Good Intentions Are Not a Mentoring Program: How Healthcare Builds People Who Stay

WEBVTT

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There it is.

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Big fancy intro.

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It's official here on the operator

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podcast.

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This week, Larry dives into this.

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Every health care organization says they

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have great mentorship.

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It's the M word.

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It's on the career page.

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It's in the job posting.

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It's something every new grad looks for

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and hears during the interview.

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The latest article on the operator asks a

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simple question.

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How do you know?

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How do you know?

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Because assigning someone a mentor isn't

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the same as having a mentoring program.

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Those are two different things.

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So Larry, let's start here.

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You open by saying every healthcare

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organization promises mentorship.

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Why do you think so many organizations,

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they genuinely believe or at least say

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they're delivering it,

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but why is that a disconnect?

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Yeah,

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I think it's because nobody ever checks.

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I mean, if you think about, you know,

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I think if you check your benefits,

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you got health insurance, well,

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you got to get a health insurance card,

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right?

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And it's just the most common lie that

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I see in operations,

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maybe not a deliberate one.

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Because mentoring, on the one hand,

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is supposed to be unstructured.

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But on the other hand,

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if it's not structured enough,

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it won't exist.

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But it's a thing that everybody believes

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is happening,

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but nobody's really verifying it.

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And the promise during recruiting is

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somewhat sincere.

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But like any other system,

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it has to have checks in it and

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accountability to make sure that it's

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happening.

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Maybe they paired somebody on day one,

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but from that moment forward,

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nobody measures it, nobody owns it,

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nobody calendars it.

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And the only person who really fills the

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gap between the promise and the delivery

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is the new hire.

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And she or he is not going to

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name it because they're polite and they're

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new.

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And, you know,

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so it starts to unwind and evolve.

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And eventually it's probably the reason

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why a lot of people leave.

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You know, you're assigned a mentor,

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you're introduced by email on week one,

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you have coffee on week two,

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by week six,

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you were planning on meeting again.

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The intention was there, but as you said,

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there's no structure.

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I think the title says a lot.

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Everybody has mentoring,

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almost nobody has a mentoring program.

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You sort of covered that a second ago

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there, right,

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about the difference between that is one

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is a promise, the other is a process,

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right?

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No, that's right.

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It has to have structure.

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It has to be systematic.

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And when something is systematic, Jimmy,

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it's defined, it's taught, it's lived,

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it's monitored, it's re-engineered,

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it's held accountable, it's rewarded.

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Everybody has mentoring,

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two people paired up, good intentions,

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maybe even an occasional coffee.

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But the program has four things the

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brochure skips.

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It has to have milestones and a

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curriculum.

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Number one, number two,

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it has to have a written development plan.

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You have to have mentors who are trained.

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Would you train a therapist to be a

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clinical supervisor for a student?

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Of course you would.

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In fact,

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the APTA has a credential for it.

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You ought to do the same with mentorship

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and it has to have obviously bilateral

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accountability.

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And here's the part people really get

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wrong.

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Structure isn't the boring part of

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mentoring.

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It is the whole thing.

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Yeah,

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assigning a mentor is not a mentoring

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program any more than buying a gym

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membership as a workout, right?

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Both are real, both are well intentioned,

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but both produce exactly nothing without a

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formalized structure that turns, you know,

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intention into repetition,

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and then repetition into, you know,

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what you're really looking for is outcomes

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and results.

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Yeah,

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you want to change or you want to,

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you know, you're selling structure.

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And if it lacks to be there,

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everybody gets cheated.

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You mentioned this,

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something you call the recruiting

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brochure.

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I've said this phrase before, you know,

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you're in the middle of something like

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this was not on the brochure.

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You know,

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I didn't see I didn't see this one.

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I didn't think this was happening when I

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signed up.

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That felt just painfully familiar.

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So how does mentorship become something

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that's great for recruiting,

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looks awesome on the brochure with some

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stock images and some people smiling,

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but quietly disappears after day one?

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Yeah, and if you look,

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you'd be hard-pressed to find a physical

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therapy company or a healthcare company

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that doesn't promise mentorship.

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So it's built as a recruiting asset,

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but it's not an operating commitment with

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intentionality.

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um it's really one of the one of

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the two or three things that a clinician

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is sold on you know schedule you'll have

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some flexibility uh you'll hours or eight

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to whatever and money um and we're going

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to mentor you we have a strong commitment

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to it so it's so sick the closure

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right then the investment ends the moment

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they sign no curriculum like i said is

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behind the sentence

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uh no protected time no one no one's

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job it is to make it real i

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will tell you that a lot of companies

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started substituting mentorship for

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formalized residency and there is some

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truth to that right i mean you know

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because then the apta approved clinical or

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abpts approved clinical residencies abt

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ref whatever the name of that is the

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initials are um you have to have so

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many mentoring hours that's a requirement

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although they've gotten pretty

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lackadaisical is that remote is that what

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does that really mean so i think for

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a while that started to be the substitute

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but you really should have both because

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mentoring involves clinical and

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non-clinical the the the socialization the

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you know other support services you know

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we had mentoring when i was in the

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military and that was somebody who helped

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guide you to the socialized lifestyle of a

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military person, how to access services,

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who to know,

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sort of the informal networking, all that.

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Now, in a company, though,

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you could spot this stuff out in a

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minute.

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The mentorship appears,

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and it's oftentimes even in the offer

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letter, right, or on the career page.

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But it's not in anybody's job description.

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If you're an experienced therapist and

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your job description doesn't have that

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you're

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supposed to be a mentor,

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you don't get somewhat rewarded for it.

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You know, in dental, it's interesting.

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We actually pay our dentists to be mentors

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because they go out of their way.

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It can actually decrease their

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productivity and their productivity is

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their income.

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And so we actually backed that commitment

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out with a little different, you know,

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it's why we have so many dental directors

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and I think PT should go to that

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model.

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I think PT should have PT, you know,

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directors, not clinical directors,

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not businessy, but on the purely on the,

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on the clinical side that rewards them for

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going out of the way and being mentors,

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you know, otherwise what, what, you know,

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show me an incentive and I'll show you

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an outcome and it's just not going to

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be done.

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Yep.

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You mentioned that coffee chat that I just

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sort of alluded to a second ago.

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Two people meeting up, good intentions,

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no structure,

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both sort of waiting for magic to happen.

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Why is that model almost always guaranteed

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to fail?

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Yeah,

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it's guaranteed to fail on the clinical

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side.

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because really that model runs on

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friendship, and friendship's a good thing,

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but friendship's not a development system.

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How many of your friends sit down with

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you and guide you, Jimmy?

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They don't, and so there's no milestones.

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There's no way to know if anyone's

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progressing, no curriculum.

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Content is whatever top of mind that week.

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There's really no plan.

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Some people have a journal club and they

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call that mentoring.

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Journal club is certainly a function for

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it, but that's not mentoring.

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And the other thing is the mentors always

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get busy because they're getting beeped by

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their BI tool about their productivity and

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units per visit.

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And the reality is your best clinicians

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are really busy and they're probably some

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of your best mentors,

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which is why exactly their schedule is

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full.

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But here's the reality to tell.

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We would never run clinical training this

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way.

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Spend time with patients,

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you'll pick it up, right?

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We would never do that.

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We define the competencies,

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we sequence them,

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and we check whether they're reached.

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That's what we do with student interns

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that are on their clinicals.

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Mentoring deserves the same discipline.

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The question isn't whether it feels good,

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it's whether anyone is really measuring

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measurably better for it.

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We used various systems over the years,

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but checklists and skill checklists and

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making sure that people understood the

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clinical prediction rule or understood a

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certain manual therapy technique.

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And that level of accountability is a good

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thing.

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And if done right,

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it helps a therapist progress to mastery

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and to board certification,

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which is sort of the ultimate,

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which is what you want.

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Yeah,

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one of the biggest ideas that I didn't

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think about because I've been on the

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receiving end of this recruiting brochure

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is that mentoring isn't disappearing

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because people don't care.

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They're not qualified or they're not

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there.

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Simply, it's because nobody owns it.

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So that accountability is the missing

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ingredient, it seems like.

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yeah absolutely um you know you get what

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you measure and what you reward and in

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really most platforms mentoring doesn't

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show up in a metric doesn't show up

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in a board deck unless they're trying to

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impress somebody there's no incentives

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there's no review it's it's purely a

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discretionary effort

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laid on top of a full clinic load.

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Like I said,

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I think you have to reward clinicians for

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that.

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I had a meritocracy system where maybe

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didn't pay them extra for the mentoring

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time,

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but those time counted towards

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a classification system that moved them up

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the ladder where they did get paid more

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money and or more paid time off it

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was a combination of both or in some

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cases a one-time bonus you know

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discretionary effort is the first thing

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that we cut when we're under pressure you

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know right units per visit visits and you

00:10:10.445 --> 00:10:12.066
know all these all these things happening

00:10:12.427 --> 00:10:15.028
um and all that stuff really happens and

00:10:15.048 --> 00:10:16.990
the mentoring just slides and it's it's

00:10:17.029 --> 00:10:19.711
the same lesson the ninety day rule

00:10:19.750 --> 00:10:21.452
teaches that work isn't a role

00:10:22.351 --> 00:10:24.173
is the work that disappears the moment

00:10:24.192 --> 00:10:25.433
someone gets busy.

00:10:26.073 --> 00:10:27.475
The work that isn't a role, I mean.

00:10:27.934 --> 00:10:29.836
So when somebody gets busy,

00:10:30.596 --> 00:10:31.596
what gets shortchanged?

00:10:31.836 --> 00:10:34.239
Mentorship is that kind of thing.

00:10:35.759 --> 00:10:38.341
And you cannot run retention on favors or

00:10:38.400 --> 00:10:38.942
promises.

00:10:38.961 --> 00:10:40.001
You just can't.

00:10:40.062 --> 00:10:41.003
No, no.

00:10:41.143 --> 00:10:41.383
OK,

00:10:41.442 --> 00:10:43.183
so if I'm a clinic director or an

00:10:43.264 --> 00:10:43.964
owner listening,

00:10:44.004 --> 00:10:45.504
what's the smallest thing I could do?

00:10:45.544 --> 00:10:45.705
I mean,

00:10:45.725 --> 00:10:47.886
you describe what a really good mentoring

00:10:47.927 --> 00:10:48.246
program

00:10:49.028 --> 00:10:50.288
Should actually look like.

00:10:50.308 --> 00:10:51.490
So if someone's listening,

00:10:51.529 --> 00:10:52.951
what's the smallest thing they could do

00:10:52.990 --> 00:10:54.991
and implement tomorrow that would move

00:10:55.011 --> 00:10:56.613
them from, you know,

00:10:56.753 --> 00:10:59.394
wishes and good intentions toward a real

00:10:59.434 --> 00:11:01.096
program?

00:11:01.277 --> 00:11:01.437
Yeah,

00:11:01.456 --> 00:11:03.337
I think there there's a couple moves you

00:11:03.357 --> 00:11:05.460
can make in sort of one day's work.

00:11:05.539 --> 00:11:07.160
First thing I would do is write down

00:11:07.280 --> 00:11:08.942
what you believe the milestones are.

00:11:09.539 --> 00:11:11.441
what your new clinician should be able to

00:11:11.500 --> 00:11:13.182
do at thirty days, ninety days,

00:11:13.241 --> 00:11:14.003
six months.

00:11:14.523 --> 00:11:16.464
And I like monthly checkpoints and

00:11:16.504 --> 00:11:17.104
checklists.

00:11:18.024 --> 00:11:19.206
And you can certainly make them all

00:11:19.245 --> 00:11:20.547
electronic now and everything.

00:11:20.586 --> 00:11:22.548
But you could also now use A.I.

00:11:22.607 --> 00:11:23.727
and say, you know,

00:11:23.989 --> 00:11:25.669
all those kinds of things to protect it.

00:11:26.669 --> 00:11:29.211
That single act converts that coffee chat

00:11:29.231 --> 00:11:31.072
we talked about into something with a with

00:11:31.133 --> 00:11:34.215
a spine because progress becomes visible

00:11:34.274 --> 00:11:35.855
and really stalls when it's

00:11:36.696 --> 00:11:38.317
You know, when it's not detectable,

00:11:38.576 --> 00:11:39.716
that's the first thing you could do.

00:11:39.797 --> 00:11:42.197
Milestones, objective things, calendar,

00:11:42.258 --> 00:11:42.738
checklist.

00:11:43.038 --> 00:11:46.298
The second, if you'll do it,

00:11:46.339 --> 00:11:49.139
is put mentoring in the job description

00:11:49.740 --> 00:11:51.681
and the review of the therapist.

00:11:52.000 --> 00:11:52.682
And in that case,

00:11:52.721 --> 00:11:54.381
it holds them accountable to their annual

00:11:54.422 --> 00:11:56.123
review or to the review moment.

00:11:56.602 --> 00:11:58.744
The moment it counts towards how a senior

00:11:58.764 --> 00:12:00.083
clinician is evaluated,

00:12:00.224 --> 00:12:01.964
it's no longer discretionary, right?

00:12:02.104 --> 00:12:04.004
It is what you're supposed to do.

00:12:04.544 --> 00:12:04.764
Now,

00:12:05.085 --> 00:12:06.625
you have to organizationally have a

00:12:06.666 --> 00:12:08.985
commitment to it.

00:12:09.005 --> 00:12:10.125
Interesting, you know,

00:12:10.225 --> 00:12:11.447
I did a post on this,

00:12:12.106 --> 00:12:13.086
I guess about a year ago,

00:12:13.167 --> 00:12:14.647
maybe a little over a year ago now,

00:12:15.388 --> 00:12:17.727
and I had a niece graduate from PT

00:12:17.748 --> 00:12:18.048
school.

00:12:18.067 --> 00:12:18.388
She said,

00:12:18.427 --> 00:12:20.188
what are the questions that I should be

00:12:20.288 --> 00:12:21.708
asking in my interview?

00:12:22.489 --> 00:12:24.090
And that's one of the things I pointed

00:12:24.129 --> 00:12:24.309
to,

00:12:24.450 --> 00:12:24.929
show me

00:12:26.109 --> 00:12:28.572
verifiably how you hold your mentoring

00:12:28.613 --> 00:12:30.294
accountable and that it's a formal

00:12:30.355 --> 00:12:30.936
program.

00:12:31.937 --> 00:12:34.721
Because I do believe that applicants have

00:12:35.182 --> 00:12:36.764
every bit of right to evaluate your

00:12:36.803 --> 00:12:38.166
mentoring program as they do your

00:12:38.245 --> 00:12:40.208
healthcare insurance or your dental

00:12:40.288 --> 00:12:41.770
insurance or your life insurance.

00:12:42.985 --> 00:12:44.748
The cheapest version of a program is the

00:12:44.827 --> 00:12:46.389
one you write down before the best mentor

00:12:46.428 --> 00:12:47.710
leaves and takes the whole thing out the

00:12:47.730 --> 00:12:49.371
door in his or her hand.

00:12:50.352 --> 00:12:52.114
The most expensive one is the one where

00:12:52.153 --> 00:12:54.816
you contribute effort and energy and

00:12:54.875 --> 00:12:55.876
resources to it.

00:12:57.519 --> 00:13:00.000
As you well know, exit interviews,

00:13:00.581 --> 00:13:02.041
oftentimes don't mention mentoring,

00:13:02.081 --> 00:13:03.581
but if you really drill down,

00:13:04.562 --> 00:13:07.001
it does get to that as a really

00:13:07.422 --> 00:13:09.302
significant portion as to why young

00:13:09.342 --> 00:13:11.243
therapists change jobs very often.

00:13:11.283 --> 00:13:11.462
You know,

00:13:11.503 --> 00:13:12.623
keep in mind the average therapist

00:13:12.643 --> 00:13:13.102
changes,

00:13:14.043 --> 00:13:15.683
doesn't last on their first job less than

00:13:15.703 --> 00:13:16.024
a year.

00:13:16.563 --> 00:13:17.244
Yeah.

00:13:17.283 --> 00:13:20.605
You've got an almost stunningly simple

00:13:21.504 --> 00:13:23.524
diagnostic to figure out if there's a

00:13:23.565 --> 00:13:24.904
mentorship program in place.

00:13:24.965 --> 00:13:26.645
And it seems like it's two questions,

00:13:26.905 --> 00:13:27.905
like walk us through that.

00:13:29.408 --> 00:13:32.269
yeah so the you know the clinician you

00:13:32.289 --> 00:13:33.811
know asked what are you working on with

00:13:33.831 --> 00:13:35.412
your mentor this month and what would you

00:13:35.451 --> 00:13:38.893
know if it happened um you know that

00:13:38.932 --> 00:13:40.673
that's it structure can answer it and

00:13:41.554 --> 00:13:43.916
fondness or you know pleasantry can't

00:13:43.975 --> 00:13:45.557
right if the answer comes back in one

00:13:45.576 --> 00:13:46.976
clean sentence with a name and a

00:13:47.136 --> 00:13:49.557
checkpoint i'm working on x and we review

00:13:49.597 --> 00:13:50.359
it at our monthly

00:13:51.160 --> 00:13:52.142
You have program.

00:13:52.562 --> 00:13:54.102
This actually harkens back,

00:13:54.123 --> 00:13:54.744
if you remember, Jimmy,

00:13:54.844 --> 00:13:56.846
to the series we did on meetings and

00:13:56.905 --> 00:13:59.148
why they're important and why they should

00:13:59.207 --> 00:14:00.227
also be structured.

00:14:01.028 --> 00:14:02.529
If it's a pause or we just kind

00:14:02.549 --> 00:14:04.511
of check on it or it's a warm

00:14:04.572 --> 00:14:06.553
story with nothing measurable in it,

00:14:07.114 --> 00:14:09.035
you can have a coffee chat at best

00:14:09.596 --> 00:14:11.076
and you have something on a brochure.

00:14:12.357 --> 00:14:13.860
The fondness in the answer isn't the

00:14:14.000 --> 00:14:14.419
signal.

00:14:14.460 --> 00:14:17.081
The structure, really the formality,

00:14:17.121 --> 00:14:18.523
the backbone is.

00:14:19.524 --> 00:14:22.066
It's really an engagement detector.

00:14:22.505 --> 00:14:24.467
If you look at Gallup, for example,

00:14:24.528 --> 00:14:28.191
they predict whether someone stays with a

00:14:28.250 --> 00:14:29.192
key question.

00:14:29.251 --> 00:14:30.172
It's a Gallup question.

00:14:30.231 --> 00:14:31.153
It goes something like,

00:14:31.592 --> 00:14:33.875
I have somebody at work that encourages my

00:14:33.955 --> 00:14:34.655
development.

00:14:35.535 --> 00:14:37.037
They have another question that says,

00:14:37.177 --> 00:14:40.019
I have someone at work that cares about

00:14:40.059 --> 00:14:40.279
me.

00:14:41.221 --> 00:14:44.802
I have something at work that gives me

00:14:44.822 --> 00:14:46.565
the opportunity to grow and develop.

00:14:47.441 --> 00:14:51.003
For a new clinician, that's most of it.

00:14:51.783 --> 00:14:54.144
I would teach my managers that in addition

00:14:54.605 --> 00:14:56.245
to those three questions,

00:14:57.927 --> 00:15:01.068
do I have somebody that gives me the

00:15:01.089 --> 00:15:03.571
tools and resources to maximize or to

00:15:03.630 --> 00:15:04.932
optimize my job?

00:15:05.672 --> 00:15:08.333
And am I proud of the company?

00:15:09.014 --> 00:15:09.594
So, you know,

00:15:09.614 --> 00:15:11.534
you take those kind of things and you

00:15:11.595 --> 00:15:13.855
boil them down to some level of simplicity

00:15:14.937 --> 00:15:17.217
and you realize that the mentoring has

00:15:17.238 --> 00:15:18.958
sort of the intended consequences,

00:15:19.019 --> 00:15:20.580
but it has a lot of unintended

00:15:20.639 --> 00:15:21.340
consequences.

00:15:21.379 --> 00:15:23.801
It really drives engagement because it

00:15:23.841 --> 00:15:26.201
holds people accountable to each other's

00:15:26.241 --> 00:15:26.923
development.

00:15:27.802 --> 00:15:29.624
And, you know, it all goes back,

00:15:29.644 --> 00:15:31.325
Stephen Covey, to learn, to live,

00:15:31.365 --> 00:15:32.424
to leave a legacy.

00:15:32.605 --> 00:15:35.726
You know, people want to grow and develop.

00:15:36.206 --> 00:15:39.028
It's oftentimes an unstated driver.

00:15:39.128 --> 00:15:39.788
And, you know,

00:15:39.827 --> 00:15:42.448
are you an organization that drives people

00:15:42.469 --> 00:15:44.049
to grow, to maturity,

00:15:44.090 --> 00:15:45.610
to master clinician level?

00:15:47.371 --> 00:15:47.572
you know,

00:15:47.692 --> 00:15:49.953
what is the legacy that you have here?

00:15:50.053 --> 00:15:51.414
And I think ultimately,

00:15:51.696 --> 00:15:53.636
ultimately that's how companies end up

00:15:54.177 --> 00:15:56.980
being judged because that all converts to

00:15:57.019 --> 00:15:59.841
the downstream effect of better EBITDA or

00:15:59.861 --> 00:16:01.082
better cash flow.

00:16:01.144 --> 00:16:02.764
Yeah, it does touch the big scoreboard.

00:16:02.784 --> 00:16:05.086
It feels fluffy and fuzzy and warm and,

00:16:05.874 --> 00:16:07.274
and a little emotional,

00:16:07.315 --> 00:16:08.596
but if the people leave,

00:16:08.615 --> 00:16:10.136
that does affect your bottom line.

00:16:10.177 --> 00:16:12.138
So the people are the thing actually in

00:16:12.158 --> 00:16:13.778
these professions delivering the service.

00:16:14.318 --> 00:16:15.720
So let's imagine.

00:16:15.759 --> 00:16:16.080
By the way,

00:16:16.120 --> 00:16:17.620
to that point on people leave, you know,

00:16:17.640 --> 00:16:19.142
one of the things that's been, you know,

00:16:19.221 --> 00:16:20.702
I'm going to do some writing on this

00:16:20.783 --> 00:16:23.325
is that we have this bad habit in

00:16:23.365 --> 00:16:24.806
health care service businesses

00:16:25.725 --> 00:16:28.626
Of commoditizing our therapists.

00:16:28.647 --> 00:16:29.226
So, oh,

00:16:29.246 --> 00:16:31.607
we brought forty five new therapists on

00:16:31.628 --> 00:16:33.488
this month and we lost forty three.

00:16:33.528 --> 00:16:33.947
Therefore,

00:16:33.988 --> 00:16:35.749
we're a net gain of two therapists.

00:16:35.869 --> 00:16:36.129
Right.

00:16:36.729 --> 00:16:36.869
Well,

00:16:37.188 --> 00:16:39.250
the problem with that is tell me about

00:16:39.309 --> 00:16:40.990
the forty three that you lost.

00:16:41.730 --> 00:16:43.030
Were they your best people?

00:16:43.230 --> 00:16:45.410
Are they regrettable leaves to where

00:16:45.431 --> 00:16:47.711
they're billing and they're they're

00:16:47.851 --> 00:16:48.591
mentoring?

00:16:49.192 --> 00:16:50.732
You can't replace that with another PT,

00:16:50.753 --> 00:16:51.253
at least not right away.

00:16:51.293 --> 00:16:51.452
Right.

00:16:51.493 --> 00:16:51.653
Right.

00:16:51.673 --> 00:16:54.453
Yeah, it's important.

00:16:55.328 --> 00:16:56.370
So five years from now,

00:16:56.389 --> 00:16:58.210
a health care organization becomes known

00:16:58.690 --> 00:17:00.750
as the place new clinicians want to build

00:17:00.811 --> 00:17:01.150
a career.

00:17:01.230 --> 00:17:02.711
I know several of those in the country.

00:17:02.731 --> 00:17:04.893
And it's almost like you can spot them.

00:17:05.932 --> 00:17:07.574
But from across the street,

00:17:08.134 --> 00:17:09.354
you might not be able to until you

00:17:09.374 --> 00:17:11.355
start to look into why that is.

00:17:12.095 --> 00:17:14.276
So what's true about their mentoring

00:17:14.316 --> 00:17:14.855
program,

00:17:14.915 --> 00:17:16.856
the place that people know as the great

00:17:16.896 --> 00:17:17.636
place to start?

00:17:17.656 --> 00:17:19.077
What's true about their mentoring program

00:17:19.097 --> 00:17:21.778
that isn't true about other places?

00:17:23.123 --> 00:17:24.865
What's true about their mentoring program

00:17:25.065 --> 00:17:27.587
is the consequence of being a destination

00:17:27.627 --> 00:17:28.087
employer.

00:17:28.148 --> 00:17:29.809
Where do new grads want to go?

00:17:30.211 --> 00:17:31.612
They want to go where people have

00:17:31.711 --> 00:17:32.993
graduated from there.

00:17:34.469 --> 00:17:39.291
and have either spent their careers there

00:17:39.311 --> 00:17:40.413
or a good portion of their career and

00:17:40.432 --> 00:17:41.773
they came out better for it.

00:17:42.134 --> 00:17:43.013
When they came out better,

00:17:43.054 --> 00:17:44.775
they opened a practice or they in turn

00:17:44.894 --> 00:17:47.777
mentored other people.

00:17:47.797 --> 00:17:51.378
You develop this legacy reputation and you

00:17:51.419 --> 00:17:53.680
develop a reputation as a destination

00:17:53.740 --> 00:17:55.240
employer.

00:17:55.260 --> 00:17:56.102
When you do that,

00:17:56.142 --> 00:17:57.782
your recruitment costs are less,

00:17:58.123 --> 00:17:59.544
your turnover is less,

00:17:59.584 --> 00:18:00.844
your production is more,

00:18:01.365 --> 00:18:02.846
everything benefits from it.

00:18:04.465 --> 00:18:06.507
This is a real difficult times for

00:18:06.547 --> 00:18:08.267
healthcare service platforms because we've

00:18:08.307 --> 00:18:11.008
had this post COVID hiccup of decreased

00:18:11.048 --> 00:18:13.728
payments, headwinds around all of that.

00:18:13.768 --> 00:18:15.528
You have headwinds around shortages,

00:18:15.548 --> 00:18:17.288
you have headwinds around inflation.

00:18:17.328 --> 00:18:17.848
My gosh,

00:18:17.888 --> 00:18:18.910
we thought we were getting rid of

00:18:18.930 --> 00:18:20.309
inflation actually got worse.

00:18:21.130 --> 00:18:22.810
And now all of a sudden,

00:18:24.230 --> 00:18:26.912
what can you do to get margin back?

00:18:27.832 --> 00:18:29.771
And it's really, really difficult,

00:18:29.811 --> 00:18:30.913
but some of the things you can do

00:18:30.992 --> 00:18:32.073
as an organization

00:18:33.020 --> 00:18:35.722
is to be that destination employer because

00:18:35.742 --> 00:18:37.904
you'll have less costs going out the door

00:18:37.924 --> 00:18:38.664
for recruitment.

00:18:38.765 --> 00:18:40.385
You'll have less costs going out for

00:18:40.445 --> 00:18:41.146
replacement.

00:18:41.906 --> 00:18:45.309
And the difficulty with that is we tend

00:18:45.349 --> 00:18:45.710
to,

00:18:45.849 --> 00:18:47.391
at least in the healthcare services

00:18:47.530 --> 00:18:47.932
business,

00:18:47.971 --> 00:18:50.433
think of capital expense as I'm going to

00:18:50.493 --> 00:18:51.453
open up a de novo.

00:18:51.653 --> 00:18:52.994
I'm going to buy a machine.

00:18:53.556 --> 00:18:56.298
I'm going to name an asset, right?

00:18:56.738 --> 00:18:59.519
What we have to think about is how

00:18:59.559 --> 00:19:01.561
much can I invest in human capital?

00:19:02.221 --> 00:19:03.803
And so my investment in mentoring,

00:19:03.863 --> 00:19:05.844
my investment in talent creation,

00:19:05.943 --> 00:19:08.565
my investment in an academy that upskills,

00:19:09.005 --> 00:19:09.566
in our case,

00:19:09.645 --> 00:19:11.267
dentists for what I'm doing now,

00:19:11.767 --> 00:19:13.867
that commitment takes real capital.

00:19:14.167 --> 00:19:15.328
It has to be budgeted.

00:19:15.648 --> 00:19:16.929
It has to be prioritized,

00:19:16.949 --> 00:19:18.089
and it has to be part of your

00:19:18.130 --> 00:19:19.510
value creation strategy.

00:19:20.070 --> 00:19:21.672
And when you do that effectively,

00:19:22.271 --> 00:19:23.633
everything else benefits from it.

00:19:23.913 --> 00:19:25.334
But if you're waking up and saying,

00:19:25.374 --> 00:19:26.834
what new de novo am I doing?

00:19:26.875 --> 00:19:29.355
What new piece of equipment do I want?

00:19:29.455 --> 00:19:31.257
What do I want to spend money on?

00:19:31.958 --> 00:19:34.185
And you're not waking up thinking of how

00:19:34.226 --> 00:19:36.354
can I make human capital my number one

00:19:36.394 --> 00:19:36.996
investment?

00:19:38.315 --> 00:19:39.675
Healthcare service platform companies are

00:19:39.695 --> 00:19:41.416
gonna be rewarded by the best operators.

00:19:42.057 --> 00:19:42.778
And as you know,

00:19:42.798 --> 00:19:44.180
from several talks that you and I have

00:19:44.200 --> 00:19:44.539
had,

00:19:44.640 --> 00:19:48.222
operations become secondary or tertiary to

00:19:48.282 --> 00:19:49.604
leadership and management.

00:19:50.325 --> 00:19:51.986
But now we have to really focus on

00:19:52.066 --> 00:19:53.928
operational excellence and pride in that.

00:19:54.468 --> 00:19:56.329
And the companies that do that well will

00:19:56.349 --> 00:19:57.170
be rewarded.

00:19:57.210 --> 00:19:58.570
And the companies that do that well,

00:19:58.791 --> 00:20:00.653
certainly mentoring is a key hub of their

00:20:00.692 --> 00:20:02.434
talent, management,

00:20:02.474 --> 00:20:03.855
human capital perspective.

00:20:04.409 --> 00:20:04.828
Yeah.

00:20:04.868 --> 00:20:05.990
Well, if I took anything away from this,

00:20:06.029 --> 00:20:07.451
I would say mentor doesn't fail because

00:20:07.510 --> 00:20:08.311
people don't care.

00:20:08.352 --> 00:20:10.953
It fails because good intentions are not a

00:20:11.074 --> 00:20:11.513
system.

00:20:12.234 --> 00:20:13.875
And unless you put those things in place,

00:20:16.498 --> 00:20:18.019
it doesn't have a return for the people.

00:20:18.358 --> 00:20:19.720
And we know what that can lead to.

00:20:19.839 --> 00:20:19.920
Yeah.

00:20:20.689 --> 00:20:22.529
It's tough to manage because you have to

00:20:22.549 --> 00:20:24.271
have a lot of systems, right?

00:20:24.632 --> 00:20:25.653
But ultimately,

00:20:26.334 --> 00:20:28.134
your systems are your priorities,

00:20:28.155 --> 00:20:29.596
your priorities are your values,

00:20:29.636 --> 00:20:31.117
your values are your strategies.

00:20:32.019 --> 00:20:36.242
And mentoring and human capital,

00:20:36.824 --> 00:20:38.005
all of those things

00:20:39.559 --> 00:20:43.962
really should be integral to companies

00:20:44.063 --> 00:20:46.023
because that is what's going to allow them

00:20:46.064 --> 00:20:47.644
to have sustainable growth,

00:20:48.085 --> 00:20:51.207
sustainable profits, you know,

00:20:51.227 --> 00:20:52.807
just success in the marketplace and

00:20:52.867 --> 00:20:54.308
ultimately get the benefit of being a

00:20:54.368 --> 00:20:56.871
destination employer who's highly focused

00:20:56.911 --> 00:20:58.471
on nurturing and developing their people.

00:20:59.682 --> 00:21:01.864
if this conversation made you rethink the

00:21:01.903 --> 00:21:03.626
difference between culture and structure

00:21:04.146 --> 00:21:05.769
maybe go deeper in the article subscribe

00:21:05.788 --> 00:21:07.951
to the operator on substack until next

00:21:07.991 --> 00:21:10.255
time larry keep operating thank you buddy