MGMA Insights: A Strategic Approach to Building High-Performing Teams
Download MP3Well, hi, everyone. I am Daniel Williams, senior editor at MGMA and host of the MGMA Insights podcast. And today we've got a guest who is going to be talking about some of those most persistent pain points in healthcare: hiring the right people. So our guest today is Doctor. Michael Neal.
Daniel Williams:He's a practicing optometrist and founder of Build My Team. And after struggling with turnover and hiring frustrations in his own practice, Doctor. Mike created a new approach, one that's now helping practices across the country build stronger teams. So you and I were talking offline, Doctor. Mike, but I just wanted to say welcome to the show.
Dr. Michael Neal:Thanks so much for having me, Daniel. I'm excited.
Daniel Williams:Yeah, it's so good to have you here. So like many people that are in healthcare, you have ventured out to do other things as well. So let's just talk about that. Let's go back a little bit and share some highlights from your origin story. Just getting to know you better, whether that's through your journey in health care or even getting out more as an entrepreneur and a speaker and a coach as well.
Daniel Williams:So let's talk about that.
Dr. Michael Neal:Well, thanks. So I started the Build My Team journey simply because I was a practicing iDoc in a small group practice in rural Pennsylvania located right next door to the middle of nowhere. And we have, as far as the talent pool, it's not a pool, it's a puddle. It used to be six inches deep. Now I think you'd be hard pressed to get it at three inches.
Dr. Michael Neal:It's really, really tough. So I didn't start out to create a company out of this whole journey. It was simply to find great people. That's all. Great people because our practice was hiring, using resumes.
Dr. Michael Neal:It was awful. We were getting absolutely horrible results and we didn't know what the heck we could do differently. So I took a look at other companies figuring, hey, look, there's a whole bunch of people out there that are a lot smarter than I am. What are they doing? And companies like the Four Seasons, Disney, Ritz Carlton, some of these big organizations that just have amazing customer service, you know, what are they doing?
Dr. Michael Neal:Because that's essentially what we're trying to do in health care. Of course, we don't call them customers, but, you know, patients. We're trying to bend over backwards to help people take care of people and do so in a way that they want to come back. And so I looked at their hiring models and they just weren't doing it the same way as we were. They would post jobs.
Dr. Michael Neal:So they write a great job description. They'd post jobs. They would have all of these applicants apply, but they wouldn't start off with interviews right away. They'd put them through an assessment process. And I was like, what's an assessment process?
Dr. Michael Neal:Well, it turns out that you can predict people's behavior based upon how they answer these assessments. And we ended up creating an entire process to do that and to get outstanding results. We had to change everything that we were doing.
Daniel Williams:Let's talk about that then. You mentioned names like Disney and the Four Seasons and Ritz Carlton and others like that. What were they doing? What were their hiring models? And can that be adapted to medical practices?
Daniel Williams:Are they you talked about pools and puddles to draw from, but those are types of organizations. But at the heart of it, no matter what our business is, we're working with people and people like to be respected and they like frictionless contact and different things of that nature. So let's just talk about that. What did you draw from them that you could then apply to your optometry practice or to other practices?
Dr. Michael Neal:Oh, great question. Well, you hit the nail on the head. They take care of people and they take care of people in unique and incredible ways. Guess what we do as healthcare professionals? I got news for you, Dan.
Dr. Michael Neal:Big surprise. Good thing we're both sitting down. We take care of people. We do so in unique and incredible ways, right? It's the same thing, even though you don't think that it is.
Dr. Michael Neal:And sometimes it's not, but it could be. It's an aspirational thing for us. Why is that doc buddy of yours got all five star reviews in his practice and in another practice for struggling, that type of thing. So it becomes very challenging, but it can be done. And that's what they were doing.
Dr. Michael Neal:They weren't making their decisions on resumes. That's the key point. They would run people through the assessment process that they had. They would determine if they would be fantastic at the job before talking with them, before meeting them, before looking at resumes. And then when they were done, they would look at the resume to determine if the person had any relevant experience, which a little teaser here can be a massive red flag.
Dr. Michael Neal:So we'll talk about that later. But that's how they would approach it. And we were approaching it completely opposite. Hey, you applied for a job, you throw an absolutely disastrous, awful resume in front of us. You're one of the few people applied.
Dr. Michael Neal:Why don't you come in for an interview? Oh my goodness. That's like sitting there and asking a patient, Hey, what's wrong with you? Okay, well, know what? We're going to skip all the testing.
Dr. Michael Neal:We're going to skip all the lab work. Here's your prescription. Next. Nobody does that, right? You can't practice medicine that way or healthcare at all.
Dr. Michael Neal:So the reason we were doing it that way is we didn't have a better way. That's all it was.
Daniel Williams:You make really good points there that, it does seem like, as opposed to really strategically finding the people that fit in with your organization, sometimes in healthcare, it sounds like it's just we're desperate and we need somebody. So, we're going to take somebody. Is that something that you solve over and over again? Because it does seem like, particularly at the front desk, we will see it's a turnstile. You know, there's just such turnover.
Daniel Williams:As we've talked about on this podcast before, many people lose front desk people to Starbucks and the local grocery store and other people like, you know, organizations like that. And then hopefully it just won't continue that way. What do you have? What are your thoughts about that?
Dr. Michael Neal:Our approach is to find people based upon their mindsets, their strengths, and their talents, how fast they learn, what they're naturally bringing to the table. Okay? If you zoom out from this and you look at this at a 50,000 foot view, you have a job. It requires a person to be really good at certain things. Okay.
Dr. Michael Neal:Let's just that's straightforward. We all know that. Mhmm. Then let's go find a person who's really good at those certain things. Okay.
Dr. Michael Neal:That's what we're all trying to do. What our approach does is we will determine that incredibly accurately without asking them. Hey, do you handle stress really well, Dan? Oh, absolutely, Doctor. Mike.
Dr. Michael Neal:Know, Even though I'm shaking like a leaf right now and sweating profusely, I am outstanding at handling stress. It's just hot in the room. Well, no, Dan, it's 67 degrees. You're not telling me the truth. And that's a standard interview nowadays.
Dr. Michael Neal:So you know, we measure stress, we measure, sorry, we measure the stress tolerance, we measure how fast they learn. That's another critical component. If you're not going to learn fast enough in healthcare, you're not going to work out. There's no such thing as a healthcare position that doesn't change, that doesn't have some level of routine improvement to it. It's the nature of the profession.
Dr. Michael Neal:So things like that, for each position, and you mentioned front desk earlier, your front desk is critical, absolutely critical to a practice. You make bad impressions, you're going to have all kinds of problems. You make great impressions. You're going to have people that won't stop promoting your practice. Easiest, most binary way to grow a practice that there is.
Dr. Michael Neal:And so for each of these positions, we know exactly what makes a terrific candidate. We know what these strengths and talents are, and our entire process is essentially So when these candidates apply, our software will determine who's best for these positions.
Daniel Williams:You mentioned a term earlier, mindset. I think her name is Carol Dweck wrote the book Mindset. We talked about it in our MGMA book club probably brought it up here in a previous podcast. But in your terms, what is the mindset you're looking for when you are screening people or interviewing people for your practice or for other ones that you would recommend there?
Dr. Michael Neal:First of all, would love to meet her someday because work is seminal. There's a bunch of things we're looking for, specifically a hardwired requirement to serve other people. You want to help other people. And everybody listening to this is like, Who doesn't want to help other people? Guess what?
Dr. Michael Neal:I got a news flash for you. Most. Okay. Most people don't want to help other people. Right.
Dr. Michael Neal:All right. Most people who are applying for healthcare positions, yeah, a lot of them do, but a whole lot of other people who are applying for healthcare positions want an incredibly stable paycheck. They want to work in air conditioning and they want to work in a position that's not going away anytime soon. You don't believe me, roll back to COVID.
Daniel Williams:Right.
Dr. Michael Neal:Okay. The people that stayed, that was a huge component to that. Air conditioning was a little bit of an issue at the time with COVID, but let's skip that. Know, what I'm saying is they want a cush job. Not going to be standing outside baking in the sun.
Dr. Michael Neal:They're not going to be getting generally screamed at on a routine basis like they would in perhaps a call center or something You like know, from a mindset standpoint, we want people who are helping folks. They enjoy that. They get up in the morning to do such a, you know, to have such a position. And they're also looking for fulfillment. And this is critical.
Dr. Michael Neal:You would be shocked at how many people will take a slight pay cut to go home with a huge smile on their face because they helped a whole bunch of people at the end of the day. That's one of the strategies we employ.
Daniel Williams:That is amazing, and I love that, and I totally agree with you in everything you just said. So let's talk about outcomes then in looking at notes through your organization, Build My Team. Let's just start there first. Let's talk about Build My Team. What is it and what can you share about that?
Dr. Michael Neal:Sure. So we have a full service hiring approach. And what we do for our clients is it's a completely done for you service. We focus on administrative clerical team members, unfortunately, and everybody have a deep sigh here. We don't hire clinicians.
Dr. Michael Neal:So that's the our tools can be used to help clarify which clinician would work out best for your practice. But we generally don't do that. We focus on the people that do the work, the folks that are the heavy lifters in the practice, the ones delivering the patient interactions other than the clinical care. And boy, oh boy, when you have a stupendous team, I have to tell you, because I went through this, I went from an awful team to a top tier team. You go home as a doc or a clinician with a smile on your face.
Dr. Michael Neal:You have energy for the kids. You have the ability to look forward to the next day and not see an oncoming freight train. So what Build My Team does is we find those team members in an automated fashion for extremely affordable price that will deliver those results.
Daniel Williams:Okay. And then who are you primarily working with? Are you staying in the optometry world or give us a demographic here of the kind of organizations you work with.
Dr. Michael Neal:Yeah, so I'm an optometrist. I started out with eye care because we knew that implicitly. What we found out very quickly and rather unintentionally is that a private practice is a private practice. Yeah. It doesn't matter what profession you're in.
Dr. Michael Neal:You can go all the way from eyes to toes and everything in between. What we focus on is staffing private practices with A players, A and B plus players. So it doesn't matter what type of private practice you're in, you still need front desk coverage. You still need to get paid. You still need people to help the clinician clinicians, and I should say.
Dr. Michael Neal:In eye care, you might have a retail component. In, let's say, dentistry, you might have a slight retail component with treatment coordinators, things like that. There's all kinds of different options. And so we found out in a real hurry that what we're doing in eye care works the same for other healthcare practices. And now we're in over 10 different healthcare practices, types of healthcare practices, I should say, in over 40 states in the country.
Daniel Williams:Wow. One of the things I see here is in your notes is some things are transferable across specialties, but then some things need to be tailored. Just talk about that. What have you seen in working with practices over 40 different states? So you've seen a little bit of everything.
Dr. Michael Neal:Oh, absolutely. I think there's two ways to answer that question. One, I'm always careful about experience. Okay. Dentistry in particular got absolutely murdered after COVID with people with experience.
Dr. Michael Neal:And the quick story there is folks were mercenaries. We had dental hygienists jumping from practice to practice to practice for a 25¢ an hour raise. Woah. It was everybody's worst nightmare, essentially. Practices shut down.
Dr. Michael Neal:They had all kinds of issues. So you can take that as a really tough example. But as far as the other types of practices, what we've basically seen is in general, when you're hiring for this approach, when you're using the strengths and talents, when you're not focusing on resumes, you get a completely different level of experience for the clinician and you don't have those types of people causing problems in your practice.
Daniel Williams:I was trying to do the math in my head. Is $0.25 an hour, is that like $500 raise or so? Something? I mean, is it worth moving to what you know, the devil you know, to this unknown quantity? Mean, we're going to mindset and psychology
Dr. Michael Neal:of those aren't our people. Let's time out on that one. Do not bring those folks to the table. That's what some practice were facing. And it was awful.
Dr. Michael Neal:I mean, can you imagine the level of stress for the practice owner on that? What do you do?
Daniel Williams:Well, it just sounds like such a difficult situation, and I wanna be really compassionate to people that maybe even $500 more a year is a difference for you. But at the same time, you've gotta be realistic about it doesn't look good on your resume if you're just jumping around from job to job, but also just the, I don't know, unless there's a real opportunity that's beyond just $0.25 more an hour, there's got to be something more there for you.
Dr. Michael Neal:Yeah. And what ended up happening is a lot of those folks left the profession. I don't know that 25¢ an hour was the core reason. I think dissatisfaction and sheer unhappiness were probably more foundational in that sense.
Daniel Williams:Right. And I don't want to get fixated on the dollar amount, but it just it plays into that bigger picture of what's really important. You know, if you were talking about, are you working in a culture? Are you working in an environment where you go home at the end of the day and you have that energy to play with the kids or go to the gym or do whatever is you're passionate about? And I think that's so important here.
Daniel Williams:One of the other questions I wanted to talk to you about and I talked to you about off line a little bit, is the burnout that we're seeing in healthcare across the board, no matter where you are. So talk about that a little bit and how hiring the right people in the right jobs can help push that down a bit.
Dr. Michael Neal:I really can't stress this enough. That is the one outcome from Build My Team taking over the hiring in our practice that changed everything, like the one lever that moves everything. I was going home at night, pulling my hair out. As you can see, I did a great job if you're on video. I was so depressed because I would I was whack a mole.
Dr. Michael Neal:It was hiring whack a mole. You'd you'd come in. Anybody who's who's running a practice right now can understand this. Sunday night was always tough. You go to bed nervous.
Dr. Michael Neal:What am I waking up to Monday morning?
Daniel Williams:Right.
Dr. Michael Neal:You know, what text am I gonna get Monday morning? I'm gonna walk in. What envelope's gonna be on my desk? And that's if you're lucky. You're lucky,
Daniel Williams:you get then the respect little to give the envelope. Right, right.
Dr. Michael Neal:Right? I mean, nowadays, it's the front door. They just walk out the front door. So those were the things that I was dealing with. And now with a team that is A player level, B plus level, these are great folks who do great jobs.
Dr. Michael Neal:You do not have to babysit them. If you're not a kindergarten teacher, you're not a cat herder, a professional cat herder. You're none of those things. And it's a completely different approach. So in terms of burnout and culture, to specifically address those, If you have a team where you are the kindergarten teacher and the cat herder, you are looking down the barrel of burnout.
Dr. Michael Neal:It is unavoidable. I don't know anybody who's been able to do that for year after year and get up the next morning and be like, let's go herd the cats again. It's not who we are in health care. The other hand, on the cultural side, this is a bit of a controversial opinion, and coming at this out of the blue, but if you want to change the culture of your practice, you start off by letting the lowest performers go. Okay, you're going to have some high performers in almost every practice.
Dr. Michael Neal:You're going to have the, like, you think of your team right now, who would you be terrified to lose? Okay. That that's a visceral reaction. Your your brain didn't tell you that. Your gut did.
Daniel Williams:Yeah.
Dr. Michael Neal:So that person you want to keep. That's your higher or highest performer. See about number two. See about number three. Where does it trail off where you're like, okay?
Dr. Michael Neal:And then at the end of that list is the person or the people that you're just terrified to let go because you're not sure if you can replace them. That's what Build My Team's for. Right off the bat, they're holding your growth and your mental health hostage. You don't realize it when you're in the thick of it, but that's what's happening. And I'm not saying it's intentional, it's just I'm describing where a person's at.
Dr. Michael Neal:So when it comes to the concept of the cultural side, yeah, you most certainly let the people on the bottom end go and you replace them with the high performers. What you're going to be able to do then is have your team turn around and start performing. You also stop the low performers from repelling the higher talent. And that is critical because the higher talent, they will do anything to work with A players. An A player only wants to work with an A player.
Dr. Michael Neal:They'll tolerate a B player, but guess what? They're going to quit their job because they have C and D players on their teams. They're carrying the weight of those people, everybody knows it, so they end up leaving. And you can't replace an A player who left because of those reasons with another A player. It's just going to happen again.
Dr. Michael Neal:And that's where the revolving door comes. So you focus on the other end of the employee team, you focus on the people that aren't performing well and get those folks off the team and replace them with somebody better.
Daniel Williams:Okay.
Dr. Michael Neal:And that's the why behind it.
Daniel Williams:Sure. Now you mentioned earlier that you'd love to meet Carol Dweck and talk to her about mindset. Are there any other experts in this field or books that cover this field that you would want to share as resources for any of our listeners here that you think are just really top of the game here that you can learn from?
Dr. Michael Neal:Well, I think Rocket Fuel, Geno Wickman, that's an interesting book. Now that's more on the entrepreneurial side. But guess what? If you're a practice owner, you're an entrepreneur.
Daniel Williams:And
Dr. Michael Neal:that helped a lot for my journey because I'm more on the visionary side and I needed help on the operational side. And so many times the leaders in the practice are tough, in a tough situation because they don't want to relinquish any level of control. That was a terrific jump to help me realize that without doing that, I'm toast. It's a must do. But you want to relinquish a level of control to people who are good at it.
Dr. Michael Neal:Otherwise, we never hand that stuff off, right? That's the nature of it. So that was an interesting book that really helped me. And there's a whole bunch of them, of course.
Daniel Williams:For sure. So a final question here then, I just think it's so interesting. So in reading about you outside of work, when you're not running an optometry practice or you're not running build my team or doing all these other things, you're a marathoner. And if that's not enough for you, you're something called an ultra runner. So you're going to have to tell our listeners who may not know what an ultra runner is.
Daniel Williams:That must be an extra marathoner. But tell us about your outside endeavors.
Dr. Michael Neal:Yeah. Boy, oh boy. I don't like talking about myself from this sense, obviously. But ran the Boston Marathon in April. That was a really fascinating experience.
Dr. Michael Neal:Even if you don't run, it was a wild experience. Boston went absolutely bonkers for that event. Then as far as an ultra run, I I my record is I ran a little over 60 miles in twelve hours.
Daniel Williams:Wow.
Dr. Michael Neal:Yep. And didn't die. Wow.
Daniel Williams:You're here to prove that.
Dr. Michael Neal:Yep. Didn't die. That's that's that was the the goal at of that race was run, twelve hours as far as I could and not die.
Daniel Williams:Yeah. You know, there's the old what is the old saying? Like, what is it about a mountain? Why did you climb the mountain? Because it's there or something along So those why does someone run an ultra marathon or an ultra runner of 60 miles?
Daniel Williams:What is in your mindset that would drive you to do such a thing?
Dr. Michael Neal:Well, probably crazy right off the bat. I mean, clinically, there are some people listening to this that are like, Oh yeah, that box is checked. No, I think like I started running in 2022. I was super late to the party on that. And the health benefits are incredible for me.
Dr. Michael Neal:Just I have teenage kids, preteen and teenage boys, and keeping up with them is every day a level of challenge. This allows me to do it. But I want to see if I can do it. And this kind of ties back to a little bit of the practice owner side of things. When you were a kid, did you think you could ever be a doctor or be a senior person in in a practice?
Dr. Michael Neal:No. For most people, but yet you did. Right. Right. Did I ever think that I could run a marathon?
Dr. Michael Neal:No, I started out running from the couch to the fridge for the ice cream and back again when the ice cream started to melt. You know, that was it. That that was the start of my that was the start of my running journey. And so it it it really became something that I completely and utterly fell in love with. I don't know that I'm going to do another race that that long.
Dr. Michael Neal:I got some birthdays under my belt and you're always concerned about injuries and stuff like that. But I did it.
Daniel Williams:Yeah, it's it's so impressive. And so running 60 miles in twelve hours or whatever the numbers are there, what does the body feel like? I mean, did you feel like afterwards? Did you have any injuries from it? Did you wear out an entire pair of shoes and switch shoes midway through?
Daniel Williams:Tell us So about
Dr. Michael Neal:it was a slow and steady wins the race approach. I beat a guy who's 24, which was really exciting for me because I'm not 24. I'm not even a backwards 24. What did it feel like? Was Past a certain distance, it's all about what you eat.
Dr. Michael Neal:Nutrition wins the race. It's remarkable. Imagine hot mash well, warm mashed potatoes squished through a tube. That's those were those were the the winning solution.
Daniel Williams:Oh, boy.
Dr. Michael Neal:As far as hurt goes, yeah, there was some ibuprofen involved, some ibuprofen and acetaminophen at the same time works wonderfully. Got up to the limits of what a human should probably do during that period of time. Was just mandatory. Had to.
Daniel Williams:Right.
Dr. Michael Neal:And my feet, that was a whole nother story. Three shoe switches. I had a team of people who were keeping track of all that stuff because I don't know anybody, well, professionals still have a brain that works after a certain number of miles. Mine was mush. I mean, I'm happy it didn't leak out my ears, but it might have.
Dr. Michael Neal:I wouldn't have known. So I had a team that was was keeping track of this and they would tell me, sit down, we're changing your shoes, you have to eat this and that. And sitting down was magical, but I'm telling you getting up was hard.
Daniel Williams:That's what I would think. It's the
Dr. Michael Neal:getting Everything's up seized up. Yeah.
Daniel Williams:Yeah. Are you listening to stuff? Do you have AirPods in and listening to music or motivational stuff? Or you strictly no noise going on there?
Dr. Michael Neal:Some runners love music. I'm not one of them. I don't. I've tried it. I listen to music in every other aspect of my life, but it's just not me for running.
Dr. Michael Neal:I don't know why. It's kind of bizarre. No. But I spent a day thinking until I was unable to think. And then, I don't really know what I did other than just plot along.
Dr. Michael Neal:Okay. But you know what was really fun and was totally motivating is whenever I would run by somebody, I would tell them they're doing great.
Daniel Williams:That's awesome.
Dr. Michael Neal:And it kept me going. It's it's like you're doing awesome. And it just gave me that little bit of extra boost too. It was
Daniel Williams:a lot Incredible. Alright. Last thing I'll ask you then. You've got an image behind you. I don't think that it's not a real brick wall, is it?
Daniel Williams:Is that one of those? You've got your build my team for people who can't see it. But then on the other side of you, you've got think about things differently and the differently is upside down. So you're owning that. So talk about that.
Daniel Williams:This will take us out of the podcast, but I would love to hear what thinking differently means to you, Doctor. Mike.
Dr. Michael Neal:Well, in the sense of Build My Team, it's straightforward. You're hiring, you're getting the same results over and over again. The definition of insanity, right? It doesn't have to be We've that created a new way to get these team members. It's done for you.
Dr. Michael Neal:You pay a small fee. It's handed off. We get these outstanding team members, in front of you to interview. They we already know they can do the job. He can go eeny, meeny, miny, moe and come out 10 times better than what you're doing right now.
Dr. Michael Neal:And it's inexpensive. I'm not over promising. This is what we do. This is the only thing that we do. And so our challenge is always to get practice owners, senior leaders to think about things differently.
Dr. Michael Neal:That's why it's there. And if you do that, the results that I'm describing to you will come. If you continue down the path that you're on, just know we're here when you're ready.
Daniel Williams:All right. Well, Doctor. Mike, thank you so much for joining us. I love getting to talk to you and learn about your organization and your mindset.
Dr. Michael Neal:Thanks so much, Daniel. This is a lot of
Daniel Williams:Yeah. So everybody, for more information on Build My Team and Doctor. Mike's work, we'll include links in the show notes. So until then, I just want to say thanks again to all of you for being listeners to the MGMA Insights podcast, and we'll see you next time. Thanks so much, everybody.
Daniel Williams:Thank you.
