12: Does Culture Drive Profit

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Hello, everyone. This is your fearless host, Emmett Scott. And I'm so glad to have you here on another episode of DSO Secrets. All right, this is going to be a fun topic and it's around culture. Now, culture is one of those things that frankly gets thrown around like customer service or I have a good platform. But the question that I really want to take on today is, is culture hogwash? You know, does it really bring any value or is it simply some kind of icing on the cake or some kind of lipstick on the pig that's become vogue but doesn't really drive any end result that that can be measured. I was recently at this conference, I was actually on a panel and started talking about the culture of our group. And another dentist who was on the panel said, I absolutely hate that culture talk. Which I was thrilled that he brought it up. He said, at our group, we're about results, were about productivity. You either perform and get better or you get out. And he said, sometimes I've been through seven dentists in four weeks and that's how I drive my group. And I'm not focused on all that culture crap. Then there was this nice pause and it was perfect for me because then I was able to say, well, thank you, Doctor, for explaining what your culture is. It sounds like you're a high performance culture with a lot of accountability around some metrics. And you're also a culture of very high turnover. That got a big applause from the crowd for identifying that. I think, though his point was a good one, which is culture's kind of been hijacked. The principle of culture has been hijacked by our perception that culture is nap time and lunch food, bars and whatever else that you might think of that kind of the Googles and Zappos and other large companies have created and shown as kind of this quote unquote culture. And I think because of that, people have started to perceive it as either Number one, something that only really large companies with high profitability can drive and that it's made up of a lot of gift giving type stuff. Or it's about being very lackadaisical, you know, allowing dogs to come to work or whatever it might be or that. Number two, it's about non performance, you know, it's about giving people a lot of relaxation time and that, that is what culture is really about. So I love the discussion around it and I'll give you my definition of culture. I think culture is whatever the human principles are going to be that you use to run your business. Okay, so, so think about that in a DSO environment. We're not a manufacturing group. We don't look and say, come check out this equipment that's kicking off parts and pieces faster than a competitor. We're not competing in some high flow commoditized market. Our asset is the people. Now you might say, well no, because I bought this CEREC machine and I've got X ray machines and I got the best chairs and so forth. But at the end of the day, the revenue production is happening because of the people, because of that front desk person and how they answer the phone, because of how people feel when they come into your practices. And so the people component, and frankly, if you look at your P and L, your most expensive investment is in payroll. So the entire infrastructure is, and the entire asset is really a bunch of humans stacked on top of each other with different roles and responsibilities. To scale your dso, to completely ignore what the human principles you're going to use or to make those conscious and only allow them to run subconsciously I think is a big mistake. You want to take the time to say what are going to be the principles and values that we run our company off of now again, I think a lot of times this has gotten a bad name in that the perception is you sit down, you come up with these very idealistic values, they get framed on a wall and never talked about again. So if you're really going to take a proactive approach to your asset, you're going to look at those values, those principles and you're going to say, so how are we going to reinforce them and take a proactive approach so that they're not just sitting on the wall? You know, part of the questioning that I think we have to go through is at the end of the day, why am I growing my dso? Why am I adding practices? What is the impact I'm trying to have? I don't believe that most dentist or entrepreneur business people or the combination of them working together is doing this strictly for money. I've never believed that. I've met too many entrepreneurs in too many industries to know that the way that they tick is about how they're contributing to the world, how they're innovating, the changes they're making, the impact that they're having. So I think going back to those roots and saying, at the end of the day, for our patients, for our doctors, for our staff, when this story ends, or as the journey is going on, what is the impact that I really want to have on people?

Another I think pretty detailed question is

how do I want customers, patients and employees to feel within my practice? I was in a big mastermind group with several billion dollar CEOs and most of them had, well, I guess all of them, they were all entrepreneur founders, had built their entire companies from the ground up. And one of them was sharing that to do improvements, process and system improvements. He used shadow shoppers, which, that's not an innovative idea. Have somebody come in, go through the experience and find places where it breaks down. But what he did was instead of them trying to look at process type issues, excuse me, he, he only had them track how they felt at every stage of the process. So imagine in our industry having someone come in and say, all right, when you open the doors, or maybe even before that, when you drive into the parking lot, you know, how did you feel when you opened the doors? How did you feel when you, you know, walked up to the front desk, when you looked around? Like, what were all the impressions that you felt? Even more importantly when you were sitting in that chair, when you were talking to that doctor, getting your X rays done, working with that assistant, the hygienist, et cetera, how did you feel? And I think sometimes our logical brains want to make business this very calculated process around price and technology, etc. But at the end of the day, our customers are humans and they're not logical beings. And how they feel and their insecurities or their confidences or how they feel respected has a huge impact on your P and L. And it's not that your private equity partners and other finance partners are always going to understand or appreciate that they might. But it's critical that you understand that. It's critical that you appreciate the fact that your business is completely made of humans walking around and how you're going to support them towards success or decide, like this other doctor, that you are going to support them, but only in short sprints. So if they can't get there in a certain period of time, then they're out and you're going to have a turnover process for that. Or you're going to decide that you have a longer support system where you look at your systems and your processes and continue to figure out how to get people at their highest and best use. To me, in that thought process, in that decision making, you're creating your culture. So it does come back to substantial hard things of not just principles and values, but how is your team designed around the process and system support you're going to provide to your practices, to your doctors? When a doctor is underperforming, is your culture set up such that you're saying, hey, we're looking to get that doctor as far as we can, you know, up the value chain and give them the resources, whether they're clinically based or whether they're treatment acceptance based or staff relations based, you know, or general leadership capabilities. Are we going to have a platform in place to support them with that, or are we going to churn through people kind of hoping to get and hire just ideal people who already have those capabilities? To me, that's defining your culture. Now, a question I often get is, okay, I get it. I actually really agree with it. How do I take like those values on the wall and how do I make them into something that people say, no, we really live by this culture? Well, one I just gave you, which is to decide what system, support and investment you're going to make to actually follow through on the, the timelines and values that you have there. But let me give you another example that we did. One of our values is gratitude. Nothing special there. You can have that as one of your values too, and I'm sure many companies do. But we were thinking, how do we actually make gratitude? We have nine pillars that, that we go off of, but how do we make gratitude? One that at the practice level, they're actually exercising, or we're measuring the amount of gratitude that they have. We believe that if you create an organization with a high level of gratitude, they recognize, you know, part of gratitude is seeing what resources you have around you. And so they recognize the resources and the opportunities that are around them by having that mindset. So we have substantial business reasons why we want everyone to have gratitude beyond the fact of what that culture and feel that it creates. So one idea that we came up with that has worked really well is in the break room, we put little sticky notes and on those, with a pen, and the staff would Come in and write things that they were grateful for, primarily about other staff on those sticky notes. And then they'd stick them on a whiteboard and within a week we would have a whiteboard that was full of these sticky notes that had, you know, I'm really grateful for Joseph and his help. You know, I didn't know how to use the sensor for this X ray, whatever, and he helped me, whatever it might be. And then they'd write their name on the back of the sticky note, whoever was giving the compliment. And then we used those in staff meetings. We take all of those down each week and stick them in a bag, read off a few of them. But then we basically did a drawing off of it. So, you know, sometimes you have to incentivize culture. Well, always you need to invest in your culture with, with money as well. So in that drawing they'd reach into the bag, pull one out, and on the front you had whoever got the compliment, and on the back you have whoever gave the compliment. And each of them got a gift card and we named it Food for Thought. Now I'm not saying that that's driven, you know, all of our success because of that one thing, but I think that it created a feeling of camaraderie and it got rid of a lot of gossip and noise that often happens in a practice because of a mindset to constantly be looking for places where their team was supporting them and other things that they could be grateful for. So just an idea, one that you can either steal and start using or maybe one that gives you ideas of some of your principles and values that you would want to include. So as you think of culture, you know, I don't know that that needs to be something that you, that you hate or you think just decreases productivity or is it, you know, just about hanging out and having kind of a kumbaya sessions. Culture can absolutely be things that are driving productivity and profitability. But doing so with a mindset that we have a bunch of humans running around in an organization and we have a bunch of humans coming in as customers and how they feel is probably going to determine, well, is greatly going to determine my top line revenue and also my turnover expense. So hopefully this gives you a perspective. I'd love your feedback. Feedback on culture and whether you think it's something that is just hogwash, or if it's something that's brought value in your DSO or in your practices and maybe other ideas that you've used to help reinforce the idea of good culture and principles and values. So love to hear your feedback on our Facebook group DSO Secrets. And until next time, keep smiling.

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