Ep. 108: Finding the Right Office Manager for Your Practice
If you’re a regular listener, then you already know how important it is to have a highly competent Office Manager for your practice. This week, we bring on special guest Sabri Blumberg to discuss how to find the right person, what attributes to look for, and getting them started on the job successfully.
Links:
Running the Day Checklist - https://www.mgeonline.com/running-the-day-checklist
MGE Power Program - https://www.mgeonline.com/power-program
DDS Success (coupon code RX269) - https://ddssuccess.com
Free Consultation - https://www.mgeonline.com/free-practice-analysis
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Questions From This Episode
What does Sabri say separates a real office manager from the traditional "good front desk worker" version of the role?
A traditional office manager is really just a competent administrator handling tasks like insurance and bookkeeping. A real office manager runs the business side of the practice, responsible for its profitability, expansion, and the quality of patient care, essentially the person running the practice day to day, under the doctor's oversight.
What personality traits does Sabri look for when evaluating whether someone could become an office manager?
She looks for ambition and a genuinely solution-oriented outlook, someone who believes a goal is achievable rather than immediately listing reasons it can't be done. Sabri says these traits tend to be fixed parts of someone's personality rather than something that develops with age or experience, so she doesn't weigh a candidate's age or tenure heavily in the decision.
What does Sabri recommend when a practice's current "office manager" doesn't actually have the right attributes for the role?
She says you can't strip someone of a title they already hold without creating real damage, so that person keeps their title and role, often narrowed to a specific area. The practice then looks internally first for someone else to train as a business manager, since good salespeople in a practice often make strong manager candidates too.
Why does Sabri disagree with the idea that spouses shouldn't work together as owner and manager?
She says it's actually one of the best combinations she's seen, since both people are fully invested in the business, as long as they set ground rules: not doing each other's jobs, not bringing work conflicts home, and treating each other with the same basic respect they'd extend to any other coworker.
How does Sabri say a doctor can tell within the first few months whether a new office manager is working out?
The clearest signal is statistics, real, meaningful movement toward whatever goal was set, along with whether the manager is actually taking initiative rather than only acting on direct orders. She says most doctors already know deep down within the first few weeks whether it's working, but often delay acting on it while hoping the person's attitude will somehow change on its own.
Episode Transcript
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Jeff: How would you describe the perfect, or ideal, office manager in a dental practice? A lot of that depends on how you define the position to begin with. Back in episode 19, I talked about how we here at MGE view the office manager position, along with its responsibilities, duties, and outcomes.
In a nutshell, if you want long-term success in your practice, an office manager is one of the most important, if not the most important, hire you'll ever make as a doctor owner. So if that's the case, where would you find this person? What qualities would you look for? And while nothing in life is guaranteed, what are the boxes you'd want to check to feel comfortable making someone your office manager?
That's what we're talking about this week. My name is Jeff Blumberg, and I'm your host, joined this week by Sabri Blumberg, our Deputy Chief Operating Officer. If you've been listening to the podcast for any length of time, you've heard Sabri quite a few times, she's probably my most frequent guest, wouldn't you say?
Sabri: Yeah, probably. I've been on quite a bit.
Jeff: Sabri is our Deputy Chief Operating Officer here at MGE, and our top technical person, meaning she's in charge of all of our technical delivery. I think it's fair to say you've worked with several thousand clients over your time here.
Sabri: That sounds about right.
Jeff: I wanted to have you on this week specifically because, as you know but the listeners might not, you've been involved directly in helping clients select the right office manager and build strong office manager performance, probably more than anybody else here.
Sabri: Sure, along with training those individuals.
Jeff: Not just the office manager, but the doctor too.
Sabri: Right.
Jeff: Before we get into how we actually find one, how would you briefly describe the office manager position, the way we see it?
Sabri: Usually in dentistry, an office manager is treated more like an administrator, or sometimes just a very competent worker, someone at the front desk who knows everything about the front desk, which gets labeled a "good worker" or "very competent employee." Sometimes they do a bit more, basic bookkeeping, paying bills, some hiring. That's the conventional view of a manager.
But when you actually look at what "managing" means, it means you're doing something, running the place, responsible for the expansion and profitability of the practice. That includes the quality of the product too, and by product, I mean are we actually turning out healthy, happy patients. That's what an office manager is responsible for, which means they need to be conversant in management: getting people to actually get work done, organizing things productively, and turning a profit. They're really running the business end of dentistry.
Jeff: I think this connects to something we talk about with clients constantly, doctors also have to know how to manage themselves. That's actually a question I wanted to ask you later. When we train a manager, we always train the doctor at the same time. Some people wonder why we can't just train the manager, but the owner has to stay in control of the business. You also can't be in a position where your office manager goes skiing, breaks their leg, and the whole practice falls apart.
Sabri: You can still manage with a broken leg, though.
Jeff: Not if you're in traction. But where it really goes wrong is that the doctor, in most offices, is the primary producer. So who's watching the store, who's managing the business while you're producing? You're not going to manage at night or before you start seeing patients in the morning. The manager is really making it possible for the doctor to produce.
Sabri: So the manager is the person running the business, essentially, for all intents and purposes.
Jeff: With oversight from the doctor owner.
Sabri: Correct.
Jeff: Got it. The manager runs the business and is responsible for its profitability and expansion, and the doctor, when they're being the doctor, is responsible for the product of the business, meaning the dentistry. So with a new client, we're not just looking for someone who's really good at filing insurance.
Sabri: That might be one of their skills, and it's something they certainly need to understand, but it's not the whole job.
Jeff: Right, they're a manager. So let's walk through this with a new client coming onto the MGE Power program. Obviously we have a doctor, since they're the client, and I know one of the first things you do is figure out who the office manager actually is. Say I come to you and say, "I have somebody I call the office manager," they've been called different things, office manager, front desk manager, business administrator, who knows, there are a million variations, but I'm calling this person my office manager. How would you know if they're the right candidate to do what you just described?
Sabri: The first thing I find out is what they actually do in the practice right now, their current functions, filing insurance, maybe some hiring, whatever it is. Then I look at whether they're trainable into the office manager we're actually looking for, based on the doctor's goals.
Say a doctor's doing $80,000 a month and wants to get to $200,000 while cutting back their own hours, that's their goal, and you need a genuinely good manager to make that happen. So then you bring in your prospective manager to meet with me.
Jeff: You mentioned something I want to drill into, whether they can be trained into the role. Nobody's perfect, and hiring the already-perfect office manager is incredibly rare, I've maybe seen it happen a couple of times in 30 years. So usually you're looking for specific attributes and asking whether the person is trainable. What are you actually looking for there?
Sabri: I'm looking for someone ambitious. Someone upbeat, and I don't mean perky, I mean they have a genuinely good general outlook on life. They're solution-oriented rather than problem-oriented, they need some sense that what the doctor wants is actually possible. If the office manager doesn't believe it's possible to build something like that, we're done before we start.
So if I'm interviewing you and your prospective manager, and you tell me, "I want to do $200,000 and cut my hours back to 25 a week," and your manager starts listing all the reasons that can't be done, that's probably not a good fit. But you can also just ask normal questions, "how's it going," and get a sense of where their head's at. Say they handle over-the-counter collections and insurance, maybe even some quasi treatment coordination. If they tell me things like, "the economy's tight right now, people aren't really paying, I think we should just go with whatever insurance covers instead of what the patient actually needs," you can sense the attitude there. That's a pretty non-winning, stuck-in-a-rut mindset. Versus someone who says, "I do my best, I present treatment, dealing with insurance companies is a pain, sure, but I fight for the patient, every insurance company owes us and I go after it." Even if they're not naturally thinking about sales, you can see real drive and fight in how they approach the same frustrating job. It's hard to quantify exactly, but it's an attitude you can pick up on pretty easily if you're paying attention in the conversation, whether someone believes something can be done, or has resigned themselves to "this is just how it is."
Jeff: Fair enough. Now, I've heard this one before, and you probably have too: a client has a dental assistant with all the qualities you just described, but she's only 24, and the doctor hesitates to make her the manager because they don't think she's mature enough. Do you put any weight on that?
Sabri: None whatsoever, because it's a personality you're looking for, specific personality attributes, and those generally aren't things that develop over time, that's just who the person is. I don't give any credence to age. I've seen people doing this a long time who never developed that attitude, it's just not them. It's the same as asking whether someone's introverted or extroverted, if I'm hiring for sales, am I picking the introvert or the extrovert? That has nothing to do with maturity or age, it's a personality trait. The person could be 26 or 66, it doesn't matter. If I'm introverted, that doesn't change over time on its own, not without real personal development work, which isn't something that happens inside a dental practice.
Jeff: That makes sense. So say I've got this person, you've interviewed them, and they're going to work out, great, we train them. Now say I've got someone who isn't going to work out as the manager, maybe they keep doing what they've been doing, or say I have nobody at all posted as office manager. What would you do with me in either case?
Sabri: If the current office manager isn't ambitious, outgoing, solution-oriented, trainable, doesn't check those boxes, but they're still a competent, good worker, you're obviously not going to fire that person.
Jeff: So it gets a little sticky if they're already carrying the title "office manager."
Sabri: Right, that's the fun part. You can't take that title away from someone, it's a straight demotion and it'll create real problems. So usually what we do is let them keep the office manager title, keep their function exactly the same, sometimes narrowing their responsibilities to one specific area, they become more of the senior front desk person. Their pay doesn't change, they're still "the manager." But we bring in a business manager alongside them.
That new business manager isn't necessarily someone from outside the practice, that's usually my last resort. The first thing I do is look internally, is there anyone else with those attributes we could train into that role.
Jeff: Which is really the same process as if I had no office manager at all. Say I come to you with four staff, a dental assistant, a hygienist, two people up front, and no one holding the office manager title. You're looking at all four of them, including the hygienist, to see who could be the manager.
Sabri: Exactly, that's usually the first choice, over going outside the practice. But you have to be a little politically smart about how you handle it internally. Sometimes you can't just announce, "this person is now the business manager," if there's already an office manager, since a newer hire suddenly outranking them creates World War III in the practice. So you might frame it as, "I'm going to have this person help me with some management since they have the time," or "this person is going to help me execute some things I want done," so it looks more like they're working directly for the doctor rather than immediately handing them the title, if giving it outright would upset the practice.
Jeff: So we've covered: I have someone I already call my office manager and they're going to work out, easy, we train them. Then, I have someone I call my office manager who probably isn't going to cut it, so we look internally to elevate someone else to business manager, with going outside the practice as the worst-case scenario. Let's do the third scenario: I come to you with literally no office manager at all, we have to hire someone. Are we placing an ad, or looking at people I might already know first?
Sabri: Either way, but usually I'll ask if there's someone they already know, a friend, family member, spouse, that could be a great fit. You sometimes hear that spouses are a bad combination for this, that husbands and wives shouldn't work together, and from what I've seen, that's completely untrue. It's actually one of the best possible combinations.
Jeff: We've had plenty of spouses become the manager.
Sabri: Absolutely, and it works well because they're both fully invested in the business, as long as some ground rules are in place, they know how to actually work together, neither one is doing the other's job or telling them how to do theirs, and they're not bringing the work home in a way that creates fights.
Jeff: We actually did a whole episode on setting ground rules for working with family. When you're home, you're home, being those people. When you're at work, you're at work. You're not litigating how mad you are at an insurance company at eleven at night in bed.
Sabri: Right, and there's also a certain baseline respect you naturally extend to a coworker that sometimes gets skipped between spouses, and that's usually where upsets start. As long as you're treating each other the way you'd treat any other employee or coworker, it shouldn't be a problem. Known quantities are always better than unknown ones, so if there's someone like that available, that's the move. If not, then we go outside and hire.
Bringing in someone from outside carries the usual risk of any outside executive hire, some potential resentment internally, but if there genuinely was nobody on the team who could have done the job, that resentment tends to be much smaller than if you passed over someone internally who should have gotten the shot. The real problem case is when you have a staff member who genuinely shouldn't be on your team at all, and you avoid making them manager because you know they're a bad fit, but you keep them around anyway. Then you bring in an outside manager, and the tension isn't really about the outside hire, it's about why that other person was never dealt with in the first place. There are usually a million reasons doctors give for not replacing that person, the only problem is, the practice isn't going to expand unless they do.
Jeff: That makes sense. Now, this might seem like a loaded question since we do executive training for doctors and managers, but how important is it for this manager to actually get trained as an executive?
Sabri: How important is it for a dentist to have a doctorate?
Jeff: Setting aside the legal requirement.
Sabri: I wouldn't want someone working on me who didn't know what they were doing. Conversely, I wouldn't want someone running my business who's just trying to figure it out as they go, hoping they have some innate ability to work with people or figure out a business. Eventually they'll get there through trial and error, sure, but how much money, time, and heartache does that cost along the way? So either you bring in someone who already genuinely knows what they're doing, or you train them. And honestly, it's rare to find someone who already knows what they're doing without needing training, because that comes with its own problems.
The first issue is that any job posting for a "dental office manager" is going to attract the traditional dental office manager we described at the start of this episode, and that's not what we're actually looking for, and those candidates usually come with a high price tag. If instead you bring in someone with, say, a business degree, they typically have zero knowledge of dentistry specifically. Either way, if they're genuinely good, they come with a significant price tag.
That's part of why, on the MGE Power program, shameless plug, we run the doctor and the manager through the exact same executive training, so they're on the same page managerially.
Jeff: We touched on why the doctor has to get trained too, they need to know how to actually run the manager. But the impact is real. We have a client who bought a practice down here, they were licensed in another state, got licensed in Florida, bought the office, and brought in MGE-trained office managers, which is genuinely a line people put on their resume now.
Sabri: It's funny, I get calls, sometimes from people who aren't even MGE clients, just trying to verify that a candidate they're hiring is actually an MGE-trained office manager. It clearly means something in the market.
Jeff: This client brought in two trained office managers for this location, since they're planning to open more than one. Numbers-wise, the practice they bought was doing $30,000 to $40,000 a month, associate-driven, and within the first month under the new setup it crossed $200,000, and stayed there through the first three months.
Sabri: And the doctor who bought it has only physically been in that office four or five days since it opened.
Jeff: Associates running the clinical side, MGE-trained managers running the business. If you want proof, that's the proof, real results. Anyway, that's the shameless plug for the episode, I'll put a link to the Power program and the office manager training on the episode webpage, and I'll stop there.
Sabri: One more thing, while we're doing shameless plugs: not everyone who comes through our door ends up on the Power program, sometimes they don't need it, or the timing just isn't right for their life circumstances. At minimum, when we identify a manager, or a client already has one, I have them watch the basic management videos on DDS Success, the Practice Jumpstart series. It's cheap, it's easy, and it at least gives them a sense of what they're actually supposed to be doing day to day. That, honestly, is the biggest problem I see in dentistry generally, the office manager doesn't even know what they're supposed to be doing.
Jeff: I'll put a link to that on the episode webpage too. So, next question: say a client's had a manager for three, four, six months in. How do you know if this person is actually making it?
Sabri: The first thing is statistics, is there real improvement toward whatever goal the client laid out, and is that improvement meaningful, not so small it barely counts. Is everyone becoming more competent, do people have better control over what they're supposed to be doing, are patients getting healthier, which then shows up as bigger numbers. That's the most telling part, honestly, the numbers are the big thing.
The second thing is whether the office manager is actually taking control of the practice, are they telling people what needs to be done, or just operating strictly on the doctor's orders. I don't want a robot running the practice, I want someone thinking, taking responsibility, coming up with their own solutions for how the place is going to grow. That's part of why we offer a handout called Running the Day, it gives a new manager a sense of how to structure their day, line up their stats, and what to focus on to increase productivity. It's something you hand a new manager early on so they get the flavor of the role, and we're offering it as a free download with this episode too, five or six pages on the episode webpage.
Jeff: And if you download it, I'd suggest only implementing pieces of it at a time, not trying to do the whole thing at once, that's overwhelming. Start with something like the morning meeting and build from there.
Sabri: Exactly, but ultimately it comes back to the stats.
Jeff: What might you see in those first three months that tells you this probably isn't going to work out? What are the early bad signs?
Sabri: Getting into conflicts with other staff members. Operating strictly on orders, nothing sinking in from the training. Their numbers just aren't moving. Generally having a bad attitude, not getting along with the doctor, there are a lot of possible red flags, but what it usually comes down to is that the doctor owner already knows in their gut that it isn't working. They don't need me to tell them that.
The biggest problem I actually see with training office managers is that the doctor usually knows within the first few weeks whether it's going to work, because they're there every day and I'm not, but instead of acting on that, they're hoping something changes, hoping this person has some kind of personality transplant, some miracle shift. That's not going to happen. The doctor has to understand that the manager role is fundamentally their own job, the owner appoints someone to take it on.
Jeff: So just to clarify, the owner's job is technically to be the manager, and they're appointing someone else to take that on.
Sabri: Right, and it's interesting you'd call the office manager the CEO of the practice, because that's really what it is. The owner is divesting that job to someone else to run day to day.
Jeff: That's a good comparison, actually, it's like hiring an associate. You're the main doctor, you can't do all the dentistry yourself, so you bring on an associate to pick up fillings and emergencies, but you're still ultimately responsible for that dentistry. You have to make sure the person you hired is actually capable, diagnosing the way you would, or close to it, treating patients the way you'd want them treated so there aren't upsets down the line. It's much easier to just blame the associate for doing a bad job.
Sabri: Which is completely fine, as long as you actually handle it once you notice.
Jeff: Right, it's the same with a manager. How wild would it be to hire a doctor, put them on as an associate, and never check their work, their diagnoses, or how patients are doing afterward?
Sabri: Crazy, but not unheard of, we've seen practices run that way.
Jeff: It creates huge problems, and usually the owner doctor knows within days whether that's working. They need that same attitude toward the manager role: it's their job as owner, they're just not the one doing it day to day because they're busy in someone's mouth, but they're still ultimately responsible for it. And they usually know within a few weeks whether it's working. If it's not, that doesn't mean it's fine because "it's just administrative," it's a five-alarm fire, the same as when an associate isn't working out and needs to be replaced.
Jeff: I know it's a lot of work, and a genuine pain, but if you actually want to hit your goals in practice, you have to put in that effort for a while, and then it settles down.
Sabri: Very well said.
Jeff: Thanks. Any last thoughts on finding and placing an office manager?
Sabri: Dentistry is probably one of the most fun businesses in the country. It's rewarding to grow, you can build something where everybody genuinely has a good time, your patients, your staff, you can bonus people, give them a life they didn't think they could have. You were talking to someone yesterday, I was sitting right there, about how dentistry is the second-best business in the US right now, the second least likely to go bankrupt.
Jeff: The second most recession-proof business in the country, right behind funeral homes.
Sabri: People always ask what's number one, and you never really want to say it.
Jeff: Not quite as fun as dentistry, though. So stick with dentistry. The point is, you already went through all the trouble to earn a dental degree, that's not easy, otherwise everyone would be a dentist. We have a shortage of dentists precisely because it's hard to become one. But you made it through that. If you just put in a little more work to do the business side right, you can have a genuinely wonderful life. That's honestly what frustrates me most, people not taking responsibility for that executive hat, making sure the office manager piece is done correctly. Don't cut corners on it, just do it, and you get a great life on the other side.
Sabri: And the longer you wait, the more time you're wasting that you can never get back.
Jeff: Right, why would you want to make your own life harder than it needs to be? Well, Sabri, thank you so much for being on.
Sabri: You're welcome, always happy to.
Jeff: As always, we've got downloads: a link to the MGE Power program if you have questions about that, the office manager checklist, the Running the Day handout if you want to download it, and a link to DDS Success if you want to learn more there too. And folks, if you have any questions about MGE, you can find us online at mgeonline.com or call us at (800) 640-1140. Have a great week, and we'll see you at the next episode.