#002 Do Less, Then Obsess

A case study on hiring in the post-pandemic dental world

I definitely find it hard to focus sometimes. Right now, at work, we are hiring for a new role. The first job I put up was for a "Dental Receptionist with Leadership Potential". Out of 85 total candidates, only about 15 actually had dental qualifications. Of those, after e-mails back-and-forth, only about 10 phoned in for a first interview, and 5 for a final interview. During the process, we made one offer, and that person ended up ghosting us. I’m still trying to figure out why. I’ve got my guesses, but I may never actually know why.

After that two-week intensive interview process, I felt pretty run-down. It takes a lot of energy to juggle that many resumes and that much scheduling. But I feel like I have learned something from the process. For the person we are hiring, I learned that it doesn't make sense to expect too many different roles from one person. And for the practice, I learned that we need to make sure that everyone in the practice has a strong clinical background.

Basically, in hiring for this role, I was looking for someone who has a strong background in dental assisting (so, they know dental procedures first-hand, they know how patient flow in the office works, they know how to sterilize instruments, and they can assist chairside in a pinch), they also know dental reception (they know how to greet patients and make them feel welcome, and they know how to fill the schedule and keep it full). Initially, we were also looking for someone who would eventually be able to develop leadership skills with the rest of the team (perhaps eventually being able to take on certain management responsibilities).

That is a big ask for any one person, and especially for someone new coming in to the office. Our top candidates had many of these qualities. They were also asking for top dollar to come in and take on this kind of role, which is slightly premature in an office that is just starting up. In other words, I wasn't setting people up for success.

What Kind of Hiring Process Has Been Successful So Far?

The people who have worked with us and stayed with us for a long time have had time to grow and develop on their own. The times when they have been overworked have usually been when they have been spread too thin. For example, when I was doing office management for our first practice, I also did a lot of the bookkeeping myself. So, when someone else stepped into the office management role, I assumed they would continue with the bookkeeping. It wasn't until a consultant suggested that we outsource the bookkeeping (and helped us through the process) that the office management job started to get simpler, and the office manager started to feel more successful.

This brings us to the book Great at Work by Morten T. Hansen. I started reading the book because my usual strategy, working more and more hours, has stopped being effective. I remember, when we set up the business, we wanted to be relatively settled by this point in our lives, so that we would have room to hang out with the kids. So far, that hasn’t entirely been the case. While we do get time to hang out as a family, we still end up working a lot of hours. It can be really challenging to turn work off.

In Great at Work (and specifically, in chapter 2: “Do Less, Then Obsess”), Morten pulls out performance results for 5,000 study participants. The graph divides the people in the study into four groups:

• accept more, then coast: people who accept a bunch of work and then don’t put in the effort,

• do less, no stress: people who choose to focus on a few new tasks, and who choose not to obsess,

• do more, then stress: people who take on many tasks, and then get overwhelmed (even though they are putting in the work), and

• do less, then obsess: these are the people who actually perform, who “excelled at choosing a few priorities and channelling their obsessionlike effort to excel in those areas”.

One big takeaway from this graph is that focusing but not working hard, or working hard but not focusing, get us up just past average. The only way to really perform is to focus and put in the work. Both of those things need to happen.

I’m afraid that I normally fall into the “do more, then stress” category. In running dental practices, it’s easy to take on one more job, to avoid hiring because it’s cheaper (and in the short term, faster) to do it myself. I want to perform, I really do. What I find difficult is learning what to say no to.

And it’s similar for the person we are hiring. If I am approaching my work from a perspective of service, of what I can do for other people, then one thing I can do to help this person be successful is to help limit their initial scope of work. To give them time to be successful.

“We don’t need to add more work activities to excel. There’s a better way to work, one that prevents us from falling into the spread-too-thin and complexity traps. If we select just a few items and obsess to excel in those, we can perform at our best. What does obsession look like in the workplace?” - Morten Hansen, Great at Work, chapter 2

Tactic: Do Less, Then Obsess

After going through this first hiring process and not hiring anyone, I felt completely defeated. My first thought was that I could have done absolutely nothing for two weeks, and achieved the same result. I can tell when I start to go into overwhelm, because my mind starts racing, and I try to cover three or four different projects at the same time. It wasn't until after a conversation with my business coach that I started to feel better about the work I put in. The hiring process was a good learning opportunity, and I had hit the end of a loop. I took the time to reflect. I have a better understanding of what the clinic needs (namely, someone with a good personality and clinical skills who can help us provide patient care), as well as a better way of interviewing (I'm going to do the initial phone screening, and then have the doctor and the team do the in-person interview—at the end of the day, they have to work with the person).

For that first job, I entirely closed down the job posting. I am now posting for an "Experienced Dental Assistant". This takes care of the clinic's immediate need (for one experienced person to take care of ordering dental supplies, ensuring rooms are stocked and organized, and for assisting chairside). It also gives that person breathing room to grow and get better as the practice grows. There is no pressure to take on more work and responsibilities. As the practice grows, eventually we will need a manager. And when that day comes, someone on the team will already be an obvious choice.

When it comes to finding the right people and the right fit, it's something that I naturally obsess about. That starts with new hires. If we only hire Certified Dental Assistants from here on out, people who assist chairside, then as they grow with the practice, we can develop people who can help on the admin side, and who still know how to ensure the patient is being taken care of clinically.

The case study on the actual job descriptions and analysis are going to go behind the paywall. This is the nitty-gritty of what I do, and how I do it. If you are responsible for hiring in a dental office, I wrote this with you in mind, and I hope that you’ll find it useful.

Case Study: What Do We Hire For?

This is the story of how I hired for one position and didn’t get the result I wanted, and then hired for a completely different role to get a better result.

The first job description we put out was the “Dental Receptionist with Leadership Potential”. You can see it here on my Indeed profile (screenshot below). I chose to sponsor the ad because I was feeling desperate. I wanted to get someone in as soon as possible. I figured that, since I’m not paying any kind of staffing agency, I can afford forty bucks to sponsor the job.

Below is the actual job posting. It’s a long image, but at least it’s legible. The first thing that jumps out at me is the “85 Rejected” in blue on the top-right corner. That’s the number of people who applied for the position. The problem was that I wasn’t clear enough about who wouldn’t be a good fit for the role. About 60 people had little to no dental experience. About 8 had a bachelor’s of dental surgery from another country (and thus had the experience), but weren’t HARP certified here (which means they can’t take radiographs or sterilize instruments), and so they wouldn’t be qualified to help clinically.

We lost our top 5 candidates for the following reasons:

• we gave our top candidate an offer, but then they completely ghosted us,

• two more seemed to have roughly the right experience, but they wanted a high salary, hours and benefits right out of the gate,

• and two rejected us (politely, and without providing an explanation, so we don’t really know why—if I had to guess, I’d say that something we were offering wasn’t matching up with what they were looking for).

Here is the job description. Then we’ll jump into the analysis.

What Went Wrong with the First Job Posting?

The job posting was successful in getting applicants who had some leadership/management experience and who also had experience in the dental field. The trouble was that I was trying to hire a junior person who was ready to become senior. We don’t really use the concept of “senior” and “junior” in dental, but it’s a useful way of looking at hiring.

Essentially, when I posted this job, I was looking for someone with that “senior” skillset. My thinking was, they should come in and know how to sterilize and assist chairside. They should know codes. And, since they will be in the only admin person in the office, they will naturally become that go-to person, the one who should know all of our cases and where everyone stands.

There were also a couple of problems with my approach:

• The office is still small, and doesn’t need a manager (yet)

• On a similar note, the office can’t afford a manager-level wage

• 80% of candidates didn’t have the necessary experience (we didn’t have enough disqualifying questions—reasons why the person shouldn’t apply for this job)

• The top candidates were already in a senior role, making senior wages, and (reasonably) wanted to earn the same or better when moving to our office

Basically, 80% of candidates were underqualified, and the other 20% were some variety of overqualified.

How Did I Learn?

I learned from the candidates on this one, and I learned from our office manager and principal dentist (who did the second-round interviews).

From our candidates, I learned that our interviewing process needs to be more streamlined. I was originally doing a phone interview, then I would do an in-person interview, then our office manager and principal dentist would do an interview (and this was a second location, because that’s when our principal dentist was available). I believe this process looked messy to people coming in for interviews.

I also learned from feedback from our office manager and principal dentist. For them, any candidate coming through the door had to be willing to assist chairside, sterilize instruments, order dental supplies, and take patient radiographs.

What Did I Learn?

Basically, they were saying that at this stage, the practice needs a dental assistant who can learn reception. The funny thing is, our current dental assistant has already taken over the reception role for the past 3 weeks. She’s learning on the job, the schedule is filling up, things are going well.

From the first job posting, I was able to tell that basically I had the wrong “bait”. I was getting lots of candidates, but they weren’t the right fit for the actual needs of the business. Dental practices are small shops. Everyone needs to know how to contribute to the success of the patients, the practice and the team. Hiring for the wrong role takes resources away from the team: it takes a tremendous amount of time and energy to hire them in the first place, and then even more to bring them up to speed on our systems. Bringing someone on, training them, and then losing them is a significant loss.

At the same time, what we are doing now (getting by with a bunch of temps) isn’t sustainable either. Temp hourly rates are high. They don’t know our systems. Our team keeps needing to remind them about stuff, or pick up after them. And it’s also very energy-intensive, since we need to constantly keep an eye on the schedule, post for those shifts (either on a public site like Indeed, which takes time, or using a temp agency, which is expensive), update the running list of who is working when, and also hope that the temp shows up. We have made this a little easier by creating our own list of temps, but it’s still not perfect: our temps are not always available.

Here is the updated job description.

With this updated job posting, we started to get the kinds of applicants that fit with what the business needed. We still ran into some of the same problems, with people ghosting us at various stages of the process. However, it did lead to a hire within the week!

I learn best from nature. In the case of the dental clinic, I learn from watching it grow. I’m taking away from this experience that the people who work with us best over the long term tend to start in an assistant role, chairside, and then grow from there as the business grows.

See you all next week.