Ep. 190: Hiring Decisions That Build Culture Not Chaos

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Hey, what's up everybody? You're listening to another episode of Walk-Ins Welcome with Nick and Michael. And as always, we want to make sure that we're helping you get more patients, deliver better care, get repeat visits. And today we'll be talking about scaling your clinic. What's up, man? And I'm drinking some poppy, some prebiotic soda because I'm hip, but no, not really. I just actually kind of like them now. So it took me a while to get to those, but the poppies, the poppies, I didn't like them at first, but then I discovered Alpine blast, which tastes like Mountain Dew. That's not this one.

Okay, that looks like strawberry compote or something. It's all right. If I started with this one wouldn't like it. Anyway, we'll just get right distracted. Yeah, poppy come sponsor us. We'll take some of your drinks. Yeah, that's okay. We'll drink them up for the longest time we had a lot he knew but let's get it took that away. All right. So let's get into the podcast today for first of all, my goodness, we've been in a whirlwind season. It's been amazing. Y'all have been so incredibly responsive. We've been

⁓ Thank you. Adding, adding new urgent cares. What feels like, I will say this, we've had exponential growth over the summer in urgent cares that, that want to grow their clinics. They want to stay a steady flow of patients through, through the summer, the summer scaries, the summer doldrums, wherever you want to call it. ⁓ You know, summer's not really that long. as a kid, felt short and long. Like an eternity. Yeah. And then when it ended like

because my birthday is in July. So I remember as a kid with my birthday, I'm like two weeks away from school. And now as an adult, it comes and goes so fast. I mean, don't as an adult even get a summer. Like we're in summer, but we don't get off for summer. And then for urgent care, you guys really have, you do have it rough for two months. That's right. Because it's coming off of May, June is rough for you. We fully see that in our numbers and all the things like at the end of the day, summer's real. Summer slows down.

And then July is not too much better. But then you have some other opportunities. And then you have August and people are back in school. That's right. And then they get to give it two weeks after being in school. And then here comes your sickness. But we've been on a content tear. Yeah. In addition to all of you awesome urgent care centers coming into business with us again. Thank you. ⁓ And ⁓

We've just been on a tear of content. got a chance to be a speaker on an Xperity webinar. Yeah, super cool. So if you were if you were listening in on that, I hope you got value from it. We really tried to make it good for you. You know, it's funny about Xperity. I remember when we first started going down this urgent care path, we saw Xperity and Clockwise. They're like, they would never talk to us. I know, right? Remember that conversation? Like, they're never going to look at us. And now that we've been on a webinar with them, they've been with us now on a podcast, which just went out.

with Alan and ⁓ and they're really cool people. I've enjoyed getting to know Alan and Jenny and just the whole team over at Xperity that we've interacted with. ⁓ Priya, got a chance to. Yeah, she's she's about a couple years on with Xperity. Just a great team. And I've enjoyed getting to know them and talking to them. ⁓ As a matter of fact, one of the people that were on that ⁓ webinar.

⁓ Brent is going to come and that's right. He's going to be a guest on our podcast. He owns an urgent. owns an he's the CEO of an urgent care out in Oregon. Yeah. So ⁓ anyway, he's going to come hang out with us. ⁓ We had a webinar that was a lot of fun and it was all about ⁓ empowering, powering, overpowering, data powering. I don't know what it does your front desk. Yeah, so we did have a webinar. It's out there for replay. So if you haven't seen it, you can go check it out ⁓ or

reach out to hello at PitchcareMarketPers.com and Hannah will send you straight to it. But no, it was about, it was an extension of my talk from UCA Dallas about front desk evolution, which was like how to change your front desk from a customer service person to a salesperson. And then the webinar was all about, here's how to hire. Here's how to do the practical application, swipe and deploy. Yeah, basically, we're telling you to do this and we took all the hard work out of it and just download here.

and then just put your name in it and then go to work. So that's on our resources page on our website, patientcaremarketingpros.com. So if you get a chance to go to that webinar, you didn't get the replay, maybe you didn't even register for it, which is okay. That's your problem, not mine. We had 70 registrations for it, which I'm proud of. Yeah, that's a win. But you can go back and get those swiping deploys. I think more than anything, whether you watch us or not, even though if you want to know the practical application of it, you'll watch it. But

The swipe and deploys there. I mean, we have we have job descriptions. We have interview questions. ⁓ We have a little ⁓ customized chat GBT for you to train your front desk questions. Anyway, we try to put some really good resources for you. So go check that out on our resources page. Here comes the segue. Yeah, now it's not to talk like with it with this wave as you were talking about since you're doing the way they're segue. ⁓ We are we are hiring because we're growing.

Yes. And so it's actually really cool. Yes. And I love that. And we've hired two new client success managers. As you get to interact with us more, you'll get a chance to meet them. They'll be on discovery calls and strategy sessions and all of that. We've added another production person. Our goal is to add another production person, hopefully in the next few weeks. Yeah. It's weird for us too, because typically summer is not a big hiring time for us. Usually it's after summer or the beginning.

we're really about beginning of the year we would do a bunch of higher stuff it felt like but not this year this year was very up just like it was opposite for you guys for flu season take forever to show up it was opposite for us typically like the first year is a little chaotic but lots of good stuff this was not the case and now we're feeling the good stuff this summer which is funny because typically like when you guys are slowing down our you know our

communication kind of just slows down not by purpose. It just happens this way. Like summers typically are slower for us has not been the case. This has to be the busiest summer I think we've ever had on record. Yep. And I'll take it all day long. Yeah. A couple of things just with that. And of course we'll talk about, you know, how this applies to urgent care. I heard it was said by an early mentor of mine. Well, in my early 20s, a mentor of mine, I heard

Larry say, you'll never outgrow your ability, your capacity to serve your clients, right? So ⁓ you'll never be able to outgrow the room that you can fill. That's what he was talking about from that perspective. ⁓ You know, your clinic will only grow to the size of which it can serve the patients. right. Yeah. And the reason I say that is because we have grown because we have prepared in advance for the growth by

not having reactive hiring but proactive hiring. And that's one of the things I want to talk about. And it's proactive but strategic. We've done both by the way, just to be clear. We've done reactive hiring and proactive. And we've also done, we've done the bad version of proactive hiring. Yeah, yeah. It was proactive but we had no like...

evidence of being that proactive. I think proactive could also be considered strategic would be a good way to say it. Yeah. But here's what reactive hiring is. Michael, we've done this before. Right. So we have all this stuff to do and I don't have enough people. Let's hire. Can they fog this mirror? Like, can they breathe? Can they do something? And what happened to quality of work? Terrible. Right. What happened to culture? Stress. What happened to our core values?

What core values? Yeah, exactly. So granted, I was grateful for the business coming in, but I couldn't serve them at the level that I wanted to. And that business that came in, that business left. That's right. That's been a thing in the past. Revolving door business is what we call that. Yes. Revolving door business is some of the most painful business you can have because there's so much work put into it. And then there's so much emotion when it leaves. That's right. And then you are hitting the

I was better off not taking them on. That's right. Strategic. Hey, here's where we want to be. In order for us to be here, what strategic moves do we need to make in our hiring process to move the pieces on the chessboard to be able to serve people at a very high exceptional level with excellence, not perfection. That doesn't exist. But how are we to be able to serve our clients and our team, by the way, because I care just as deeply about my team, right?

How can we serve all the people that we're, I don't know, in connection with at the highest level and let's start filling those seats up and making sure that we're bringing on the right people. And so now when we're going into interviews with people, we just tell them this ain't going to be a quick hire. You need to know that. So if you have 30 job offers on the table, ⁓ I'm just telling you like you're five, six, seven interviews away. And I just said that now, some of you almost just wrecked your car. Okay.

I'm not saying that that's what you have to do. I'm just saying I know what a challenge it can be to go through that many interviews and I don't much like it either and we'll talk about that. Yeah, you don't. ⁓ And I've grown to dislike them because it takes up a lot of time. It does. And then sometimes you're given a candidate and you're like, why are we talking? This is not you're not. are you? How did you get this far? Exactly. Because it happens, especially when you feel like you thought you were getting the person. Then when they get in the car like.

you do like we even had ⁓ no names being mentioned, but we had one that fantastic on the video fantastic on the not in person, but the virtual part of it brought about that person in and then it just fell apart. And we're just like, Yeah, what happens without felt so good until this moment. Yeah, that's right. I've seen that happen. For sure. And you said the video it's funny. I'm just going to share our process because I know it's not for everybody. But we don't want to screen in person.

for hours at a time, dozens or hundreds of candidates for a position. So we use what's called a video ask. have video ask.com. It's owned by a company called Typeform, but I've created five videos of me interviewing that person. So video one, tell me about yourself. They send a video back to me right through the app. They tell me about themselves. It's basically five video questions that require five video answers.

And we do the video and we even have like a straight, because it's so funny because the video ask itself, yeah, it's there to help filter and to save time. But the fact that we asked him, I need you to do this video interview first. And they're like, I'm not turning my camera on. Bye bye. Because you don't care enough. For what for what we need for what we now for an urgent care may be different. But at the same time, if you're hiring someone that's going to be facing people.

Turning on a camera shouldn't be a big deal. Well, so let me add that to the urgent care space. If you were going to use the video, ask, you should use the audio format if you're hiring for a front desk. I need to know what they're going to sound like on the phone because you're not going to see their face. You could even do the video, ask like, here's a script. I need you to respond by reading the script as if you worked in the urgent care. That'd be good. Yeah, just to see how they would. And then how would you answer this question? That's right. And I'm listening.

Are they smiling when they talk? Do they care about what they have to say? Are they energetic or are they Debbie Downer? Sorry if your name's Nick the narcissist could be another way to say it. I don't know how you want to say it, but anyway, ⁓ you know, you're looking for those tones before you bring them into another interview. And really our second interview is just really a meet and greet. Hey, I'm Nick. Here's who you are. Thank you for putting on a video. feel like I already know where you are and all that. Here's the job.

Do you really want it? Here's the pay. Do you really want it? Are you confident? Here's what our culture looks like. Here's what the daily looks like. What questions do you have mindset? then, yeah, interview probably lasts 20 to 30 minutes, depending unless it's really good. And then we go up from there and say, OK, do we like them? Is it worth it in person? Because at this point, the goal, so just a reminder.

we put the jobs out on Indeed. Kim, who's our HR person, will take all the candidates that come through and just throw out the resumes that don't match at all we're looking for. We all do that, right? Like at the end of the day, how that's stage one. Right. Then all the ones that say, all right, all right. Yeah, yeah. This like this appears to be a good fit. Send the video, ask requests. I don't want to do camera. Goodbye. And then the ones because I

I want to say one of our last hires I went through VideoAsk, I think we had like 200 or 300 resumes. And then we sent requests to probably 30 or 40 VideoAsk. And then only 10 to 15 were willing to do it or responded to it. And then we had about five that we wanted to go one step further with. And then we were down to three that we brought in. And we hired two. Yeah, and we hired two to three. you know,

It's just, you know, I'm buying back my time by investing an hour or two hours or whatever to create these videos for me to do that. And then my HR team can go in, know, Kimberly can go in and she can screen them all because she knows what we're looking for for the job. Well, and that's the other thing too. Those videos you did weren't new. Like they were a little like I built those two years ago. Yeah. Well, no, no. I built them right when we moved in here. Yeah. So a year and a half ago, you know, when we finished this out.

Over a year, about a year ago. Okay. Yeah. So about a year ago, you did those videos and then it's now been used in three different hiring cycles, which means the hour that you spent or two hours spent doing it has now saved you hundreds of hours. Yeah. Hundreds of hours. Yeah. Right. And so that's the whole point is just creating, I guess, all of that to say, create a process for your hiring that, that, that one saves you time to brings the best

candidate to the front for you to interview and three puts the right person in the right seat. Yeah, right. Exactly. So those are really what I'm trying to accomplish with that. My time, just like your time, just like your time, just like their time, by the way. Also, it's all valuable. So anyway, I'm proactively hiring for the positions for media people to serve. So let's put this into practice. Your urgent care is at 35 people.

and you're trying to figure out why you're stuck at 35 people, there's a strong possibility it could be that you can only serve 35 people. Yeah, it's possible. That's that's a real thing. Yeah, was good. Because there are a lot of if you're not sure look at English standards and see where you stand, right? Because I think what it's it's interesting in this in the trend right now, urgent care is looking for efficiencies and stuff.

where we've talked to urgent carers that were down to one staff person per location, but there's limitations that come with that. I was talking to two different urgent carers in the same state. I'm not going to say what state, but they were both in the same state and they had both been in business for two years. Yeah, I remember that. Right at two years. One of the clinics was at five patients per day after two years. And the other was at 35 and looking to get to the next level. The one's just trying to survive. The other one's trying to get to the next level.

⁓ And again, not mad at either one of them, but as I asked questions to both of these clinics, again, at two different discovery halls, found one, ⁓ I'll let you guess which one you think it is. One of them was working by themselves with just a front desk person. They didn't want to invest in marketing. They didn't want to spend money, ⁓ not even with us, but just in general, like they had no spin on anything. They had not the best website and the website was getting no traffic. Everything was shoestring.

Everything they were serving exactly what they had built. Yeah, they they they were serving the exact audience that they had built. The other one making moves, looking to go from 35 to 60 wanted to do it rapidly was hiring people was looking at us as a marketing agency to hey, how can you help us take this to the next level? Two completely different conversations. One was looking for a way to get advice without spending money with us. One was looking for a way for it to have strategy to do business with us and grow.

Yep. And I think there is a mindset along with hiring as well as that. Do you want to grow? Are you looking to grow your business or are you just reacting somebody quit? Yeah, exactly. So well, you know, it's interesting because I'm. Admittedly, you like risk more than I do. I do have fun with risk. You do have fun with risk. I have less fun with risk. I take some risk. I risks coming here.

But my risk that was I have to be honest with you Michael Ray The risk you took to come work with me is the biggest risk that I would have never taken. Yeah I had nothing to lose That took some stones. Just saying that was that you say you don't have risk tolerance. That was intolerable Risk for me. I couldn't have done it. Yeah, it was a lot ⁓ But anyway, so like it's paid off Yes, it took a while paid off is there now

Small business is fun. anyway, you have a higher risk tolerance than I do. So when you say proactive hiring, my mind goes to, let's be careful, because we've also put ourselves in a pickle in the past of you hired ahead without the clients to support the hires. And we've done it through advice of being told to do that.

But I think the biggest thing now compared to then was there was no predictability then of what we're doing. now there's some predictability right now and there's some confidence going into that. So I think even now where, you know, don't fill up your clinic with 10 staff and you're still currently at five patients per Well, there's also a lot of strategy in that too. I have a mix of high skill workers.

And then I have a mix of people that can that can deliver and check boxes all on the same team. Nothing like no one's better than the other. Right. But they're different income levels. There's a spread there. There's a different strategy going into this just as you learn over time. And I don't know what that looks like for your clinic. Maybe that's part time nurse nurses versus full time nurses so that you can have more nurses available to staff. Yeah. And less overhead ultimately. Correct.

Yeah, I mean, one, you're probably paying less benefits that way. Or no benefits. Yeah, stuff like that. And they're getting paid very well. Yeah, it's a higher hourly rate that way. But it's offset by benefits and payroll taxes and all that. So anyway, the point is, I said proactive, and you're right, the switch is from proactive to strategic. And so when you're thinking about hiring for your clinic, again, ask yourself, am I stuck at 35 patients per day? Because literally,

My front desk person is overwhelmed. I've got one, one assistant, one nurse practitioner. I've got one doctor. That's all I have. ⁓ Or is it you have people sitting around swiddling their thumbs? One of those problems is different. Yeah, totally different. Where if you have good performing people and they're not, and you know, they're not doing as well as they could be from a quality standpoint, because we feel that like there's

Like we have said, there's a reason why we hired two CSMs one time is because... Client success manager in case you're wondering what that is. Yeah, the person that gets to talk to you as a client. That's right. Anyway, so we brought that to the mindset because a human's a human. There's only so many hours in a day and things are going to get dropped. And so like bringing them on is helping let that person perform at top peak again. And so look at your clinic.

is your front desk person being like, if you're not sure, just pull your call log and you'll find out really fast. Just ask them. And now, if they're a good employee, ask them. Well, ask them, but then also remember, they're never going to give you the most time, they're never going to give you the full scenario or the reality because they're afraid, they may be afraid. It depends on your management style and how good you've been to them ⁓ and how you react to bad news. Because I think some people miss that when you react poorly to bad news that first time you've

dealt with someone, the chances of them giving you bad news against low or the real bad news. Well, and if you're a newer urgent care, you don't know. Yeah, you don't know. So but yeah, so if you need some just quick pull your call logs. Wow, man, our front desk gets a we may only be getting 10 patients today, but they just entered, you know, 200 phone calls today. Why is that? Yeah. And then you say, why are there so many missed calls? So then you can start piecing together that maybe they're getting overwhelmed and these are talking to them and then you realize, okay, there is some

Because we see it right now. We have lots of clinics that, you know, when they're overwhelmed, you can see it happening. Or the training isn't what it's supposed to be, and you see it happening. But yeah, going to like, maybe you have to sometimes expand the hiring to increase the quality, because then when you increase the quality, chances are the volume will start following that quality. Just give it a little bit of time. Well, you just said another key piece to that is, well, half of these calls are going unanswered. ⁓

do you have your front desk person? Are they filing paperwork? Are they checking in patients? There's 10 patients that came in and they're missing phone calls because either they don't know how to multitask or there's so much call volume. You're not growing past that because you're afraid to hire another person at front desk. One that's just answering calls and booking patients into your calendar and the other one doing paperwork and checking in clients. I've learned- And one's on lunch. And I've learned very recently- ⁓

a quick indicator that you know the front desk is busy or not trained the way you want to be. If you have a lot of phone calls that are being answered, but they're less than 30 seconds, they're actually patients or potential patients, but they're trying to get them off the phone as quickly as they get them on. That's ⁓ right. We hear this a lot. but recently, because I always, you we always make the assumption of it's under 30 seconds that either just didn't pick up or whatever. Well, now I'm seeing, ⁓ no, they picked up.

And they answered that one question and then hung up. Let's do it real quick. Are you ready? Yeah. All right. Hey, ring ring. Well, was whatever urgent care. Sweet. Hey, what time? What time are you all open today? Eight to eight. Awesome. Thanks. Bye. Literally. Or now here's a better one. Pretend that you are asking about appointments. Okay, perfect. Ring ring. Ray urgent care. Hey Ray, this is Nick. I need to get an appointment today and my child's sick.

You can just walk in. We're open from 8 to 8. ⁓ Man, my time. I mean, are y'all busy? Because I don't have tons of time. It looks like we have a 30 minute wait right now. just you can just whenever you want to come in, just come in. Okay, bye. That's awkward. That's a real call. that happens all the time. actual call. ⁓ But that's the difference in training your front desk versus you ring now. Ring ring.

Hey, it's Nick's Urgent Care. Thank you for calling. Give me just a few minutes. I am helping a patient right now. Do you have a second? Yes. Excellent. I'll be right back. Yeah. Now, if you're getting those calls and then they're bouncing because they don't want to wait on the person to pick back up, well, you're too busy and you need another friend. But, and then you have good training, right? So like the training shows, okay, they know what to say. They literally, they physically just can't get to it. That's right. And that's a completely different thing. And so identifying, are they sitting there twiddling their thumbs? Are they too busy? Yep.

Or do they just not give it real? And I got to tell you, I'm going to throw this out there because, I don't think I'm wrong. Three out of four clinics that calls that I screen, they don't care. They could not care less. But anyway, that's not what we're talking about today. There's a whole training on that in resources on patientcarebargainingbroad.com. And maybe that's a proactive reactive.

You fire them and then find somebody else. And then you're entering the phones. That's pre-acted. ⁓ Anyway, ⁓ the whole point there, the whole point of the exercise is to scale your clinic. And so you have to staff the clinic for the prepared volume. Now, I want to back out a little bit of this. All right. And you had mentioned it earlier. If you don't have the other pieces of your business in place,

you don't have a system for bringing patients in. You don't have a system for checking them in. You don't have a system for your 45 minutes to 50 minute door to door time. If all of those systems are broken, great marketing campaign is going to make a bad business model fail faster. Same thing with volume. More volume is just going to break your clinic faster. And like that's lessons that we've learned personally where bringing in more people doesn't solve the problem. It just makes it more expensive for the same problem.

Because we've had experiences where we thought our process of her good. And then it was just a, oh, I need more help. You need more help? Yeah, I need more help. What help do you need? I just need more help. don't know what I need. I just need some. I just need somebody to give them something. Right. And we learned, OK, yeah, let's help. We don't want you to be stressed on this. Let's help you. And then that additional costs went unused. Right. And then all of sudden,

this service is now costing us more money and the results are exactly the same because the process was never actually fixed. Right. Because you can't fix a process with just pure people. That's right. Exactly. Exactly. Yeah. I mean, you can't throw money in a problem. You can't throw people at a problem either. So it just cost you more money. But I did want to talk about experience as well. So the other question that I have here is, are you hiring an employee or are you hiring a team member? Let me explain. ⁓

An employee is somebody that I'm going to hire and I'm going to bring in and I'm going to have them fill a position. A team member. Well, just think about it. If you've ever been on a team before, you had to make the team. Yeah. Well, you don't have to make an employee like you just you're an employee. But you have to make a team. And so when you when you are put on to a baseball team, a football team, canasta, I don't know, can you name it? It's just some stupid sport. Anyway, sport cricket.

Whatever all the different things I'm learning. The point is, like when you make a team is because you earned your way onto that team. Right? Right. Right. They saw something in you. They wanted you there. It matched the culture of the team. That's right. And all the things because we all know when there's a bad egg or a bad apple, like it exposes it pretty quick on a team. That's right. Or so anything. Oh yeah. Easily. And a good team will hold that bad team member accountable and get them off the team. Yeah.

get that person off my team because I want to win. Yeah. An employee shows up late, clocks out early and is on their phone the other half of the time. And then annoyed. Yeah. And they don't want to be there and they spread gossip like it's wildfire. Right. So I don't mean to be down on employees. What I'm saying is there's a mindset shift from being an employee at a company and versus being a team member on a team on a high performing team. And I want your clinic to operate as a high performing team. Right. ⁓

So one of the things that, that in our training that we put together videos and everything to train our team as we bring them on, because that's my goal to get them educated and up to speed and taking good care of our clients. want them off the bench and in the game as fast as possible. Right. That's a totally different thought process. When you go through all of the hiring, again, if you're throwing out resumes and just trying to get somebody to fog them here, don't put any SOPs together. Don't care about it.

If you're trying to build somebody who are going to who is going to show up on time, they're going to bring it when they're there. They're going to care about their coworkers. They're going to hold themselves and their team to a high standard. Totally different animal. That's a totally different process. So that's what I have for today's episode, man. So, you know, are you proactively hiring? Are you reactively hiring? Are you not hiring at all? Because there's a fear. Right. Where are you? Urgent care? What urgent care owner that's listening?

What category are you currently in? Because the other thing too worth mentioning, because you said this, I fully believe in it. I've told other people and they believe in it too. And I forget where you got it from, but you're never staffed. You're understaffed or overstaffed. That's so true. Michael, forgot about that. You can never just be staffed. Yeah, you can never just be staffed, which is so funny to me because you started thinking about is that real? And then you're like, yeah.

Because you could say right now, to a certain degree, we are slightly understaffed. Working on it. And then the second we make this next hire, we'll be slightly overstaffed. Yeah, there's never just, I've got enough people for enough accounts. I've got enough accounts that feed enough people, and nobody's stressed, and there's no money issues, and there's no cash flow challenges, and there's no hiccups. That doesn't exist. There's always something. There's always something going on. You know.

Yeah, you're driving right now. You're probably on the treadmill. You know, it's always something you're not in your head right now. I know it. And I just think about this episode. There's that moment. There's once you accept that, it becomes easier to make the hire because you're realizing you're just teetering right now. And which which side do you want to be on right now? And the reality of it is, if you do it right over staff, it just means you're moving to the point where you'll become understaffed again, because that's the goal in my mind.

is that you'll never be staffed, but you should be overstaffed. I think you'll eventually get understaffed with the same people. Slightly overstaffed. Slightly overstaffed to slightly understaffed because you grew. And then you do it again and again and again. And then the goal is that the percentages will spread more and more over time. So when you do overstaff and understaff, it actually just, it's not as painful. It gives you room to do it. anyway, it's just a

thinking about that makes me laugh because I told somebody else that it's like you're never just staff they just start as an owner and you start laughing. It's like, yeah, that's accurate. mean, it never it reminds me of the movie Clueless. You can be overwhelmed and you can be underwhelmed. But can you ever just be well actually it's the same thing, right? All right, we're leaving. Well, have a great week. All right. Yeah, seriously. Y'all have a great week. Thanks for all you do. And we'll talk to you next week. See you.