253 Do we Fire or Train Part 1

Welcome to the KC CHIROpulse Podcast.  

This week’s topic: Why most Chiropractors hire the wrong people!

The KC CHIROpulse Podcast is designed for Chiropractic professionals ready to elevate their practice to new heights.  This week, the show is hosted by Kats Consultants’ coaches Dr Michael Perusich and Marisa Mateja, seasoned experts in Chiropractic business management.  This podcast provides invaluable insights and actionable strategies to help you create a flourishing and sustainable Chiropractic business.

In the first of two episode series, we discuss:

• Why not every employee issue is a firing issue
• Which employees might be really dragging the practice down
• Why creating better hiring and training standards is so important
• Why the hiring process is strategic, not administrative
• …and so much more…

In each episode of KC CHIROpulse, we delve into crucial aspects of building a successful Chiropractic practice, covering topics such as establishing a strong foundation, adopting a patient-centric approach, mastering marketing techniques, achieving financial fitness, fostering effective team building and leadership, integrating technology and innovation, and navigating common challenges in the field.

Whether you're a seasoned chiropractor or just starting your practice, the KC CHIROpulse Podcast offers a wealth of knowledge and personalized practical advice to help you navigate the intricate world of Chiropractic business. Join us on this journey as we explore proven strategies, share success stories, and connect with industry experts to empower you in your pursuit of building a thriving Chiropractic practice.

Don't miss out on the latest insights and expert guidance. Subscribe now and unlock the secrets to taking your Chiropractic practice to the next level. Your success is our priority at Kats Chiropractic Business Advisors.

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Transcript

Hire or Fire part 1

Why Hiring Goes Wrong

[00:00:00] 

Dr. Michael Perusich: Doctors, do you know why most chiropractors hire the wrong people? Hi everybody. Welcome to the KC ChiroPulse Podcast, bringing you cutting edge business strategies that are over the top and here to make you outgrow your competition. I'm Dr. Michael Perusich, your host, and this is my guest host, not guest host.

My co-host Marisa Mateja. Hi Marisa. How are you? 

Marisa Mateja: I'm good. How are you? 

Dr. Michael Perusich: I'm good. We're getting ready to dive into a two part series, y'all. So hang on. We are gonna talk about something that's really important and I think it's a conversation that oftentimes doesn't go deep enough. When we hire people, that's kind of what we're talking about here.

It's kind of a surface level thing most of the time. And we really need to dig deep in very, very deep on this topic because too oftentimes we're hiring the wrong people. And what, what happens, we wind up with a whole bunch of turnover. We talk to you guys out there all the time and everybody's facing the same thing.

Oh my gosh, I've gotta hire staff again. 

Marisa Mateja: Yeah. 

Dr. Michael Perusich: And it's not fun. So 

Marisa Mateja: the other side of [00:01:00] that is sometimes we keep people. We shouldn't, right. So sometimes we 

Dr. Michael Perusich: exactly 

Marisa Mateja: hire too fast and sometimes we keep too long. You know, there's a balance somewhere in there. And I would say you might even have to diagnose your people figure out, 

Dr. Michael Perusich: and that's really, that's the big issue.

Marisa Mateja: Yeah. 

Dr. Michael Perusich: Figure 

Marisa Mateja: out who 

Dr. Michael Perusich: is, we're not really 

Marisa Mateja: do you need and who you're gonna hire. Yeah. 

Dr. Michael Perusich: And sometimes we not really getting cross, getting crossways with staff isn't really the right term, but sometimes we feel like they're not working out or they're not engaged enough or something.

And is that their fault or is it our fault? 

Marisa Mateja: Yeah. 

Dr. Michael Perusich: As the clinic owner. And I think we have to learn how to diagnose our people so we know how to train them. And of course that's a whole big topic, you know, that's kind of a pet peeve of mine. A lot of doctors want to just throw some thoughts, throw, show somebody how to do something once, and that's not, that's not training, that's not [00:02:00] how you practice.

That's not how you get better. So I love this concept of you have to diagnose your people. I think that's very, very important. You know, because when we get into scenarios where it seems like an employee isn't working out, maybe it's not always a firing issue. Sometimes we just have to learn how to save good people.

And if we don't diagnose them, we don't understand them deep enough to know whether or not we should save them. 

Marisa Mateja: Sure. And I think that that goes with having a good training programs set in place. It goes with continual training and then having your leadership on point to make sure you're paying attention to whether they're saveable or not.

Dr. Michael Perusich: Yeah. Yeah. You know, and docs out there you don't build a high value practice without doing training. Training is so important and we don't spend enough time doing training again, we just wanna throw some thoughts at, at people and, you know, show 'em [00:03:00] how to use your EHR once and gloss over how billing and collections works, and maybe they don't, don't have any experience at it.

And so we're not giving people a deep enough understanding for them to be able to do things the right way for us. 

Slow Down and Train Right

Marisa Mateja: Well, I think, I think it's normal in most of our practices that when we get ready to hire, we're doing it. Under pressure, right? Like we're we're typically in panic mode. We've gotta get somebody in there, we've gotta get somebody in that seat.

We've gotta fill it now. And so 

Dr. Michael Perusich: Yeah. 

Marisa Mateja: Instead, so we 

Dr. Michael Perusich: fill it with a warm body. 

Marisa Mateja: Yeah. And, and we've all been, in those scenarios and it happens. So a lot of times I feel like we've gotta slow down mm-hmm. To really make sure we've got our job descriptions. Put out there correctly, making sure that it's exactly what we need, that we're hiring for.

Then we've got to make sure that the people we're interviewing are going through some personality tests, some communication tests. [00:04:00] We're making sure that they're truly who we want in that seat, and sometimes we've got to slow down, but in our practices, because we run our practices. With a lot less staff and those kind of things than a lot of other practices, do you end up in these panic moments because, well, I just don't have enough people to get the job done, so we've got to just hire and put 'em in there, whatever, and then we go back to, if we're not leading them along the way, then.

We're not giving them the knowledge base and I'll give you a great example. I was talking to an office the other day and they've got somebody in a role that really has no understanding of insurance and billing, but yet they're collecting money for the practice. Okay. Wow. Stop. Stop right there.

That's a training issue. That person has to have the knowledge, they have to understand the insurance, they have to [00:05:00] understand what's going out to be able to know what to ask for from the patients. That's huge misstep. If you ask me if you've got people in roles that don't understand what they're doing.

Is it a training issue? Probably this person's very intelligent. They could pick it up, but they've not been given the information. So that goes back to we've got to lead our people in the right places to make sure that they can be the people that we want to keep on our team. 

Dr. Michael Perusich: Yeah. 

Hire for Profitability

Dr. Michael Perusich: And that's a great example of really why we should be hiring people.

We should be hiring people, not to just fill a position, not to just fill a seat, not to bring another warm body in. That just increases the chaos in practice. But we need to be hiring people with return and profitability in mind. 

Marisa Mateja: Yes. 

Dr. Michael Perusich: And if we don't. Do that. Then your example is perfect. That person who's doing your collections, [00:06:00] that's a pretty important role, right?

If they don't understand how patient's insurance works, how write-offs and those kind of things work. Mm-hmm. How the allowables balance on their Yeah. Allowables and limiting fees and you know, all those great things. And they don't understand how the balance on a patient's account actually was calculated and got there.

How are they ever gonna explain it to a patient? And one of the number one ways to spin a patient out of practice, out of the office is to confuse them about finances. 

Marisa Mateja: Absolutely. 

Dr. Michael Perusich: And so that person, only because they haven't been trained and their knowledge level hasn't been brought up to speed, they've put, been put in a position where they're actually going to depress.

Our return and our profits are gonna be lower because of that. 

Marisa Mateja: Well, it's it's this clear sign of people leaving the practice because they don't understand what their insurance is gonna do. They don't understand, and I hate to say this, but I feel like a lot of us are scared to talk about money, right?

It's. [00:07:00] Plain and simple, but a lot of it is the training. It's just not understanding it. Once you understand it, it can be very black and white, right? Here's what our fee is. Here's what your insurance is gonna do, here's what you owe. It can be very black and white if you make it that, but you have to have the knowledge to start with to get to that point.

So are people really a hiring mistake or is it a training issue? That's what you've gotta define. 

Dr. Michael Perusich: Were we really thinking when we hired that person, not only are they the right person, but can they, are they somebody who can gain the knowledge that I need for them to have in that position to be able to produce and protect our revenue streams?

Marisa Mateja: And everybody on the team, in my opinion, should be a revenue generator of so kind. 

Dr. Michael Perusich: Absolutely. A hundred percent. Hundred percent. 

Marisa Mateja: They've gotta be able to dig into the practice and help. 

Dr. Michael Perusich: Yeah. We need to take a quick break. We're talking about something that's very, very important. So I hope y'all are sitting up and taking [00:08:00] note of this.

This is probably a podcast you're want to gonna come back and listen to more than once. 'cause there's gonna be a lot of jewels in here. And remember it's a two part series too. So we'll be right back, um, after a quick word from our sponsors.

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Dr. Michael Perusich: Okay. Okay, everybody, welcome back to the KC ChiroPulse podcast.

Marisa. We're talking about something that's pretty darn important and that's the hiring process. 

Marisa Mateja: Yeah. 

C Players and Standards

Dr. Michael Perusich: And there, there's a concept that [00:09:00] you bring up actually quite a bit and it's. Kind of the silent killer sometimes in the hiring process, and I'm gonna let you kind of roll with this, but it's the C player versus the A player.

Marisa Mateja: You know, I love thinking of it like this, right? Everybody could be an A player is my feeling, however. 

Dr. Michael Perusich: Mm-hmm. 

Marisa Mateja: Are they an A player on your team? That's the nugget that we have to remember is that not everybody's going to. Be that person that generates revenue for your practice. Not everybody's going to be the person that learns all the insurance.

They're not gonna be the person that talks about money. They're, mm-hmm. There are people who just don't fit certain roles. Have you put somebody in a role that's making them a C player? Yep. That's, that's the question, right? Are we putting them in a position? Well, maybe they're not bad enough to fire, but they're not strong enough to grow.

What do I do with them? [00:10:00] That's the bigger question, right? 

Dr. Michael Perusich: And far too often we let them just lumber along and continue to be a C player. And what do you get out of a C player? You know, if you've played sports, what you get out of a C player is you don't get excellence and you don't get complete failure.

It's just kind of this neutral result and. In, in this scenario, neutrality actually leads to negative outcomes. 

Marisa Mateja: Yeah, for sure. And I, I think that's the, I think that's the position we all end up in is, okay, do I have the right person, but they're in the wrong role. Is the C player trainable? Can they make it up to an A player?

Those are the questions. But you've gotta have somebody that creates urgency in the practice, that communicates value to your patients, that engages all the patients in the education process, and having [00:11:00] them understand from the very beginning, here's what your insurance is gonna do for you.

Here's what our cash plan looks like. Here's what you know. It's communication throughout. And if people aren't in the right role, what do you do with them? I mean that, that's the biggest, because your business is going to require momentum. You can't live on maintenance. You've gotta have some kind of momentum moving forward.

Mm-hmm. And if your players, your teammates are C players, you've got to do something with them. And it's either train them or let them go. Yeah. 

Dr. Michael Perusich: And here's 

Marisa Mateja: the thing, you're not doing, you're doing them a disservice because they could be an A player somewhere else. 

Dr. Michael Perusich: Sure. Absolutely. And c players are not hard to spot.

You know, they're, they're the teammate that doesn't create any urgency with their role. 

Marisa Mateja: Yep. 

Dr. Michael Perusich: They're not, I don't wanna say they're lazy, but they're just. It, they, they just [00:12:00] don't have that urgency behind them 

Marisa Mateja: mm-hmm. 

Dr. Michael Perusich: To really help drive the vision of the clinic. They don't know how to communicate value to patients, for example.

And in today's world, that is hugely important. They don't know how to create, uh, be part of creating the, the patient experience in the office, and they don't know how to help you. The doctor, keep patients engaged in care. And these are all important. I don't care what role you're in, in the office, those are the basics.

And if you don't see those things with your staff you've gotta decide, is this a training issue? Is this a individual training issue? Is this a team training issue? Do I need to restate the vision or do I just have the wrong person in that role? 

Marisa Mateja: Yeah. Yeah. And it could even be a standard issue. It could be a standard 

Dr. Michael Perusich: issue, meaning, 

Marisa Mateja: you know, do we have a team that has energy ownership, engagement, all of these things, or are we [00:13:00] not leading that kind of energy?

So I feel like that could also be a factor that we've gotta watch. Are we creating a higher standard for our employees every single day? 

Dr. Michael Perusich: Okay, so you bring a great point here. Doctors, you can't just throw the practice to your staff. You have to lead. 

Marisa Mateja: Yeah. 

Dr. Michael Perusich: And so they're always going to follow your lead.

And if you're acting like a C player, and you better not be if you own the clinic, 

Marisa Mateja: right? 

Dr. Michael Perusich: You need to be the a plus player, but they're gonna follow your lead. All day long. And if your energy is low, if you're not engaging patients, if you're not helping to create that patient experience, if you're not driving the vision and the profitability of the practice, your team won't do it either.

Marisa Mateja: Well, that's 

Dr. Michael Perusich: what you tolerate. So they can't take, yeah, they can't take over that role for you, but they can support you in it and make it better. So , you, you can't have a really bad, poor, skilled [00:14:00] quarterback on the field and expect the rest of the team to win the game. It just ain't gonna happen.

So we've gotta step up , and really step into that role and that, and that's what Marisa's talking about here when she's talking about the standard, we have to set the role of what that standard looks like. And, you. You don't get what you hope for. 

Marisa Mateja: Right. 

Dr. Michael Perusich: You get what you tolerate. 

Marisa Mateja: Yeah.

It's it's setting that higher standard. Don't just stay down here. You know, if you 

Dr. Michael Perusich: Right. Don't accept CA, 

Marisa Mateja: c average. 

Dr. Michael Perusich: Yeah. 

Marisa Mateja: You want, you've got to set the standard for what you want and don't just hope that it happens. 

Dr. Michael Perusich: Right, right. Exactly. 

Marisa Mateja: It's your business. 

Dr. Michael Perusich: We need to, uh, real quick hear another word from our sponsors.

So everybody hang on. We're talking about the hiring process. This is good stuff in this two part series. So, hang in there. We'll be right back.

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Dr. Michael Perusich: Alright everybody, we are back. Marisa. There's a lot of takeaways here. Yeah. And you know, I love this idea that we have to have a higher standard, we have to have leadership in the practice. We have to lead by example 

Marisa Mateja: train 

Dr. Michael Perusich: Our, we have to train. And that's a constant thing. That's a constant thing.

Marisa Mateja: And we have to set very good rules for what we're hiring. Who we're hiring. Yeah. What we're hiring for and who we're hiring in those roles. 

Teaching vs Training Wrap Up

Dr. Michael Perusich: And let me throw out this concept. There's a difference between teaching and training. And I think too often we have this mixed up in this profession and we do a lot of teaching.

So what, what is teaching? Teaching? Well, let's go back to school where you were taught things. Mm-hmm. You taught something out of the textbook one time you take a test on it to test your one time knowledge. 

Marisa Mateja: Mm-hmm. 

Dr. Michael Perusich: But how many of you still [00:17:00] remember basic algebra? I mean, you remember being in the class, but do you really remember the confines of basic algebra and all the rules?

No, because it was taught to us one time in a lack of use environment. In practice, it needs to be an over and over concept. So training is what you do as part of a team in sports, for example. Mm-hmm. You train constantly, you train Monday through Saturday to go out and play the game on Sunday. 

Marisa Mateja: So it's it's 

Dr. Michael Perusich: role 

Marisa Mateja: practices.

Dr. Michael Perusich: Yeah. And it's, it, it's a constant thing. 

Marisa Mateja: Yeah. 

Dr. Michael Perusich: And so I think far too often in the profession, we have a tendency to just wanna teach. Yeah. Here's a procedure manual. Just read it and do your job kind of idea. Instead of, let's practice, let's do this individually, let's do this as a team.

How does it all fit together? And I think that's incredibly important. Otherwise, all we're doing is creating an administrative team of task. Do. [00:18:00] 

Marisa Mateja: Yeah. And it, listen. Hiring is strategic. You know, it needs to be. 

Dr. Michael Perusich: Absolutely. 

Marisa Mateja: Absolutely. And I, the, in our practice, what we would do is look at the team that we had.

Mm-hmm. We went down to even looking at who were the people on our team, were they in the right roles and what were their personality types? Did they match up with the role they were in? And who are we missing as a full scale practice for personality types? We need 'em all. Sure.

There's not a bad personality type out there. We just have to know if they fit in the role that you're, you're hiring them for. So everything's strategic or should be 

Dr. Michael Perusich: everything's Yep. Everything's strategic and we have to make decisions, not out of emotion. 

Marisa Mateja: Yeah. 

Dr. Michael Perusich: We have to make, we have to make decisions that are really diagnostic.

Yeah. And so if you've got a hole in your team right now, maybe. Maybe somebody's left, retired, took another job, whatever. Don't panic. Don't [00:19:00] panic. 

Marisa Mateja: The biggest thing, 

Dr. Michael Perusich: stop and think about what the role is. Who do I need to fill it and how am I going to get them up to revenue, generating speed for the practice and kind of what, piggyback on what you were just saying.

How are we going to help them fit into the team? 

Marisa Mateja: Yeah. Yeah. 

Dr. Michael Perusich: And that integration is incredibly important. 

Marisa Mateja: Yeah, , it's important because , if you don't get the right thing, your clinic doesn't. Gel. It doesn't function normally. It, 

Dr. Michael Perusich: yeah, you can't get this wrong. 

Marisa Mateja: It just doesn't work. Like you, you've gotta have the right people in place or.

There's a cog in the wheel and you can't ever get going. It's just like exactly, you're just on a hamster wheel, right? You're not, you just can't get out there and run free. So it's very important to make sure that you're picking the right people to put in the right roles for that person. Because again, I'll go back to my CNA players.

You want everybody on your team to be a players. [00:20:00] 

Dr. Michael Perusich: Absolutely. And I think that's a great way to end this, this part one of our two part series. You know, next time, , we're gonna talk about the concept of do you fire or do you train more? 

Marisa Mateja: Very 

Dr. Michael Perusich: good. And so be sure to tune in for that. Marisa, anything to add before we close out?

Marisa Mateja: No, I don't think so. I think this was great. Just, you know, let's, let's make sure that we've got the right people in place. 

Dr. Michael Perusich: Yes, and when you have the right people in place, let's get them trained so they become even better over time. 

Marisa Mateja: Absolutely. 

Dr. Michael Perusich: Alright, everybody from all of us here at Kats Consultants, make sure you go to Kats consultants.com, check out all the great stuff we're doing to help doctors really create profitable practices, and that's important.

Rosa, we've got some free downloads on there and things as well. 

Marisa Mateja: Oh yeah. Free classes, free downloads. , Lots of knowledge to share with you. Of course, you can check out several of the podcasts. And different things that we've always got going. So lots of information out there for everyone to dive into.

We've also got a virtual [00:21:00] seminar coming up, uh, May 14th. And so if you are curious about what our teaching style is, uh, what we do go to our events page and sign up. Come join us for that day. It's a four hour class. Lots of information. It's called Game On. You'll see it on our events page. Go sign up.

Come see what we're doing, and see what kind of information you can share with your team. 

Dr. Michael Perusich: And I think you'd be pleasantly surprised at how different we are. Yeah, we just have a different approach to practice, which really works. All right. As I always say, know your business, know your numbers, or stay broke.

We don't want you to stay broke, so be sure to tune into the Casey Puls podcast every week. Be sure to like and subscribe as well. And we will see you next time. 

Marisa Mateja: See ya.