Ep. 80: Hiring Staff with No Prior Dental Experience
The hiring market has gotten tighter and tighter in recent years. This means you may be struggling to find good candidates right now—and particularly struggling to find ones that already have dental experience. But how important is that prior experience, really? Is it worth limiting your potential hiring pool? We’re joined by special guest Jeff Santone to discuss how he implemented a very systematic approach to quickly bringing an inexperienced new hire up to and then beyond the performance level of a more experienced counterpart.
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Questions From This Episode
Why does prior dental experience rank so low on the list of criteria for hiring a new team member?
Experience says nothing about the quality of that experience, someone could have picked up genuinely bad habits or been poorly trained at their last office, and previously experienced hires often resist a new practice's own policies simply because that's not how we did it before. It's a nice quality to have, not a reliable predictor of whether someone will actually stay and perform well.
What discovery about experienced surgical assistants led Jeff Santone to start hiring people with zero dental background at all?
When he actually quizzed supposedly trained surgical assistants on a standard instrument tray using photos his office manager put together, most only knew about 30 percent of the instruments. Once it was clear that even experienced hires didn't really know the material, it became obvious anyone could be taught the same tray setup from scratch, without the bad habits picked up at other offices.
What's the three-step training process Jeff Santone used for every position, from surgical assisting to reception?
Study, using simple written materials with lots of photos rather than dense manuals, then drilling and role-playing the material until it becomes second nature, then a two-way apprenticeship, the new hire watches the trainer work first, and once comfortable, the trainer watches the new hire do it themselves before finally stepping back entirely.
How long did it actually take to build the complete training material for a fully trained receptionist?
About 13 to 15 pages total, much of it photos and attachments, and Jeff Santone estimated the material itself could realistically be put together in about a day once someone actually sits down to do it. The real unlock wasn't the amount of content, it was finally writing down what had only existed in his own head.
What's the actual lesson for a doctor who's holding out for a perfect, already-experienced candidate to fill an open position?
Stop waiting and hire the person with the right underlying qualities instead, someone genuinely personable with real customer service instinct, since that quality is what's actually hard to find and can't be trained. Everything else, the software, the policies, the procedures, can be taught, and finding a fully pre-trained dental professional who happens to be looking for a new job at exactly the right moment is genuinely rare luck to count on.
Episode Transcript
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Jeff Blumberg: How important is prior dental experience when it comes to hiring a new team member for your dental practice? To be clear, when I'm talking about no prior experience, I'm not talking about licensed providers, dentists, hygienists, and so on, I'm talking about positions that don't require any kind of license, an administrative position, a management position, in some states or areas, dental assisting. How important experience actually is really depends on who you ask. Some people find it critical, others are completely ambivalent and are just looking for a bright, ambitious person they're willing to train from the ground up.
Jeff Blumberg: Here's the funny thing about this though: who is experience actually important to, from the perspective of real outcomes? I'll say it plainly, experience is a nice quality, but it isn't even in my top five criteria when selecting employees, because it has no real bearing on whether someone is actually going to make it. Someone may have experience, but how good was that experience? Maybe it was genuinely bad. Have you ever hired someone who gave you trouble following your own policies simply because that isn't how they did it at their last office? So how great was that experience, really? It might feel like a key criterion, but its actual predictive value isn't all that great, it's no guarantee of retention or of better long-term performance.
Jeff Blumberg: Now add to that the fact that we're in one of the tightest labor markets on record, at least as this episode is airing, which means finding employees at all is harder, and finding ones with prior experience is harder still. So the ability to find, hire, and train someone regardless of prior knowledge of the dental field is genuinely at a premium right now, and it may be the difference between whether your practice grows or contracts. So what does it actually take to turn someone with zero prior dental experience into a successful, productive, long-term employee? That's what I want to talk about in this week's episode. My name is Jeff Blumberg, and I'm your host, joined this week by Jeff Santone, the New Client Executive here at MGE.
Jeff Blumberg: You may have heard from Jeff in prior episodes, where we covered key performance indicators, the reception position, and specific metrics to track for case acceptance. Jeff is uniquely qualified to speak on hiring people with no experience, because for ten years he owned and managed an oral surgery and general dental practice in the Washington, DC area with his spouse. When he came on board, they went from doing about $50,000 a month to routinely over $260,000, more than five times over, in fairly short order. And over 70 percent of the employees Jeff hired had no prior dental experience. Jeff, I think we have you all set up over there?
Jeff Santone: Yeah, I think I'm all good, can you hear me alright?
Jeff Blumberg: Yeah, we're all set. So you mentioned hiring about 70 percent with no experience, what would that actually work out to in numbers over the years?
Jeff Santone: Geez, if I had to guess how many people came through those doors over ten years, well over thirty.
Jeff Blumberg: And of those, if you had to rank your top three best performers you ever had in that office, how many of the three had prior dental experience?
Jeff Santone: One.
Jeff Blumberg: One? Really, so two thirds didn't.
Jeff Santone: No, we made them.
Jeff Blumberg: Interesting. And what positions did you guys hire with no experience?
Jeff Santone: Everything. We were in DC, so it was a little bit of the wild west back then, pretty hands off with licensure and requirements. It was only in 2015 that x-ray licensure got required for dental assistants, and even then they grandfathered anyone already hired, so we didn't have to send existing staff through a formal training degree. We were on the surgical side, and that applied to our surgical assistants too, no x-ray licensure required at the time, and again grandfathered in once it did become required. So there wasn't much need to go out looking for experience, we were more than willing to train our own.
Jeff Blumberg: So beyond financial coordinator, treatment coordinator, receptionist, you were hiring dental assistants and surgical assistants with zero experience too?
Jeff Santone: Yeah, they'd never been in a dental practice before, other than as a patient.
Jeff Blumberg: That's demanding, especially surgical assisting.
Jeff Santone: It really is, and that's actually what led into how the whole process developed. If you hired a dental assistant, say they'd been working somewhere like Nordstrom before, one of our surgical assistants actually came from a coffee shop.
Jeff Blumberg: So she comes in from a coffee shop, and she turns into a good assistant?
Jeff Santone: She actually started as a scheduling coordinator, but loved sitting in and watching the surgical side, so we had her in as a head holder in oral surgery, which doesn't do much beyond exactly what it sounds like, holding the patient's head steady. But she was really into it, and I remember our office manager, Virginia, saying maybe she'd like to learn assisting, and that's kind of how it all started.
Jeff Blumberg: How did you actually train her, since you trained a lot of people right off the street?
Jeff Santone: We did, and honestly it didn't matter what assisting experience someone claimed to have. I remember Virginia getting genuinely fed up with people coming in who supposedly knew surgical assisting but really didn't. She was demanding, and she had to be, there's IV sedation involved, you're constantly practicing for emergencies, airway management, all of it. So I finally said, why don't we do this: make me a tray, a standard tray setup, label everything.
Jeff Blumberg: So this became part of the hiring process?
Jeff Santone: Right, part of the hiring process. She put together the tray, labeled it all, we took photos of it. Then I made a quiz out of it, a sheet with the tray photo, all the instrument names removed and replaced with numbers, and I'd ask candidates to name each instrument.
Jeff Blumberg: But these were people who'd actually trained as surgical assistants somewhere else?
Jeff Santone: Exactly, that's how this all started, because what I found out was, they didn't actually know it. They'd get maybe 30 percent right, even the experienced ones. So I thought, this is silly, they don't know the tray anyway, Virginia could just as easily train someone from scratch to know that tray and set it up properly, and they'd be a perfectly good surgical assistant. So I told Virginia, take a picture of every tray setup we use and label it for me, maybe eight or ten different setups depending on the procedure. Then I could bring in someone who wasn't squeamish around blood, which was actually requirement number one, you'd be amazed how many people passed out during the interview process, with Virginia literally catching them and setting them in a recovery chair. That was an automatic no.
Jeff Blumberg: So that became the actual setup process, teaching someone the tray and the instruments first.
Jeff Santone: Right, there was always a lead assistant in the room and a trainee, the head holder, and that trainee would eventually be the one setting up the trays for the day. So it became this graduated process: bring someone in, teach them the trays and the instruments, then quiz them. I'd give them the labeled tray to study, then throw everything into a random pile and say, now put together surgical tray one.
Jeff Blumberg: And this is someone who was working at a coffee shop two or three weeks earlier.
Jeff Santone: Right, but genuinely motivated, really loved being part of it. I remember one girl whose head kept getting in the way because she wanted to see exactly what Virginia was doing, she was completely locked in. That photo library of trays and instruments is really what started the whole thing. Everything else, breaking down a room, sterilization technique, that's stuff you can teach afterward and correct as you go. But the core of being useful as a surgical or dental assistant really came down to knowing the instruments and how to set up the tray properly, since your doctor is going to ask for something specific mid-procedure and you need to know exactly what it is and how to hand it over.
Jeff Santone: And that's what led me to realize Virginia had been right all along, these trained surgical assistants weren't actually that far ahead of someone starting from zero. They interviewed great, they were genuinely nice people, nothing wrong with that, but once I started quizzing people, I realized she was right, they didn't really know the material. So I thought, if we could do this with one person, we could do it with anybody, even someone who wasn't sure they wanted to get into dental assisting at all, and build them into exactly the kind of surgical assistant we wanted, rather than someone arriving with bad habits picked up at ten other offices.
Jeff Blumberg: So it was really the discovery that experienced hires only knew about 30 percent of a basic tray setup across those procedures that led you to realize you could teach anyone.
Jeff Santone: Exactly.
Jeff Blumberg: What about something like sterilization, how did you actually teach that?
Jeff Santone: Pretty much the same way we taught any position. Virginia used to say, see one, do one, teach one, from her training. So she'd let people apprentice, watching what she was doing and explaining why, alongside the actual sterilization manual for reference.
Jeff Blumberg: Did you actually require your assistants to read the sterilization manual, the one for the machine itself?
Jeff Santone: Yeah, the autoclave manual.
Jeff Blumberg: Very few people actually do that. It's funny, you'll see a copier in an office with a manual sitting right next to it that nobody's ever opened.
Jeff Santone: Right, same as a car manual, most people never read it, but it's in there for a reason. Manufacturers know this too, which is why cars now come with a quick start guide instead, since most people will read two pages but not the whole thing. But everyone in our back office knew that manual. I remember when we moved our sterilization setup from one countertop to another, and it wasn't quite level, so the water level in the machine was off and sterilization wasn't working properly. Thank goodness we'd actually read the manual, it told us exactly what to check and how to shim it level. We didn't have to call a supply rep and get told, it's called a shim, just adjust the legs, we already knew.
Jeff Blumberg: So that's how it worked in the back of the practice. How did you apply the same approach up front? I know you had internal and external PR people at different points.
Jeff Santone: We didn't usually hire directly into those higher level positions. By the time three or five years had gone by, pretty much everyone who mattered in that practice had started as the receptionist at some point.
Jeff Blumberg: So you brought people in at reception first. Did they handle new patient calls right away, or did you have a dedicated person for that?
Jeff Santone: I was probably handling new patients myself in the early days. But as far as the receptionist role goes, I always tell people reception is the most turned over position in a practice, for two reasons. Either they're genuinely good at it and get promoted into something else, or they're not very good at it and get let go, or they quit on their own. So it became our proving ground, which is pretty common, that's where most people start, and as they improved, we moved them into other roles. I actually joined the practice myself with zero dental experience, I should mention that. I started with nothing.
Jeff Blumberg: We've had clients come from all kinds of backgrounds, Wall Street, a bank manager who now manages three of his wife's practices, other industries entirely. Jeff, you were actually an economist at the Federal Reserve before this.
Jeff Santone: Yeah, I was, right around the banking crisis in 2008, though I want to be clear I wasn't responsible for any of that, I was already on my way out by the time it hit.
Jeff Blumberg: Good timing to leave. So back to the question, say I'm your new receptionist with zero experience, what does my first day actually look like, and how would you know I'm doing a good job?
Jeff Santone: What happens with pretty much every practice that's short staffed, and I was no different, is you hope you bring someone in who lightens your load, set it and forget it, I've got this person, I'm done. And inevitably that doesn't work out, and you're still doing it yourself. By the time we were MGE clients and I was learning the actual process of running an organization, I realized, if I ever want to actually hand this off, I need to write it up properly.
Jeff Blumberg: So you were being lazy, in a productive sort of way.
Jeff Santone: Efficient, let's call it efficient. I was tired of answering phones, and our phone system was genuinely complex, how to put someone on hold, where to park a call, how to transfer with or without the caller still on the line, a real nightmare to explain. So I created a small mini manual just on the phone, a page and a half, mostly pictures, this is the keypad, press this button to do that.
Jeff Blumberg: How long did it typically take someone to get through it?
Jeff Santone: If someone couldn't get through it in about 30 minutes, that was sometimes a sign they might not make it. Most people got through it in around 30 minutes. Then I'd drill them on specific sequences, show me how to pick up the phone, show me how to put someone on hold, show me how to transfer a call, back and forth, even with nobody actually calling.
Jeff Blumberg: So you had a whole checklist you'd run through.
Jeff Santone: I did. Once they were comfortable with the basics, I'd have them sit next to me for half a day just watching what I was doing, maybe helping greet people or hand out paperwork, but mainly observing while real calls came in. Then once I felt they had it, I'd flip it, they'd pick up the phone and I'd sit next to them, ready to help if they got overwhelmed. I'd do that for a couple of days, then let them go fully on their own.
Jeff Blumberg: Training wheels off.
Jeff Santone: Exactly. And once I thought they were genuinely comfortable, I'd throw something unexpected at them, every once in a while I'd have the whole team grab their cell phones and call the office all at once, we had eight lines, so I'd tell them ahead of time there'd be some kind of test, just to see how they handled real volume and pressure, since handling that many lines while putting people on hold, transferring calls, taking messages, and greeting walk-ins all at once really is a comfort issue that takes practice.
Jeff Blumberg: And to be clear for anyone listening who might picture reception as also handling scheduling, that wasn't the case for you.
Jeff Santone: Right, ours was a true receptionist role, that's all they did, greeting people in a beautiful reception area, handing out paperwork, answering phones, and if someone called to schedule, they were routed to a dedicated scheduling person.
Jeff Blumberg: So what did the rest of reception training actually look like beyond the phone manual?
Jeff Santone: We had what I'd call a mini training pack, the essential things you absolutely needed to know on day one, and then a more advanced pack once you were fully grooved in on the basics, covering the rest of your actual duties and responsibilities in that position.
Jeff Blumberg: Did that phone page and a half include how to actually greet callers, or was it purely about the phone system itself?
Jeff Santone: It included the greeting script too, since I assumed you were already picking up the phone at that point. I'd drill them on that specifically, make sure they actually said it out loud a few times until it became second nature.
Jeff Blumberg: So how many total pages did it take to get someone to a fully trained receptionist?
Jeff Santone: If I remember right, somewhere around 13 to 15 pages total, not a huge amount. If you actually sat down and focused, you could put that together in a day or so, and a lot of it was photos, attachments, and forms people needed to fill out, so it was pretty straightforward.
Jeff Santone: What it gave me, more than anything, was real confidence that I could actually let that person go run on their own. I wasn't second guessing whether it would get done, I could go sit in my office and know it was handled.
Jeff Blumberg: So let's say I've studied all thirteen pages, and it sounds like you broke this into two or three distinct parts: first, studying the material, since it's written to actually be easy to understand, then drilling and role-playing it, and then apprenticing, I watch you, then you watch me.
Jeff Santone: That's exactly the three-step process.
Jeff Blumberg: So say you've done that with me, I'm up and running as your receptionist, maybe after a week or two. Then the office is expanding and we need a scheduling coordinator. Am I likely to get moved up if I'm doing well?
Jeff Santone: Yes, and we'd repeat the same process with the new receptionist coming in, except now you could actually help apprentice them too.
Jeff Blumberg: So you'd have me apprentice my own replacement.
Jeff Santone: Right, I might still run the actual testing myself, but I'd tell you, this is Mike, he's coming in to help with reception until you're fully settled into scheduling, I want you to run him through exactly what we did with you, the mini training pack, and have him watch you work.
Jeff Blumberg: And presumably by that point you'd already picked up scheduling itself just from using the system daily.
Jeff Santone: Right, whatever practice management software you're in, Eaglesoft, Dentrix, Open Dental, you're already using it constantly. And honestly, we were right at the beginning of that generational shift with technology, younger hires especially would pick up the software almost instantly, sometimes showing me shortcuts to reports I didn't even know existed. So at that point it was really just, here's our scheduling policy, and either I'd apprentice you directly, or you'd sit with whoever was training you, since by then Michelle, who started as my scheduling coordinator and became a surgical assistant, could apprentice the next scheduling coordinator herself.
Jeff Blumberg: So the new receptionist becomes the next scheduling coordinator, and the cycle just continues without requiring you to sit in a chair training every single time.
Jeff Santone: Exactly, they're doing it as they hand off their own job to the next person, or moving straight into apprenticing the next role. It becomes a genuinely repeatable growth process that doesn't require your constant day to day involvement, it just requires that you've actually written it down.
Jeff Blumberg: And that's really the core lesson from the MGE Power Program's organizational training.
Jeff Santone: Exactly, that was the big realization for me: why am I still doing this myself? If someone's still coming to me asking how to do something, that just means it isn't actually written down yet.
Jeff Blumberg: I'll put a link to the Power Program on the episode webpage if anyone wants to learn more about that training.
Jeff Santone: It really was huge. And to be fair, it didn't always work perfectly, every once in a while as office manager I'd have to sit back down in a chair and apprentice someone again, if we lost a run of staff, or a scheduling coordinator left and the current receptionist said they weren't interested in that role, maybe they liked what the PR person did instead, talking to patients, gathering reviews, or maybe they preferred focusing specifically on insurance and benefits breakdowns. That's fine too, you adjust. It still happened occasionally that I had to step back in personally.
Jeff Blumberg: But you built a genuinely great staff and a strong culture there, clearly whatever you were doing was working.
Jeff Santone: It was. And that's actually a great point, because we talk to doctors constantly, I've been lecturing for MGE since 2012, and this question comes up more now than it used to: how do you find good staff? What I try to explain is that great people are out there, but you have to make great staff, they're not just found ready-made. If there is a genuinely great, fully trained staff member out there, you're probably not the one who's going to land them, that's like winning the lottery, an amazing office manager in Tacoma whose husband happens to be relocating to exactly your city at exactly the right time. That's one in a million. So you have to let go of this idea that you need someone who already has this specific dental training and background, you have to be willing to train people yourself.
Jeff Blumberg: So if I'm listening to this with a bunch of open positions, holding out for the perfect, already-experienced scheduling coordinator, should I keep waiting, or is that kind of a silly question?
Jeff Santone: Just go hire somebody. Look at people in customer service roles, retail, sales, we genuinely loved this approach. Virginia loved shopping, and every so often we'd be walking through a department store, notice someone at a makeup counter who was just really good with people, and hand them a card, ever thought about doing something in a dental practice? Or a waiter or waitress who seemed genuinely sharp and engaged, we'd tell them the same thing, since we were competitive on pay and bonuses, and if someone was already thinking about a change, we had no hesitation asking. Because I could train the rest, that part was easy. What I couldn't train was that starting point, being a genuinely good, likable person who actually enjoys other people, which, surprisingly, not everyone has. You can call some offices and it's obvious the person answering just doesn't like people very much.
Jeff Santone: So I never got hung up on where someone had worked before or how much experience they had, because leaning on that just becomes an excuse to stop paying attention, you assume they've got it handled since they have experience, and meanwhile you could be missing $300,000 to embezzlement, because you never actually verified the quality of that experience in the first place. It's a little silly when you think about it that way.
Jeff Blumberg: Jeff, thank you so much for coming on this week.
Jeff Santone: This was great, thanks for having me.
Jeff Blumberg: So if you're listening and you've got an open position to fill, the takeaway is simple: just hire somebody, and learn how to train them. I'll put a link to the MGE Power Program, the same organizational training Jeff mentioned using as an office manager, on the episode webpage. You can also learn more about us at mgeonline.com or by calling (800) 640-1140. Jeff, if anyone listening has questions, would you mind if they reached out to you directly?
Jeff Santone: Not at all, call the main number, or you can email me directly at jeffs@mgeonline.com.
Jeff Blumberg: That's all we have for you this week. Have a great week, and we'll see you at the next episode.