright guys, thanks so much. Have a good one. well. Thanks. Bye bye guys.
33:17
Alright, SWEET!
33:21
Thanks for listening. Tune in next week for another truth-filled episode of Startup Unscripted.
33:30
Check out Startup Unscripted on Facebook and YouTube. Click like, subscribe, and interact with Michael and John.