September 30, 2025 • 27 mins
Not everyone should be a leader. Not even your star employee. The DPH Coaches learned this lesson the hard way, and this episode unpacks what can happen when you put the wrong person in charge. You'll hear how to be proactive and get the right people in the right roles, the signs you may have promoted the wrong person, and why an outside hire might be the best move. Leadership is too important to get wrong, so don’t miss this one!
Topics discussed in this episode:
- Early signs Dr. Henry’s new manager wasn't a leader
- What actually makes a good leader
- Internal hires vs. external hires
- Why internal promotions don’t always work
- How respect is earned in a practice
This episode was produced by Podcast Boutique https://www.podcastboutique.com
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https://www.dentalpracticeheroes.com/playbook
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Paul Etchison (00:02):
Have you ever noticed how one wrong person in
a leadership role in your officecan derail the entire culture?
Recently, dph coach Dr HenryErnst had to make one of the
toughest calls as a practiceowner.
He had to let his officemanager go and while it was
painful and it was difficult, itreminded him of a powerful
(00:23):
truth Leadership is much tooimportant to get wrong.
Today, we're going to talk tohow to make sure the right
people are in the right seats,how to train and build up your
leadership team, and why thesuccess of your practice depends
on it.
Stay tuned.
You are listening to the DentalPractice Heroes podcast, where
we teach dentists how to stepback from the chair, empower
(00:44):
their team and build a practicethat gives them their life back.
I'm your host, dr Paul Etcheson,dental coach, author of two
books on dental practicemanagement and owner of a large
four-doctor practice that runswith ease while I work just one
clinical day a week.
If you're ready for a practicethat supports your life instead
of consuming it, you're in theright place.
My team of legendary dentalcoaches and I are here to guide
(01:07):
you on your path fromoverwhelmed owner to dental
practice hero.
Let's get started.
Hey, welcome back to the DentalPractice Heroes podcast.
I'm your host, dr Paul Etchison,and I'm joined by my DPH
coaches, dr Henry Ernst and DrStephen Markowitz Dr Henry's got
a large practice in theCarolinas 18 ops and Dr Paul
Atchison and I'm joined by myDPH coaches, dr Henry Ernst and
Dr Stephen Markowitz.
Dr Henry's got a large practicein the Carolinas 18 ops and Dr
(01:32):
Steve has got six practices onthe East Coast.
So some very experienced ownershere that we're going to talk
about.
A really good topic today andthis is something that I hear
with my coaching clients is thatthey will work with me and then
they'll say I can't believeyou've got problems at your
practice with all the systemsthat you got.
How do you have problems atyour practice still?
And I think there's thisglorified notion that once you
(01:53):
start systematizing yourpractice, the problems go away.
And it's just not the case.
I mean, things continue tohappen and I'm going to pass the
mic to Dr Henry right now, buthe had some pretty big it's a
pretty big turmoil recently.
Tell us about it, henry.
Henry Ernst (02:09):
Yeah, thanks for that introduction, Paul.
I think that the way that yousaid it is great.
We can have systems in place,we can have everything,
everything the way that we feellike is going great, but stuff
hits the fan.
And the best way I coulddescribe it is if I'm taking an
implant course and somebody'stelling me like, oh, they're
showing me all these greatthings, show me your failures,
show me where you screwed up.
(02:29):
And I think it's great on thispodcast for us to put our guard
down and say, hey, we have stuffthat happens in our practice
too.
So in our practice, you know,we're always really big on
promoting from within, having agreat work environment.
We have EOS in place and ourmost recent practice manager and
maybe I'll give you a reallyquick history we had a practice
(02:50):
manager from the two-monthinception of the practice till
about seven years and she wasgreat.
Everybody knew where they stoodwith her.
She wasn't super, super warmand fuzzy, but if I came in late
I knew that she was going tohold me accountable.
She was great in the businessaspect the front end of the
house there, which is greatbecause it complements me, and
being great with the back end ofthe house and stuff like that.
(03:11):
She left to start a family acouple years ago and we promoted
from within.
We promoted from somebody whostarted at the very entry level
entry level hygiene assistant,worked their way up, worked
their way up, got coached intobeing assistant, practice
manager and eventually practicemanager.
So, long story short, there weretimes in the last six to eight
(03:31):
months where I would getsomebody from my leadership team
telling me listen, we've gotproblems, people are not getting
held accountable, being late,which never happens in our
practice.
You know, people being late,people kind of slacking off a
little bit and nobody's holdingthem accountable.
And I use the example of achild, a child that wants to go
to sleep oh, your bedtime is 8pm.
(03:53):
Next thing you know, parentsslacks off, it's 8.15 and
nothing said.
Okay.
Next thing you know that's thenew normal.
So that's what was happening inour practice.
We have all these great corevalues and next thing, you know,
everybody's like slacking offjust a little bit, a little bit
here, a little bit there.
And that was the weakness ofthis practice manager is she
(04:16):
didn't want to have thoseuncomfortable conversations,
right.
And eventually somebody's fiveminutes late.
Next you know it turns a 15.
So we're creating a badenvironment there and, on the
other end, we're alienating thegreat team members.
The great team members are likedude, they're slacking off.
They're in the break room andI'm doing my job.
I always have to find them.
They're 10 minutes late for themorning huddle and that's.
(04:37):
It just sets a really bad, andthis has happened a few
different times and it wouldjust really aggravate the heck
out of me.
You know, we always talk aboutcreating that practice where we
can work two days a week, whichis what I have, and so I need to
be able to trust thatintegrator, my right hand, and
always defend them.
So I had a very difficultdecision to make and I actually
(04:58):
there was one of your podcastepisodes.
I had a guest from California,dr Kalasho.
Yeah, she had a great littlesnippet that actually played for
my team that she mentioned.
For example, if your officemanager is not holding people
accountable, it's not theowner's responsibility, it's the
practice manager'sresponsibility to talk to the
dental assistants, because wecan never run a business like
(05:20):
that and set the tone.
Right now we've got kind ofinterim One of my leadership
teams kind of running the showfor now, and right now we're in
the process of interviewing andthat was the first thing that I
said to this new person.
I said I told them exactlywhat's been happening.
We have great systems, we havea great reputation.
We just kind of went off therails a little bit.
(05:42):
And if I'm supposed to fly fromhere to Chicago and I've got
this pathway, that's directlypathway and for the first 10
minutes of the flight I'm goingjust a little bit off course.
It's not a big deal because wecan just correct it, boom.
But if you let that 10 minutespan go for 30 minutes, 40
minutes, next thing, you know,I'm headed to freaking
California or something likethat.
So that was what I mentioned tothe team.
(06:03):
We got off course and Ibasically said you know, these
are our principles.
We are on time, we do our job,we have respect for everybody.
If you want to be here, great,you're here, we're on the same
bus rowing together.
If not, you need to gosomewhere else.
And when this was announced,there was another team member or
two that was gettingpreferential treatment by this
(06:26):
practice manager that decided toleave also.
And that was great, perfect,right, we're clearing the deck
and now we're moving forward.
So you know, just being humble,this stuff happens.
Nobody's perfect.
I'm sure both of you havestories just like this here, and
I think the important thing isto look back, take a step back
and see how did this happen?
How could we, of course,correct it a little earlier, but
(06:48):
we ultimately make thechallenging decisions to move
forward, to correct the course.
Paul Etchison (06:53):
But I think it's hard because it's such a
disruptive decision.
It's like you're between thesethings where like, oh well, I
don't really like how that'sgoing, I don't really like that.
It's like all these like minor,like little paper cuts that
you're just like, ah, that'skind of irritating, but it's not
so big.
I mean, what eventually broughtthis to a head?
Was there a situation that justhappened recently where you're
(07:15):
like that's it, that is it, weare done?
Henry Ernst (07:18):
Yeah, so we had a couple of highly trusted
leadership team members come,and this is a hard hierarchy,
right, because we have ouraccountability chart.
So this is going outside theaccountability chart.
For those of you guys have EOSin your practices, you know you
have the visionary, which is allof us, the owner, and then the
integrator, and then everybodyis team leads and down.
So basically this kind ofskirted the pathway and they
(07:40):
came directly to me, whichshould never happen, but it was
that important that they had tocome up to me and tell me listen
, we need to talk you know, thedreaded words we always love to
hear.
As owners, we need to talk, andI would get detailed things that
were going on.
I verified again, wasted mytime, verified from looking at
cameras, footage and yes, thesepeople are late, nothing's
(08:02):
happening.
People are goofing off in thebreak room, nothing's happening.
And then it was correctiveaction on my part to say listen.
I used a John Taffer example ofthe show Bar Rescue he always
talks about.
If I'm walking down the hallsof the business and I see
somebody doing something wrong,if I decide to just I don't have
the energy for this right nowand just keep walking, you know
(08:22):
we have that right If somebody'sdoing something wrong.
Paul's like dude, I just wantto go sit at my desk and have
one of those cold hot dogs thathe eats or whatever.
Paul Etchison (08:29):
Oh, I thought you were saying you didn't have the
energy to do a Jon Tafferimpression right now.
I thought you were being like.
I thought you were reallygetting the character here for
us.
Okay, all right.
Henry Ernst (08:39):
Yeah, that would be interesting.
Don't have the energy to dothis conversation right now,
this difficult conversation.
I'm just going to walk past it.
The second that I do, that, inthat employee's eyes it's saying
to them oh, I'm goofing offhere and he just walked by.
That means it's as good, thisis the new normal.
So I had that conversation withher and telling her that when
you see something wrong, youneed to call it out right then
(09:01):
and there, in a respectful way.
Right, always give them the why.
This is why we're not, we don'tgoof off, because other people
have to take, do your job and dothis, you know.
So there was some action likethat and then it just didn't
happen.
I guess, looking back on it andtrying to do like a how did
this happen?
This person just didn't havethat ability to correct people,
(09:22):
and it takes a special type ofperson to be a leader ability to
correct people and it takes aspecial type of person to be a
leader.
Paul Etchison (09:30):
And not everybody's made to be a leader.
Yeah, that's what I've noticedtoo is that it's like with
working with so many practicesis it's you kind of don't always
know what you're going to getwith leadership, and you've got
to put people in thosesituations, you've got to give
them the opportunity to provethemselves and you've got to
give them training and help themthrough and hopefully you've
modeled good leadership.
But sometimes it's like there'sthat it and it's like how do
you, how do you correct?
(09:50):
I mean, steve, what are youthinking over here?
Steve Markowitz (09:52):
There have been times where we have had really
strong business team members andthen we put them in a
leadership position and theywere like no bullshit at
collecting AR and doing andsupposedly having difficult
conversations that I thoughtwere difficult because they were
in charge of billing or havinghandling patient complaints.
And then as soon as we put theminto a leadership position of
(10:13):
other people, they would go anddo the job for them, as opposed
to having a difficultconversation.
So I can totally understand howthat happens, understand how
that happens, and I think for usit's like how do we evaluate if
someone is capable of leadingand influencing others to do
their job, not just being reallygood at specific tasks?
But then to Henry, thank youfor sharing that.
(10:34):
I'm sure it's kind of been a lotfor you over the past little
bit, but how did you know thatyou weren't able to correct the
behavior?
Like, at what point in thisyou're like I'm hearing this,
all this information, it doesn'tsound good, but this person's
been with you for a long time.
I'm sure that there were timesthroughout that 10 years where
(10:55):
you're like I need to correctthis behavior.
I feel like I'm strong enoughto do it, but you didn't have
that feeling this time?
What was different for you andwhy?
How did those conversations go?
Henry Ernst (11:07):
Yeah.
So I'll give you a littlebackground.
This person I never had tocorrect ever.
And all this asked you know,hygiene assistant, dental
assistant.
In all this, you know, hygieneassistant, dental assistant, da1
, da2, assistant practicemanager, never, ever, ever.
And I would look, use theanalogy of, let's say, we're in
(11:27):
a boat, the darn boat has got ahole in it, it's leaking and I'm
able to plug it.
Actually, you know, it'sleaking some more and I'm just,
I just can't stop the leak andeventually I'm just drowning and
I just I had to do somethingabout it.
And in this specific examplethis is a specific challenging
example you have somebody who'venever had to correct before, is
perfect core values for thepractice and as they got
(11:47):
promoted to practice manager,they just didn't have that John
Taffer right, that ability tocorrect people and hold people
accountable.
So then you know, what do you do?
Do you demote them, do youterminate them and just tell
them why and start afresh.
So I made the decision to startafresh and when I told this to
(12:08):
the practice, everybody and Isaid this is why this is
happening.
We have to get on board.
Either get on board or I'llshake your hand and 95% of the
practice is like appreciativeand grateful because they were
the good ones that were upsetbecause others were goofing off,
so you kind of like strength innumbers.
So that was how I came to thatdecision and that's where we are
(12:29):
now and I feel like definitelycould tell there's a different
vibe right now.
There's a vibe of, okay, weneed a course correct and I'm on
the boat with you, dr Ernst,I'm going to go with you.
Steve Markowitz (12:41):
There is that law I don't know, it's some
business law that says we'regoing to promote people to a
level of incompetence.
So that's clearly an example ofthat.
But also our practices areliving organisms and the manager
that's going to be the bestleader when we're in super hyper
growth mode may not be the bestmanager when we're in mature
(13:05):
maintenance mode.
And I think that, from theowner seat or the visionary seat
or whatever we are callingourselves, we need to understand
that.
What is this person's strengthsand is that fitting with what
the practice needs right now?
Henry Ernst (13:19):
so to create maybe a learning aspect for the, the
listener out there right now, wejust decide to go a different
route where, for the first timein the history of the practice,
we're hiring a practice managerfrom outside the organization,
somebody to come in brand new.
So I kind of equate it tosports.
We've all had our teams thatwe've, you know, root for and
stuff like that, and once in awhile maybe the coach leaves or
(13:41):
the coach retires or gets fired.
And next thing, you know, maybethey bring in what's called a
player's coach.
Oh, we're bringing in a newcoach, new idea, and all of a
sudden a year or two goes by andit's like, dude, this player's
coach is not working, man, theydon't have any discipline,
they're getting penalties.
Next thing, you know, you goback to the disciplinarian coach
and all of a sudden, boom, itworks, and sometimes you're
right.
Like a team, there's cycles.
So where I'm going with this isright now we're going with
(14:04):
somebody outside yourorganization.
Paul Etchison (14:06):
Nobody knows, and I was going to follow up and
ask you, henry, do you feel like, in retrospect, that you could
have saved this had youintervened earlier?
Or do you think this was justthe top out of this person's
leadership ability?
Henry Ernst (14:17):
I think sometimes you either have it innately or
don't.
As far as this goes, you haveto be able to be comfortable to
call out people and I think somepeople just want to be a little
too much buddy.
Buddy, you know, and it's likeI always tell some of the team
like my team respects me, right,and they'll come by my office
and shoot the breeze with me.
They did this this weekend,that weekend, but at some point
(14:38):
in their mind there's like atime clock when they're like,
okay, this is good, so theyrespect me, but they don't have
to.
I hope they all like me, and Ithink they do, but they have to
respect you.
I like your head.
Well, that means a lot to me,Steve, but you have to respect
and respect has come from youknow, when you do, you're always
going to hold peopleaccountable and they know where
you stand.
(14:59):
Like I said, the previouspractice manager was not warm
and fuzzy, but when you werelate, you knew she was going to
come up to you and tell you thatyou were late and we can't do
this anymore.
That's what we need, yeah.
Paul Etchison (15:10):
I think that's you know, it's interesting.
I and it said something like asa leader, we like respect and
as a leader, like even fakerespect, like leaders still
appreciated it.
Like, even if they knew theperson was like brown nosing a
little bit and it was somewhatingenuine, the leader still
(15:30):
appreciated that because itshowed some level of respect.
Steve, you know what do youthink?
I mean you develop tons ofleaders.
You got six practices.
How do you know if this issomebody that can learn more or
somebody who's topped out intheir leadership?
How do we not make thesemistakes?
Sure?
Steve Markowitz (15:46):
A couple thoughts.
One is are we trying to findwhat this looks like from
bringing someone in from theoutside, because that's a whole
podcast?
I'd love to unpack likebringing in a leader from the
from the outside, because thatis a?
Yeah, there's a ton to unpackthere, but for most dental
practices they are like thisperson left now we're going to
promote from within.
How do we know if that person'scapable?
(16:07):
The greatest success I've everhad is not providing positional
power, for that respect occurs.
I will never forget the timewhen we announced Karen our
regional manager was the managerof the practice that she
started as assistant, as and Iwas all excited.
I brought in a freaking cake,maybe balloons, and I made this
(16:28):
announcement and I was like guys, I'm announcing Karen as the OM
and it was like silence.
It's like what?
Why is no one excited?
I thought Karen was the om.
Oh, that was the response.
Everyone was like, oh, she'salready.
I thought she already did that,she already had that level of
respect.
We already had thoseconversations.
I was to plant seeds, not withthe team, both karen of like all
(16:51):
right, do you want to take offthese responsibilities?
What does it mean?
Clearly to hold someoneaccountable.
What are our non-negotiablesFor Henry?
It sounds like if you'reshowing up late, that's a
non-negotiable.
If you're not going to holdsomeone accountable, that's a
non-negotiable.
So before we give the title, wehave a ton of conversation
(17:11):
around what does this look like?
And I almost want to talk himout of the position, because if
I'm doing a job telling them howhard this is and how much
leadership, responsibility,leadership is, how much this
sucks, and they still say thatthat's something they want to do
, then they're going to be ableto do the hard shit.
If they're like just thinkinglike this is the next step in my
(17:32):
career and I deserve thisposition because I was so good
at this, I'm going to be greatat that.
And they're more concerned withthe positional power and that's
their motivation.
Most of the time they aren'twilling to have that level of
difficult conversations, andwhat happens in most dental
(17:52):
practices is we're not proactiveenough.
So we have this opening.
We want to fill it as quicklyas possible because I don't want
to do more shit myself.
So then we look around and sayyou're the best person for this
here.
I guess You'd be awesome.
Let me tell you how great thisis.
Let me sell you on the positionas opposed to having you
(18:14):
understand truly what theresponsibilities are of
leadership.
Paul Etchison (18:17):
So you're saying that because this is interesting
, because I do this with myclients a lot and we talk about
how, when we put somebody in aleadership position, I always
feel like, as the leader, youneed to give that person the
blessing and like you need togrant them the authority of
being in a position in charge.
But you're saying you show methat before I grant you the
authority.
Steve Markowitz (18:38):
So we were just talking about respect.
Respect doesn't happen becauseyou're in a position of power.
Respect happens because you areactually influencing and
earning that respect.
That's interesting.
So what I'm telling this leader, or future leader, is earn
respect of your team.
They will fight through wallsfor you, the same way that your
(18:59):
team loves you, Paul, and yourteam loves you.
They don't love you becauseyou're the owner of the practice
.
They may like you and respectyou.
Part of it because you signedthe checks, but mostly it's
because how you serve them andhow you treated them and how you
made them feel and how you'reable to help them.
All of the things that we dofor our team is what I would
expect someone to do in aposition of leadership.
(19:20):
The owners that struggle themost and have the most HR
problems and have the mostturnover are the people that say
you're fucking here to work forme.
Paul Etchison (19:29):
Yeah, and.
Steve Markowitz (19:29):
I'm the owner, show me some respect.
And I'm the owner, show me somerespect.
And I'm like you got this wrong, babe.
It's backwards.
I'm here for you and if I canserve you and give you what you
need, alongside with what thepractice needs, then I will have
all the respect in the world.
And this team will go throughwalls for me and they'll make
sure they show up on time.
(19:50):
And they'll make sure they showup on time and they'll make
sure they do their job and theymake sure they're focusing on
results.
So I need to make sure thatperson is fully understanding
that level of responsibility andI almost want to talk them out
of it because it is heavy andit's not fair to them to put
them in a position that theydon't know if they want to
succeed in.
Paul Etchison (20:09):
You know, what's interesting about you saying
that is that I was going backthrough the six years of
coaching and I wanted to say,okay, what are the stats and
collection increases, what arethe amount of clients?
I have been able to double,triple their collection, like
things like that.
And what I saw is I had somestats that were lowered by
certain coaching clients andwhat's funny is I don't work
with these people anymore.
(20:29):
It is that leader.
It is that exact leader.
When I'm having a strategy callwith somebody and I sense that
that that person is like youwork for me.
I'm the boss, because I said so.
These people are stupid.
I can't find the right people.
Nobody does what I tell them todo.
Those are the type of leadersthat you sense it?
Henry Ernst (20:46):
I say I can't help this person, I cannot change the
way this person leads, and Ithink now going forward, my
stats are going to be evenbetter because I'm not taking
those people as clients.
Yeah, I think what's reallyimportant is servant leadership
right, no matter what positionwe're in to this day.
I mean, I walk down the hall.
I see a piece of paper on thefloor.
I'm not above doing that, right.
(21:06):
You know, the garbage needs tobe taken out.
I'm not above doing that.
It's all about respectingleadership, because we can do
anything right, and I love thisquote that I saw recently by a
football coach you know, if youwant to make everyone happy,
don't be a leader.
Sell ice cream, because as aleader, you're going to be
respected, but some people mayjust not.
They may be nervous around youor this or that.
(21:28):
It's a lonely sometimes.
Being a leader is a lonely lifesometimes, and you just have to
be able to accept that.
I'll sell ice cream and I'llmake everybody happy, unless
they're going to complain aboutthe prices.
Paul Etchison (21:39):
You can sell those WWF shortbread like cookie
, those shortbread things, withthe WWF people.
Henry Ernst (21:43):
Those are my favorite.
I think you're showing your age.
I think those are pretty oldPaul.
Paul Etchison (21:47):
Shut up, those are pretty old.
Steve Markowitz (21:49):
Paul, shut up.
They still have them.
Really, I haven't seen those in, honestly, years.
Paul Etchison (21:51):
I don't think that they exist anymore.
You're right, I don't thinkthey have those anymore.
Henry Ernst (21:54):
I think back in my day it was like a Roddy, Roddy
Piper one.
Paul Etchison (21:59):
I like some Cracker Jacks here.
They're only a nickel.
Steve Markowitz (22:01):
Paul's eating scale cookies.
He probably gets like the.
You know those old baseballcards that had the gum in them.
It would be the best tastingthing for like two bites, and
then you would immediately getlike some carcinoma of the
tongue.
Paul Etchison (22:13):
Yeah, yeah, no, my baseball cards are digital
now, so whatever, okay cool.
Yeah, you're pretty cool.
Henry Ernst (22:20):
So I'll kind of summarize too.
I know this is a good topic,for you know an episode and
stuff like that, but it maysound more of a problem than it
really really is, becauseessentially, out of our 35 team
members, you know, the practicemanager is not there anymore and
one other person decided toleave.
Another person we had to have aheart to heart, so everybody
else on the entire team waswanting this to happen, believe
(22:42):
it or not, like they wantedchange.
They wanted their workenvironment to be an accountable
work environment.
So that's actually a reallygood thing.
And another beta testing thathappened and maybe this is
another idea for large practicesis right now we've kind of got
a hybrid system.
Right now We've got one personthat's the director of
operations, kind of like, takingcare of all the business
aspects of things, and we haveone person right now that we're
(23:04):
calling the director of people.
So any people problem, whetherit's a patient, an employee that
has a problem, that's theirperson.
So it's actually worked kind ofwell.
I mean, it's not what we'regoing to keep doing, but that's
another hybrid model that I kindof thought of, because
sometimes you mentioned it,steve if you have people that
are really strong in this, butmaybe not good in this, and that
could be another hybrid modelfor a large practice that could
(23:25):
work also.
Steve Markowitz (23:26):
I love that.
Yeah, that I do not want toapply for the director of people
position.
That sounds heavy.
Henry Ernst (23:30):
That takes a special person, because your
main job is to haveuncomfortable conversations.
You're basically being the JohnTaffer.
Shut it down, john Taffer.
Steve Markowitz (23:41):
There it was.
We had energy for that, paul,we did it.
We got the.
We got him to do the.
John Taffer, it only took 26minutes.
Paul Etchison (23:49):
He had to get all amped up.
Dude, he's pumped up.
Man, he's raging.
Yeah, dude, great.
I'm so glad that we were able toshare this and it's such a good
topic for people and I thinkthe next time we do an episode,
I think we should do promotefrom within or bring it from the
outside, because I think thathappens to a lot of us and we're
always looking well, you knowwhat We'll do it the next one.
But yeah, henry, thanks so muchfor sharing that.
(24:11):
And Steve, you have some greatwisdom there.
This is a tough situation.
This goes to show you, I mean,no matter what level of practice
you get to, you will still haveissues and you still will have
problems to solve, and that'stotally okay.
That's not a failure ofleadership on your part, it is
just.
I think, like Henry mentioned,this is a tough decisions have
to be made and sometimes they'renot the most popular.
(24:33):
Luckily for Henry, for this one, it sounds like it was in a
democracy.
You've had a majority at least.
But yeah, I want to get anupdate in like maybe a month or
so and see how that's going.
But yeah, thank you so much forlistening.
Everybody, we'll talk to younext time, take care.
Have you ever noticed how one wrong person in
a leadership role in your officecan derail the entire culture?
Recently, dph coach Dr HenryErnst had to make one of the
toughest calls as a practiceowner.
He had to let his officemanager go and while it was
painful and it was difficult, itreminded him of a powerful
(00:23):
truth Leadership is much tooimportant to get wrong.
Today, we're going to talk tohow to make sure the right
people are in the right seats,how to train and build up your
leadership team, and why thesuccess of your practice depends
on it.
Stay tuned.
You are listening to the DentalPractice Heroes podcast, where
we teach dentists how to stepback from the chair, empower
(00:44):
their team and build a practicethat gives them their life back.
I'm your host, dr Paul Etcheson,dental coach, author of two
books on dental practicemanagement and owner of a large
four-doctor practice that runswith ease while I work just one
clinical day a week.
If you're ready for a practicethat supports your life instead
of consuming it, you're in theright place.
My team of legendary dentalcoaches and I are here to guide
(01:07):
you on your path fromoverwhelmed owner to dental
practice hero.
Let's get started.
Hey, welcome back to the DentalPractice Heroes podcast.
I'm your host, dr Paul Etchison,and I'm joined by my DPH
coaches, dr Henry Ernst and DrStephen Markowitz Dr Henry's got
a large practice in theCarolinas 18 ops and Dr Paul
Atchison and I'm joined by myDPH coaches, dr Henry Ernst and
Dr Stephen Markowitz.
Dr Henry's got a large practicein the Carolinas 18 ops and Dr
(01:32):
Steve has got six practices onthe East Coast.
So some very experienced ownershere that we're going to talk
about.
A really good topic today andthis is something that I hear
with my coaching clients is thatthey will work with me and then
they'll say I can't believeyou've got problems at your
practice with all the systemsthat you got.
How do you have problems atyour practice still?
And I think there's thisglorified notion that once you
(01:53):
start systematizing yourpractice, the problems go away.
And it's just not the case.
I mean, things continue tohappen and I'm going to pass the
mic to Dr Henry right now, buthe had some pretty big it's a
pretty big turmoil recently.
Tell us about it, henry.
Henry Ernst (02:09):
Yeah, thanks for that introduction, Paul.
I think that the way that yousaid it is great.
We can have systems in place,we can have everything,
everything the way that we feellike is going great, but stuff
hits the fan.
And the best way I coulddescribe it is if I'm taking an
implant course and somebody'stelling me like, oh, they're
showing me all these greatthings, show me your failures,
show me where you screwed up.
(02:29):
And I think it's great on thispodcast for us to put our guard
down and say, hey, we have stuffthat happens in our practice
too.
So in our practice, you know,we're always really big on
promoting from within, having agreat work environment.
We have EOS in place and ourmost recent practice manager and
maybe I'll give you a reallyquick history we had a practice
(02:50):
manager from the two-monthinception of the practice till
about seven years and she wasgreat.
Everybody knew where they stoodwith her.
She wasn't super, super warmand fuzzy, but if I came in late
I knew that she was going tohold me accountable.
She was great in the businessaspect the front end of the
house there, which is greatbecause it complements me, and
being great with the back end ofthe house and stuff like that.
(03:11):
She left to start a family acouple years ago and we promoted
from within.
We promoted from somebody whostarted at the very entry level
entry level hygiene assistant,worked their way up, worked
their way up, got coached intobeing assistant, practice
manager and eventually practicemanager.
So, long story short, there weretimes in the last six to eight
(03:31):
months where I would getsomebody from my leadership team
telling me listen, we've gotproblems, people are not getting
held accountable, being late,which never happens in our
practice.
You know, people being late,people kind of slacking off a
little bit and nobody's holdingthem accountable.
And I use the example of achild, a child that wants to go
to sleep oh, your bedtime is 8pm.
(03:53):
Next thing you know, parentsslacks off, it's 8.15 and
nothing said.
Okay.
Next thing you know that's thenew normal.
So that's what was happening inour practice.
We have all these great corevalues and next thing, you know,
everybody's like slacking offjust a little bit, a little bit
here, a little bit there.
And that was the weakness ofthis practice manager is she
(04:16):
didn't want to have thoseuncomfortable conversations,
right.
And eventually somebody's fiveminutes late.
Next you know it turns a 15.
So we're creating a badenvironment there and, on the
other end, we're alienating thegreat team members.
The great team members are likedude, they're slacking off.
They're in the break room andI'm doing my job.
I always have to find them.
They're 10 minutes late for themorning huddle and that's.
(04:37):
It just sets a really bad, andthis has happened a few
different times and it wouldjust really aggravate the heck
out of me.
You know, we always talk aboutcreating that practice where we
can work two days a week, whichis what I have, and so I need to
be able to trust thatintegrator, my right hand, and
always defend them.
So I had a very difficultdecision to make and I actually
(04:58):
there was one of your podcastepisodes.
I had a guest from California,dr Kalasho.
Yeah, she had a great littlesnippet that actually played for
my team that she mentioned.
For example, if your officemanager is not holding people
accountable, it's not theowner's responsibility, it's the
practice manager'sresponsibility to talk to the
dental assistants, because wecan never run a business like
(05:20):
that and set the tone.
Right now we've got kind ofinterim One of my leadership
teams kind of running the showfor now, and right now we're in
the process of interviewing andthat was the first thing that I
said to this new person.
I said I told them exactlywhat's been happening.
We have great systems, we havea great reputation.
We just kind of went off therails a little bit.
(05:42):
And if I'm supposed to fly fromhere to Chicago and I've got
this pathway, that's directlypathway and for the first 10
minutes of the flight I'm goingjust a little bit off course.
It's not a big deal because wecan just correct it, boom.
But if you let that 10 minutespan go for 30 minutes, 40
minutes, next thing, you know,I'm headed to freaking
California or something likethat.
So that was what I mentioned tothe team.
(06:03):
We got off course and Ibasically said you know, these
are our principles.
We are on time, we do our job,we have respect for everybody.
If you want to be here, great,you're here, we're on the same
bus rowing together.
If not, you need to gosomewhere else.
And when this was announced,there was another team member or
two that was gettingpreferential treatment by this
(06:26):
practice manager that decided toleave also.
And that was great, perfect,right, we're clearing the deck
and now we're moving forward.
So you know, just being humble,this stuff happens.
Nobody's perfect.
I'm sure both of you havestories just like this here, and
I think the important thing isto look back, take a step back
and see how did this happen?
How could we, of course,correct it a little earlier, but
(06:48):
we ultimately make thechallenging decisions to move
forward, to correct the course.
Paul Etchison (06:53):
But I think it's hard because it's such a
disruptive decision.
It's like you're between thesethings where like, oh well, I
don't really like how that'sgoing, I don't really like that.
It's like all these like minor,like little paper cuts that
you're just like, ah, that'skind of irritating, but it's not
so big.
I mean, what eventually broughtthis to a head?
Was there a situation that justhappened recently where you're
(07:15):
like that's it, that is it, weare done?
Henry Ernst (07:18):
Yeah, so we had a couple of highly trusted
leadership team members come,and this is a hard hierarchy,
right, because we have ouraccountability chart.
So this is going outside theaccountability chart.
For those of you guys have EOSin your practices, you know you
have the visionary, which is allof us, the owner, and then the
integrator, and then everybodyis team leads and down.
So basically this kind ofskirted the pathway and they
(07:40):
came directly to me, whichshould never happen, but it was
that important that they had tocome up to me and tell me listen
, we need to talk you know, thedreaded words we always love to
hear.
As owners, we need to talk, andI would get detailed things that
were going on.
I verified again, wasted mytime, verified from looking at
cameras, footage and yes, thesepeople are late, nothing's
(08:02):
happening.
People are goofing off in thebreak room, nothing's happening.
And then it was correctiveaction on my part to say listen.
I used a John Taffer example ofthe show Bar Rescue he always
talks about.
If I'm walking down the hallsof the business and I see
somebody doing something wrong,if I decide to just I don't have
the energy for this right nowand just keep walking, you know
(08:22):
we have that right If somebody'sdoing something wrong.
Paul's like dude, I just wantto go sit at my desk and have
one of those cold hot dogs thathe eats or whatever.
Paul Etchison (08:29):
Oh, I thought you were saying you didn't have the
energy to do a Jon Tafferimpression right now.
I thought you were being like.
I thought you were reallygetting the character here for
us.
Okay, all right.
Henry Ernst (08:39):
Yeah, that would be interesting.
Don't have the energy to dothis conversation right now,
this difficult conversation.
I'm just going to walk past it.
The second that I do, that, inthat employee's eyes it's saying
to them oh, I'm goofing offhere and he just walked by.
That means it's as good, thisis the new normal.
So I had that conversation withher and telling her that when
you see something wrong, youneed to call it out right then
(09:01):
and there, in a respectful way.
Right, always give them the why.
This is why we're not, we don'tgoof off, because other people
have to take, do your job and dothis, you know.
So there was some action likethat and then it just didn't
happen.
I guess, looking back on it andtrying to do like a how did
this happen?
This person just didn't havethat ability to correct people,
(09:22):
and it takes a special type ofperson to be a leader ability to
correct people and it takes aspecial type of person to be a
leader.
Paul Etchison (09:30):
And not everybody's made to be a leader.
Yeah, that's what I've noticedtoo is that it's like with
working with so many practicesis it's you kind of don't always
know what you're going to getwith leadership, and you've got
to put people in thosesituations, you've got to give
them the opportunity to provethemselves and you've got to
give them training and help themthrough and hopefully you've
modeled good leadership.
But sometimes it's like there'sthat it and it's like how do
you, how do you correct?
(09:50):
I mean, steve, what are youthinking over here?
Steve Markowitz (09:52):
There have been times where we have had really
strong business team members andthen we put them in a
leadership position and theywere like no bullshit at
collecting AR and doing andsupposedly having difficult
conversations that I thoughtwere difficult because they were
in charge of billing or havinghandling patient complaints.
And then as soon as we put theminto a leadership position of
(10:13):
other people, they would go anddo the job for them, as opposed
to having a difficultconversation.
So I can totally understand howthat happens, understand how
that happens, and I think for usit's like how do we evaluate if
someone is capable of leadingand influencing others to do
their job, not just being reallygood at specific tasks?
But then to Henry, thank youfor sharing that.
(10:34):
I'm sure it's kind of been a lotfor you over the past little
bit, but how did you know thatyou weren't able to correct the
behavior?
Like, at what point in thisyou're like I'm hearing this,
all this information, it doesn'tsound good, but this person's
been with you for a long time.
I'm sure that there were timesthroughout that 10 years where
(10:55):
you're like I need to correctthis behavior.
I feel like I'm strong enoughto do it, but you didn't have
that feeling this time?
What was different for you andwhy?
How did those conversations go?
Henry Ernst (11:07):
Yeah.
So I'll give you a littlebackground.
This person I never had tocorrect ever.
And all this asked you know,hygiene assistant, dental
assistant.
In all this, you know, hygieneassistant, dental assistant, da1
, da2, assistant practicemanager, never, ever, ever.
And I would look, use theanalogy of, let's say, we're in
(11:27):
a boat, the darn boat has got ahole in it, it's leaking and I'm
able to plug it.
Actually, you know, it'sleaking some more and I'm just,
I just can't stop the leak andeventually I'm just drowning and
I just I had to do somethingabout it.
And in this specific examplethis is a specific challenging
example you have somebody who'venever had to correct before, is
perfect core values for thepractice and as they got
(11:47):
promoted to practice manager,they just didn't have that John
Taffer right, that ability tocorrect people and hold people
accountable.
So then you know, what do you do?
Do you demote them, do youterminate them and just tell
them why and start afresh.
So I made the decision to startafresh and when I told this to
(12:08):
the practice, everybody and Isaid this is why this is
happening.
We have to get on board.
Either get on board or I'llshake your hand and 95% of the
practice is like appreciativeand grateful because they were
the good ones that were upsetbecause others were goofing off,
so you kind of like strength innumbers.
So that was how I came to thatdecision and that's where we are
(12:29):
now and I feel like definitelycould tell there's a different
vibe right now.
There's a vibe of, okay, weneed a course correct and I'm on
the boat with you, dr Ernst,I'm going to go with you.
Steve Markowitz (12:41):
There is that law I don't know, it's some
business law that says we'regoing to promote people to a
level of incompetence.
So that's clearly an example ofthat.
But also our practices areliving organisms and the manager
that's going to be the bestleader when we're in super hyper
growth mode may not be the bestmanager when we're in mature
(13:05):
maintenance mode.
And I think that, from theowner seat or the visionary seat
or whatever we are callingourselves, we need to understand
that.
What is this person's strengthsand is that fitting with what
the practice needs right now?
Henry Ernst (13:19):
so to create maybe a learning aspect for the, the
listener out there right now, wejust decide to go a different
route where, for the first timein the history of the practice,
we're hiring a practice managerfrom outside the organization,
somebody to come in brand new.
So I kind of equate it tosports.
We've all had our teams thatwe've, you know, root for and
stuff like that, and once in awhile maybe the coach leaves or
(13:41):
the coach retires or gets fired.
And next thing, you know, maybethey bring in what's called a
player's coach.
Oh, we're bringing in a newcoach, new idea, and all of a
sudden a year or two goes by andit's like, dude, this player's
coach is not working, man, theydon't have any discipline,
they're getting penalties.
Next thing, you know, you goback to the disciplinarian coach
and all of a sudden, boom, itworks, and sometimes you're
right.
Like a team, there's cycles.
So where I'm going with this isright now we're going with
(14:04):
somebody outside yourorganization.
Paul Etchison (14:06):
Nobody knows, and I was going to follow up and
ask you, henry, do you feel like, in retrospect, that you could
have saved this had youintervened earlier?
Or do you think this was justthe top out of this person's
leadership ability?
Henry Ernst (14:17):
I think sometimes you either have it innately or
don't.
As far as this goes, you haveto be able to be comfortable to
call out people and I think somepeople just want to be a little
too much buddy.
Buddy, you know, and it's likeI always tell some of the team
like my team respects me, right,and they'll come by my office
and shoot the breeze with me.
They did this this weekend,that weekend, but at some point
(14:38):
in their mind there's like atime clock when they're like,
okay, this is good, so theyrespect me, but they don't have
to.
I hope they all like me, and Ithink they do, but they have to
respect you.
I like your head.
Well, that means a lot to me,Steve, but you have to respect
and respect has come from youknow, when you do, you're always
going to hold peopleaccountable and they know where
you stand.
(14:59):
Like I said, the previouspractice manager was not warm
and fuzzy, but when you werelate, you knew she was going to
come up to you and tell you thatyou were late and we can't do
this anymore.
That's what we need, yeah.
Paul Etchison (15:10):
I think that's you know, it's interesting.
I and it said something like asa leader, we like respect and
as a leader, like even fakerespect, like leaders still
appreciated it.
Like, even if they knew theperson was like brown nosing a
little bit and it was somewhatingenuine, the leader still
(15:30):
appreciated that because itshowed some level of respect.
Steve, you know what do youthink?
I mean you develop tons ofleaders.
You got six practices.
How do you know if this issomebody that can learn more or
somebody who's topped out intheir leadership?
How do we not make thesemistakes?
Sure?
Steve Markowitz (15:46):
A couple thoughts.
One is are we trying to findwhat this looks like from
bringing someone in from theoutside, because that's a whole
podcast?
I'd love to unpack likebringing in a leader from the
from the outside, because thatis a?
Yeah, there's a ton to unpackthere, but for most dental
practices they are like thisperson left now we're going to
promote from within.
How do we know if that person'scapable?
(16:07):
The greatest success I've everhad is not providing positional
power, for that respect occurs.
I will never forget the timewhen we announced Karen our
regional manager was the managerof the practice that she
started as assistant, as and Iwas all excited.
I brought in a freaking cake,maybe balloons, and I made this
(16:28):
announcement and I was like guys, I'm announcing Karen as the OM
and it was like silence.
It's like what?
Why is no one excited?
I thought Karen was the om.
Oh, that was the response.
Everyone was like, oh, she'salready.
I thought she already did that,she already had that level of
respect.
We already had thoseconversations.
I was to plant seeds, not withthe team, both karen of like all
(16:51):
right, do you want to take offthese responsibilities?
What does it mean?
Clearly to hold someoneaccountable.
What are our non-negotiablesFor Henry?
It sounds like if you'reshowing up late, that's a
non-negotiable.
If you're not going to holdsomeone accountable, that's a
non-negotiable.
So before we give the title, wehave a ton of conversation
(17:11):
around what does this look like?
And I almost want to talk himout of the position, because if
I'm doing a job telling them howhard this is and how much
leadership, responsibility,leadership is, how much this
sucks, and they still say thatthat's something they want to do
, then they're going to be ableto do the hard shit.
If they're like just thinkinglike this is the next step in my
(17:32):
career and I deserve thisposition because I was so good
at this, I'm going to be greatat that.
And they're more concerned withthe positional power and that's
their motivation.
Most of the time they aren'twilling to have that level of
difficult conversations, andwhat happens in most dental
(17:52):
practices is we're not proactiveenough.
So we have this opening.
We want to fill it as quicklyas possible because I don't want
to do more shit myself.
So then we look around and sayyou're the best person for this
here.
I guess You'd be awesome.
Let me tell you how great thisis.
Let me sell you on the positionas opposed to having you
(18:14):
understand truly what theresponsibilities are of
leadership.
Paul Etchison (18:17):
So you're saying that because this is interesting
, because I do this with myclients a lot and we talk about
how, when we put somebody in aleadership position, I always
feel like, as the leader, youneed to give that person the
blessing and like you need togrant them the authority of
being in a position in charge.
But you're saying you show methat before I grant you the
authority.
Steve Markowitz (18:38):
So we were just talking about respect.
Respect doesn't happen becauseyou're in a position of power.
Respect happens because you areactually influencing and
earning that respect.
That's interesting.
So what I'm telling this leader, or future leader, is earn
respect of your team.
They will fight through wallsfor you, the same way that your
(18:59):
team loves you, Paul, and yourteam loves you.
They don't love you becauseyou're the owner of the practice
.
They may like you and respectyou.
Part of it because you signedthe checks, but mostly it's
because how you serve them andhow you treated them and how you
made them feel and how you'reable to help them.
All of the things that we dofor our team is what I would
expect someone to do in aposition of leadership.
(19:20):
The owners that struggle themost and have the most HR
problems and have the mostturnover are the people that say
you're fucking here to work forme.
Paul Etchison (19:29):
Yeah, and.
Steve Markowitz (19:29):
I'm the owner, show me some respect.
And I'm the owner, show me somerespect.
And I'm like you got this wrong, babe.
It's backwards.
I'm here for you and if I canserve you and give you what you
need, alongside with what thepractice needs, then I will have
all the respect in the world.
And this team will go throughwalls for me and they'll make
sure they show up on time.
(19:50):
And they'll make sure they showup on time and they'll make
sure they do their job and theymake sure they're focusing on
results.
So I need to make sure thatperson is fully understanding
that level of responsibility andI almost want to talk them out
of it because it is heavy andit's not fair to them to put
them in a position that theydon't know if they want to
succeed in.
Paul Etchison (20:09):
You know, what's interesting about you saying
that is that I was going backthrough the six years of
coaching and I wanted to say,okay, what are the stats and
collection increases, what arethe amount of clients?
I have been able to double,triple their collection, like
things like that.
And what I saw is I had somestats that were lowered by
certain coaching clients andwhat's funny is I don't work
with these people anymore.
(20:29):
It is that leader.
It is that exact leader.
When I'm having a strategy callwith somebody and I sense that
that that person is like youwork for me.
I'm the boss, because I said so.
These people are stupid.
I can't find the right people.
Nobody does what I tell them todo.
Those are the type of leadersthat you sense it?
Henry Ernst (20:46):
I say I can't help this person, I cannot change the
way this person leads, and Ithink now going forward, my
stats are going to be evenbetter because I'm not taking
those people as clients.
Yeah, I think what's reallyimportant is servant leadership
right, no matter what positionwe're in to this day.
I mean, I walk down the hall.
I see a piece of paper on thefloor.
I'm not above doing that, right.
(21:06):
You know, the garbage needs tobe taken out.
I'm not above doing that.
It's all about respectingleadership, because we can do
anything right, and I love thisquote that I saw recently by a
football coach you know, if youwant to make everyone happy,
don't be a leader.
Sell ice cream, because as aleader, you're going to be
respected, but some people mayjust not.
They may be nervous around youor this or that.
(21:28):
It's a lonely sometimes.
Being a leader is a lonely lifesometimes, and you just have to
be able to accept that.
I'll sell ice cream and I'llmake everybody happy, unless
they're going to complain aboutthe prices.
Paul Etchison (21:39):
You can sell those WWF shortbread like cookie
, those shortbread things, withthe WWF people.
Henry Ernst (21:43):
Those are my favorite.
I think you're showing your age.
I think those are pretty oldPaul.
Paul Etchison (21:47):
Shut up, those are pretty old.
Steve Markowitz (21:49):
Paul, shut up.
They still have them.
Really, I haven't seen those in, honestly, years.
Paul Etchison (21:51):
I don't think that they exist anymore.
You're right, I don't thinkthey have those anymore.
Henry Ernst (21:54):
I think back in my day it was like a Roddy, Roddy
Piper one.
Paul Etchison (21:59):
I like some Cracker Jacks here.
They're only a nickel.
Steve Markowitz (22:01):
Paul's eating scale cookies.
He probably gets like the.
You know those old baseballcards that had the gum in them.
It would be the best tastingthing for like two bites, and
then you would immediately getlike some carcinoma of the
tongue.
Paul Etchison (22:13):
Yeah, yeah, no, my baseball cards are digital
now, so whatever, okay cool.
Yeah, you're pretty cool.
Henry Ernst (22:20):
So I'll kind of summarize too.
I know this is a good topic,for you know an episode and
stuff like that, but it maysound more of a problem than it
really really is, becauseessentially, out of our 35 team
members, you know, the practicemanager is not there anymore and
one other person decided toleave.
Another person we had to have aheart to heart, so everybody
else on the entire team waswanting this to happen, believe
(22:42):
it or not, like they wantedchange.
They wanted their workenvironment to be an accountable
work environment.
So that's actually a reallygood thing.
And another beta testing thathappened and maybe this is
another idea for large practicesis right now we've kind of got
a hybrid system.
Right now We've got one personthat's the director of
operations, kind of like, takingcare of all the business
aspects of things, and we haveone person right now that we're
(23:04):
calling the director of people.
So any people problem, whetherit's a patient, an employee that
has a problem, that's theirperson.
So it's actually worked kind ofwell.
I mean, it's not what we'regoing to keep doing, but that's
another hybrid model that I kindof thought of, because
sometimes you mentioned it,steve if you have people that
are really strong in this, butmaybe not good in this, and that
could be another hybrid modelfor a large practice that could
(23:25):
work also.
Steve Markowitz (23:26):
I love that.
Yeah, that I do not want toapply for the director of people
position.
That sounds heavy.
Henry Ernst (23:30):
That takes a special person, because your
main job is to haveuncomfortable conversations.
You're basically being the JohnTaffer.
Shut it down, john Taffer.
Steve Markowitz (23:41):
There it was.
We had energy for that, paul,we did it.
We got the.
We got him to do the.
John Taffer, it only took 26minutes.
Paul Etchison (23:49):
He had to get all amped up.
Dude, he's pumped up.
Man, he's raging.
Yeah, dude, great.
I'm so glad that we were able toshare this and it's such a good
topic for people and I thinkthe next time we do an episode,
I think we should do promotefrom within or bring it from the
outside, because I think thathappens to a lot of us and we're
always looking well, you knowwhat We'll do it the next one.
But yeah, henry, thanks so muchfor sharing that.
(24:11):
And Steve, you have some greatwisdom there.
This is a tough situation.
This goes to show you, I mean,no matter what level of practice
you get to, you will still haveissues and you still will have
problems to solve, and that'stotally okay.
That's not a failure ofleadership on your part, it is
just.
I think, like Henry mentioned,this is a tough decisions have
to be made and sometimes they'renot the most popular.
(24:33):
Luckily for Henry, for this one, it sounds like it was in a
democracy.
You've had a majority at least.
But yeah, I want to get anupdate in like maybe a month or
so and see how that's going.
But yeah, thank you so much forlistening.
Everybody, we'll talk to younext time, take care.
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