The Talent Problem in Dentistry: What Operators Don’t Understand About Hiring

Co-host: Foreign.

Jake Larson: Hello, everybody, and welcome to another episode of Dental Operations Unpacked. I am your host, Jake Larson, here with my co host Clint Berry, and a new friend of ours. This is Umberto Briseno, uh, coming from, uh, PDS Health and, um, many years in dental, um, um, and it's great to have him. Uh, we're excited to talk about this topic today. Umberto, thank you so much for taking some time with us and joining us. We appreciate it.

Umberto Briseno: Thank you guys for the invitation. I'm happy to discuss and talk more about my functions.

Jake Larson: Ah, I reached out to Umberto because we have heard, uh, we talked, we've, we've asked people in the past, like, what's one of the biggest challenges that's facing group dentistry? What are you seeing is one of the hardest things. And almost universally people talk about recruiting, maintaining talent, finding new people. So I was like, we got to get someone on that's an expert in this, that's done it for years that can share some of the things that they've seen. Best practices. And that's exactly what Umberto does. He currently sits in the role as a senior manager of owner doctor partnerships at pbs. Um, he has some potential, uh, new things coming, which we're excited to follow as we've, as we've gotten to know Umberto a little bit. But as of today, that's the place that he sits, and he's been in that role for quite some time. Um, before we jump into the topic of Better, do you mind giving our listeners just a quick background to tell them about yourself? We'd love to ask people the question of how did they get into dental? We find some of those stories very fascinating. So tell us, how'd you get into dentistry? Tell us a little bit about your journey and where it's led you today.

Umberto Briseno: Yeah, thanks, Jake. Uh, so 20 some years ago, I landed in a dental office as a curious, uh, someone out of college trying to navigate life and trying to figure out my next steps. I was going to college at a time and someone suggested that dental assistant was a good side job while you were going to school. So I pursued that, and I really fell in love with connecting with patients. I consider myself a social person and helping people navigate their fears of being in a dental chair and then also being that bridge of communicating between the patient and the dentist. It was really something that resonated with me. I was a dental assistant for about five, six years, and then I saw an opportunity in a DSO of, um, doing more and moving to the front office. And learning the administrative side of dentistry. Right. So from there I grew into, um, deposition and went to another smaller DSO here in Orange county, where I was given the opportunity of managing a specialty dental center, where I was there for 12 years. And as a manager in a smaller dental office, you have the opportunity of doing, I was going to say wearing many hats in a smaller company. Right. One day you may be a dental assistant, the next day you may be a treatment coordinator. And sometimes as a Spanish speaker, you. I was the translator as well. So you get to wear many hats and just keeps, uh, the job fun and interesting because no day is the same as the previous. And then the pandemic hit, so that kind of leveled the feels for everyone. I was fortunate enough during that time, uh, being considered an essential worker. So our office never closed. We were treating emergent patients, emergent cases, and, uh, gave me an opportunity to really, uh, explore what I wanted to do next in my career. I loved the recruiting side of managing a dental office and I pursued my next career into recruiting and I landed a position at PDS Health. Uh, I started as a recruiting supervisor and then eventually led me to the specialty coordinator, I'm sorry, specialty recruiter, uh, position.

Jake Larson: That's awesome. We love these stories because it's so common that people, you know, they didn't intend to build a career in dentistry. It was just going to be a part time thing for you, but then you fell in love with it. And look at this 20 plus years later, doing amazing things. And dentistry has, uh, created great opportunities for you as it has for us, which is why we started this podcast. So such a fun story. Um, we appreciate you sharing, Umberto. So let's talk about the topic then. So the topic today is the talent problem in dentistry. We hear it all the time. Talent m problem in dentistry, what operators don't understand about hiring and what actually works. Um, so let's, uh, let's just talk about the reality of dental recruiting today. Tell us about, from your seat, what you've seen for the last, you know, five years or whatnot. What, Tell us about the reality. What is dental recruiting today? What are the challenges and, uh, what are people seeing?

Umberto Briseno: Well, let's start with the clinical side, with the dentist. There's just so much competition out there. Uh, in the specialty field, which was my focus, we saw that there is a lot of competition again from the DSOs. There's about 4,000 in the states, I believe, and it's growing. So we have that specialty side that we have the private practice sector. That are also looking for, um, specialists. Right, Oral surgeons to join the practice, et cetera. And then you also have those dentists who are inheriting a practice from their father, their grandfather. So that legacy also is to continue. So the challenge was giving them an opportunity to find a home where they would grow and expand and like I used to, uh, say, grow roots for the long term. That was our goal, recruiting, uh, as an early talent into the specialty space. Now when we talk about hygienists and dental assistant, I think it really tanked, For a lack of a better word, the talent kind of slow down during the pandemic just because a lot of the hygienists and a lot of dental assistants, uh, were not seen fulfilling in their profession. If I want to be frank about what I observe in my time there, even when I was at that smaller group, uh, we really had a challenge finding dental assistance because people did not want to be in the front line if they didn't have to. Of course, the pandemic, uh, six years after, but there's still been a lot of challenges finding, uh, dental assistants or candidates that want to go through the program. Right. And spend 5 or $10,000 to get their dental assistance certificate and then going into the field. And perhaps one of the biggest challenges is finding a compensation that is going to align with all the debt that they accumulated to become a dental assistant. And I feel like with hygienesis happening the same where they're not really seeing the compensation being able to justify. Right. The work that they're doing in all the bills they have. Right.

Jake Larson: Have you seen, you mentioned some of the impacts of, like, the pandemic and things like that? We hear all the time that there's just, um, a huge shortage in talent still. Are you seeing some of those same trends that there. That there are shortages? And if there are, is it at the hygiene, um, level you mentioned the dental assisting level, clinical level, um, where are you seeing those shortages the most?

Umberto Briseno: The most, we're gonna say it's a dental assistance and the hygienist, uh, especially in those areas, areas that are not densely populated. Right. If we were to compare somewhere in California, like Los Angeles, metro, but then you go inland, like Lancaster, Bakersfield. Those are our areas that are harder to find. People that are willing to become dental assistants and keep those jobs. Uh, the same thing in the east Coast. There's many places where we're having difficulties finding that talent. And the unfortunate part, and I think you, uh, did a preview of what we're going to Talk further in is not only finding the talent, but helping the operators, helping the dentist keep and nourish that talent once they found it. That's the harder part. That's the harder part, the retention part of the recruiting. It becomes a challenge.

Jake Larson: Hm, that's interesting. So the shortages might be a little bit regional. Right? You kind of mentioned that there are areas that you've seen it not be quite as difficult. You, um, mentioned aligning compensation plans. I'm sure that's kind of regional as well. Um, but let's talk about. I want to focus on the hiring to begin with and then I love that idea of talking about the retention. Right, we'll get to that. Just next. So where do you feel like hiring breaks down? Um, in, in DSOs and in group dentistry, where do those, um, uh, holes kind of show themselves?

Umberto Briseno: Because as a recruiter we are kind of a matchmaker right between the practice and the candidate. And a lot of times the break is we're seeing this great potential, this candidate, but the manager is just so focus on finding what we call in recruiting that purple squirrel, which is impossible. Right. They want the candidates to have all these requirements, right. And they're not willing to budge. So a lot of times the difficulty is coming from the recruiter trying to persuade the manager or the dentist to really move forward with a candidate because that's the only option they have at that time. And a lot of times, yeah, that comes with a caveat because you may be going into a dangerous, uh, path of hiring someone who may not be a good fit. Good fit long term. However, there's got to be some trust between the recruiter and that, uh, uh, hiring manager where they're already vetting, right? The recruiter is already vetting what the hiring manager wants from that candidate. So if it's making it to that, let's say that part of the finish line or the interview process, they should trust that their recruiter has already done the due diligence, diligence to move that candidate forward. Especially as we said, in some regions where it's very difficult to find candidates already.

Co-host: Um, let's talk a little bit about, um, you know, the places where it breaks down in hiring. Where do you see the, the biggest

Umberto Briseno: problems when you're hiring where hiring breaks down A lot of times, unfortunately, DSOs, there's um, few different stakeholders. Uh, sometimes it could be the regional manager, the dentist, owner, dentist of that practice, and someone else may be involved in the hiring process. If it's a dental assistant, the back office manager, so you got all these deciding factors. Right. And everyone has to agree. A lot of times there's not just one person that makes the decision. Uh, from my perspective, that's a little bit difficult to navigate because then now you're having three different opinions that you have to go back and forth. It will be easier if the, if the path was just the recruiter and just one single person that's making the decision, uh, for some of the roles. Obviously if it's a dentist, then probably there's more hiring, uh, managers that have to vet that person because of the severity of their position. Of course, but that's one of the, that's one of the breaking points.

Co-host: So you would say reduce the amount of people that they have to meet with.

Umberto Briseno: Yeah. And I would say not just because of the time spent. Right. By those, uh, hiring managers, but also the time spent on the candidate. It's not a good candidate experience, uh, as you go through the hiring process. I've heard horror stories of candidates having to meet with six people for a dental assistant position. And it's unnecessary. Right. They're uh, going to be working with the doctor, I believe maybe the office manager and the dentist in one panel interview should be sufficient to assess that, uh, dental assistant. Now if it's a specialist or a dentist, possible, uh, looking into ownership, then definitely more people involved. But I've heard nightmare stories again. Six interviews, video calls. It becomes, becomes a full time job before you get the full time job. Sometimes I think we forget about it. These people are looking for a job. We should make it easier for them to land that job. And for me, again, as a recruiter, we are trained to pick up red flags, green flags, yellow flags pretty quickly. And once they go through that part of the interview process again, they should rely that their recruiter has a pretty good sense of what they're looking for.

Co-host: I like that a lot. You know, when we're hiring for engineering roles, um, we often forget about the candidate experience and it makes such a big difference, especially with, you know, historically engineering roles. You're recruiting people that already have jobs and so like if you make a bad experience, they're like, I'm out, like, I'm good, you know, um, so I appreciate that you are thoughtful about that and making the candidate experience because if they have a good feeling about the company, and I know, you know, a lot of these decisions end up being emotional, you want to make sure they have a good experience and have a good feeling about the company when they come in.

Umberto Briseno: So I love that and to add on that, uh, in dentistry, it's such a small world. There's people say in the world there's six degrees of separation. In dentistry, even in the United States, there's like four degrees of separation because everyone knows someone that works in the dental field. So what I was going to say is that these candidates will be talking to each other and sharing their experience with their peers. And if it's in dental school, they're all talking and communicating. Hey, don't interview there because they're going to put you through seven interviews and then they're not going to give you the job. Believe me, they're talking amongst themselves.

Co-host: Yeah, that's crazy. But that makes total sense. So what are some of the things that are like, actually working for you in recruiting? Like what, um, um, what systems do you put in place? What, you know, what does it look like when you have a really good, high functioning recruiter recruiting engine?

Umberto Briseno: I'm going to say it's just a flow of candidates and trying to place them where you would naturally, uh, think that person is going to be a best fit. Again, navigating, uh, the graduates from residency schools, I had to really listen to them and see what they're looking for and kind of offer them what we have and what opportunities would be best for them. On, um, my role as a recruiter, I was dealing with a lot of new grads. So it was getting into the pattern of building that trust with a candidate and follow up with them. A lot of them I, um, would connect early on on their residency program and they still had two years to graduate, but I knew that they were going to be a good candidate because of our conversation. So I would tell them, I'm going to follow up with you in three months. And in three months I'd follow up with them. Um, so just following up on your word with a candidate because they will remember if you don't reach out to them and they will hold you accountable for that. And then that break in the trust and the relationship, that's really going to cost you that candidate full time. Uh, the biggest challenge was once I connected with a good lead candidate and send them to the regional manager. That was another break because they didn't see an urgency on um, this candidate because they're not graduating for another year and they needed someone right away. And so what I would try to tell them is you have to plant the seeds and they're going to grow eventually if you don't call them while they're in residency, Trust me, there's 10 other people that are going to reach out to this candidate and you're going to lose it. And it happened. And hopefully these operators learn their lesson so that they have to be, uh, proactive, uh, building those relationships, because, again, they're going to have a bad candidate experience and they're going to talk amongst each other.

Co-host: I love it. Umberto, I feel like you're like the. You'd be the person that I'd want on my team if I needed a recruiter for dental. You're out there talking to the graduates a year before they graduate to get, finding the best ones and, like, keeping a relationship. What are we sending them? Gift baskets? What are we doing here?

Umberto Briseno: I wish I had the budget to do that, but I didn't. It was just my text, an email, and maybe an early connection to the regional team. The funny thing is, we had so many candidates that would tell me, hey, is this too early to reach out to you for a job opportunity? And I was absolutely not. Because you have 100 other students that are going to wait until they graduate to reach out to me. You're taking the lead, and I'm going to remember that you took the initiative to do so, and I'm going to push for you, whereas the other ones are waiting till last minute.

Co-host: Right? So, yep, I love it. Well, as a technology guy, though, I want to hear what kind of technology do you use in, in your recruiting systems? Is that part of the deal or is it mostly just like analog communication?

Umberto Briseno: Uh, we use, uh, Indeed as one of our primary tools of sourcing, also LinkedIn, and both of them incorporated a lot of AI features as I progressed in my tenure as a recruiter. And we've seen the changes from manually going through resumes on Indeed to going into putting your search of what you're looking for, whether it was a Boolean search or just typing the city and state, et cetera. And then the system would actually feed you candidates that would match your requirements. And then from there, the AI system would either help you push them through your pipeline of candidates or just disqualify, uh, them from your search, which was really time saving. Uh, same thing with LinkedIn. There was a lot of AI features that were incorporated later and available to us. And, uh, one of which, I think it was great, we had email, uh, drafts via AI. It just made it so much faster to reach out to candidates and more efficient.

Jake Larson: Bert, I'm curious about moving beyond just like, hiring for an individual role and how a recruiter, or what advice you Give operators for looking at hiring as a way to build a team rather than just individuals.

Umberto Briseno: That's a great question.

Co-host: Uh,

Umberto Briseno: we used to, I used to hold trainings for office managers every quarter at our support center in Irvine. And I would start my presentation with telling them think of roots. Sorry, I would tell think of a tree, right? Let's take an example. The sequoias. Those are big tall trees, right? That's all you see outside. But underneath there a system of roots that are so intertwined together that holds that tree so tall and sturdy. Think of your office or your department or your team as that tree. You want to have good candidates that are the foundation of your team. If you have good candidates, you're going to have a good producing office. So um, with that we would train him and coach them in how to recruiting not just for your immediate needs, but also with the future, seeing where that person can grow into your development of your office. I uh, take myself as an example. I started as a dental assistant but whoever hired me knew that I had the potential to do more. So they brought me in, took, you know, whatever I could as a dental assistant. They say hey, there's an opportunity here to move up to the front. So just always recruiting with the future in mind. That's what's going to help these operators uh, take their offices or departments to the next level.

Jake Larson: I really like that idea, right. Of like that forward thinking, like don't just get lost in hiring for today. Think about. I like that you mentioned earlier about reaching out to these people that are in their residency ahead of time and you would hand these people off to the regional or whoever and they wouldn't reach out to them. That's a very uh, uh, uh, short term perspective. Well I don't need this person now, but if you're thinking long term, I'm going to need a bunch of different candidates because even then the relationships that you're nurturing aren't always going to pan out. So you want to have four or five people that you're, that you've developed these relationships with with the hope that you land one or two of them when that time eventually comes. And I love that, that, that uh, how that translates to that idea of building a team rather than just hiring for an individual need today. Um, I think that's super, um, insightful and I hope that other operators can kind of learn from that. Right. Don't be the operator doesn't reach out. When your recruiter finds somebody, reach out to them and build that foundational piece, so you have lots of candidates to pull from when you need them. Don't just be reactive in hiring for a specific need today. Really cool. So, Umberto, as we kind of, uh, have had this discussion, there's lots of different things that I hope people are taking away. Uh, unfortunately we're getting short on time here, but we always like to make sure that we leave every episode with a single big takeaway. So if you were to, uh, uh, as we wrap this up, what would you say is the one thing you hope operators take away from our conversation around recruiting and hiring today?

Umberto Briseno: I was going to say what I tell my candidates when I connected with them. I'll give them my phone number, my email. I would tell them you can reach out to me at any time. I'm only one text away. So if I can really help operators learn of a concept of just stopping whatever you're doing, reach out to the candidate, send them a quick text, a quick email, that seed that you sow is going to grow in the future and they're going to remember that. So hopefully being proactive and taking the time to reach out to candidates, it's really going to be productive in the long term.

Jake Larson: Uh, I love it. Have that long term perspective. Put the work in now. That'll give you those opportunities when the needs arise. Awesome. Well, Umberto, this has been a lot of fun. You did really well and we appreciate you taking some time with us. Thank you everybody for joining us on another episode of Dental Operations Unpacked. Um, as always, we invite you to share, like, subscribe, help us reach more operators so that those that are struggling or need some help in some area have a great resource like Umberto and others that they can reach out to, that they can listen to and take some of their, uh, knowledge and expertise to help them in their day to day. So thank you everyone again for listening and we will catch you all next time.