Alec Goldman (00:04.918)
Welcome to How I Grew My Practice, a 15-minute podcast sponsored by NexHealth. My name is Alec Goldman. I'm leading content here at NexHealth. I'm being joined today by Christine Sison, founder and CEO of Swiss Monkey. Christine, so glad to have you on the show. How are you doing?
And you did a good job with the last name. I love it. Good job. You feel good. That's a win for us.
Alec Goldman (00:32.43)
Alec Goldman (00:35.09)
It's a, you know, you can imagine how many different ways I could possibly butcher it. But exactly. Well, I'm glad I got it right. And again, welcome to the show. Just for the folks, our audience who may not know who Christine is and what Swiss monkey is, if you don't mind sharing a little bit about yourself and your company.
Great, thanks, I'm excited. I know we have 15 minutes, so we'll kind of do our high brush here. So my name is Christine Sison, I'm the CEO and founder of Swiss Monkey. Started this journey about, gosh.
five years ago. And really what we do is we help our doctors build hybrid teams. So really helping them connect to remote team members to help them basically do all the things that need to get done in the office where it's really challenging given all the staffing issues. And so I started a company about, gosh, it feels like dog years, right? But my background is kind of in the healthcare space prior to dentistry.
got my bachelor's in neurobiology, I have a master's in health policy and management, I was working with hospitals and clinics for a period of time. I got into dentistry because my husband's a dentist and that's how I got sucked into the dental vortex, if you will, and any of the spouses or partners know it's like this, you just get pulled in. And that's really where the dream started there and so I was helping to run the practice and staffing was, I mean it was an issue back then that was, you know.
I started the practice about 10 years ago, and it continues to be the biggest challenge from what we're seeing even now for dental practices. So, you know, our job here has been to think about, hey, how are new ways to really deal and manage the staffing challenges that maybe weren't available to us five, 10 years ago? So I'm really excited to be able to share what we can do to help managers here in terms of helping them actually run the dental practice.
Alec Goldman (02:25.998)
So even before jumping into ways to optimize an office manager's time in office, it's a mouthful, can you share a little bit about what you mean by seeing more of the labor challenges specifically in 2023 relative to what you may have seen when you were founding Swiss Monkey five years ago?
That's a great question. So I think there are lots of different kind of big trends that happened after COVID. But I would say one of the biggest kind of big macro trends was that you have this kind of turning over of the labor of the workforce generation. So kind of that baby boomer generation is really transitioning out. And really the gen Z's, the millennials, that's kind of the biggest now, the biggest workforce, right? And they just...
that group has a very different kind of expectations of what they want in their life, right? This whole kind of work-life balance, I think, prior was kind of kumbayah for us, like, oh yeah, work-life balance, you know, we're still going to work 100 hours a week. And I think what happened with COVID was that people were like, no, I choose to like, I really want to work-life balance. I might want to work four days a week or three days a week. And we had, in addition to that, a lot of, I think, women and working mothers, single parents, really trying to figure out, hey, how do I...
how do I get back to the workforce and still be able to provide for my family? So I think you have kind of the generational difference of people really wanting a better work-life balance. And I think also the gender difference, I think having women come back into the workforce, I think we just need different solutions in terms of really how to allow that women to come back into the workforce.
Alec Goldman (03:57.15)
Yeah, I mean, we see that we've been hearing a lot about that at NexHealth, working with thousands of practices, just that there's a massive labor challenge with regards to maximizing your existing staff, keeping them happy, even if they may be asking for a little bit more, but also hiring back new staff is now extremely hard. Right? So my question to you in regards to how are you optimizing staff's time? I mean, you guys must be giving tons of advice.
Alec Goldman (04:23.318)
But what is your go-to immediate sense when you're working with a dental practice? What's the advice you're giving to ensure that the existing staff remains happy? Is kind of the immediate question that I have for you.
Yeah, absolutely. So we know that there are about 10 million jobs and about 5 million people left.
we left the workforce, right? That we're still about that much short. So there are double the amount of jobs available than people in the workforce, just in the US. So regardless, we're gonna need new ways to operate, right? There just isn't enough people in the workforce. And so what do we really do? It's okay, but it's like, we're in the healthcare space. Like we need people that are kind of patient-facing. So there's really kind of two things, right? So there's the clinical piece, patient-facing things where you need dental assistants, hygienists, things of that nature. That is definitely an industry kind of solution that we're gonna need to come together to really fix.
But I think what we've been able to do at Swiss Monkey is saying, hey, what can we do with virtual front desk team members, right? We know that people wanna work from home. We know people want more of a 10-9-9 independent contractor relationship. How do we really tap into that kind of fractional labor force, people that want more independence, want more flexibility? That's a whole contingent market that I don't think healthcare has really been really good at, right? We see that a lot in the tech field, especially here in California. We have a lot of 10-9-9s kind of contingent workforce, part-time workers.
And I think the companies, we do this in hospitals as well, but the companies that can figure out how to tap into the fractional team members, the hybrid team members, people that are offsite are the ones that are gonna succeed. And what we've really been focused on over the last few years is giving our doctors and our managers the blueprint of how to do that. It's not just outsourcing, but it's saying, hey, I know that you have a really special private practice that you guys have built. And the last thing you want is to send it over to Joe Schmo, who doesn't know anything about dentistry.
and it's actually gonna do more harm than good. So we've really kind of worked with our managers and doctors is first we wanna kind of dispel all the bad things that can happen, but figure out, hey, how do you really do this well? Because if you can do it well, the promise is really cool, right? So you have the blueprint, you have to make sure that, hey, we aren't sending HIPAA encrypted information over like your bad email address or over cell phones. So the technology blueprint is really key. And then really how to provide the right communication between your onsite and your offsite team members.
and how to say, hey, do you really need someone 40 hours a week? Or maybe you just need someone three hours a day to help phones, right? Just to kind of give your onsite team members a little bit of relief. Or maybe there's, you know, someone wants to do mater, is not wants to, but we had someone who had maternity leave for three months, and it's really hard to find a full-time team member who's gonna leave their job to cover that. But we have tons of fractional team members saying, hey, I can cover for three months, and then when you're done, then I'll go look for another engagement. So really what we've been doing is helping our doctors and our managers kind of,
connect with all of these people. And there are a lot of people in the dental industry who say, hey, I want some more flexibility. I wanna work from home and I don't wanna have to spend 30 minutes commuting each way. What are my options as a dental professional? And so I think there's kind of two sides to that we're really blessed to be able to connect.
Alec Goldman (07:25.014)
Very cool. So something that I hear from all the time with practices, if you said, what makes your practice different from the one down the road or any of them in the nearby community, the go-to answer is always, always, always my team. So I can imagine a world where you say, hey, we're going to install something called Fractional Workers or what we both know is 1099s and then say, whoa, that doesn't feel like it's going to be able to scale my brand or scale what I think means good care.
Alec Goldman (07:55.696)
So how do you think about scaling somebody's personal brand to somebody who might be only working a number of fractional hours?
Yeah, that's a great, great, great question. I think one of the things here that we are really committed to is that as you use an offsite team member, that you keep that patient experience sacred, right? So there are different types of quote unquote kind of.
outsourced companies or offsite teams, things that you may be, you know, using offshore team members. And it depends on what that team member is doing, right? If they're doing non-patient things like insurance aging or following up with like why, or insurance verification, where they're not dealing with an actual patient, maybe it's okay for them to be offshore, right? Like maybe you don't need that. Maybe you want to pay the lowest cost of agents because it's not really patient facing, it's not affecting your brand. But I think for us, like.
Every office that we work with that's doing something that's patient-facing, they're on, you know, they're in the US base. And we wanna make sure that regardless of whether or not that person is working with one or three or four offices, that person is trained on that specific office. So we do have for us, we make sure, hey Alec, you're gonna be working with Dr. X, but we actually have Dr. X make sure that they meet you and they can actually train you specifically for that office. So typically for us, for our dental professionals, they're only working with two to three offices. They're not, they're not, you know, they're not usually having
you know, for one hour working with three different offices. If you are working, you know, eight to 10, it's that one office, 10 to 12 maybe another office. In other companies, it's not that are good, but in other companies typically one person for that period of time is working for three or four offices. And when that happens, that's really hard for that person essentially to be able to memorize three or four different intake forms. We try that, it doesn't work so well for us just because what we found is people on the other end is saying,
you know what, this feels really transactional for me. And actually we have higher attrition rates because people are like, this feels just like a transactional experience, right? So we've found that when you have someone working specifically with one or two offices, they feel more connected, there's more meaning and they work, you have lower attrition rates because they're not traveling, they have time to have coffee in their pajamas or whatever it is. And then the doctors also, they're like.
Great, I can train Alec because during that time, he only is working with my office. So he knows my patients, he knows my team members, he knows how we like to schedule. So I think we've been able to really marry those two, I think challenges in the past.
Alec Goldman (10:20.119)
So when you're working with dental practices and you're kind of just doing your basic qualification of just assessing perhaps how busy the front office team is if they're overworked, if they're just the array of tasks that they are responsible for on a day-to-day basis, what is your go-to thought on what should be perhaps done by a fractional worker?
Alec Goldman (10:47.09)
in order to make for more time for front office staff in office in an in-person facing role, I guess what are what are those tasks?
Yeah, so one of the really important things is when you have this kind of change in your model, it has to be a very deliberate effort because it does break the system on site, right? It's not like exchanging Glob Brand A for Glob Brand B. You're basically taking a whole new team member and you're integrating into your office. So people that are gonna do this know that it's gonna take time, like you shouldn't just half-hazardly be like, oh, I'm gonna take Alec and I'm gonna plug him in. Like there has to be, your team and your structure and your systems have to be really.
place and that's what we help them with and so I usually what we do when a doctor's or a manager saying hey I'm really overwhelmed I'm tired I don't feel happy when I come in I feel like I always have things to do as we say let's take an inventory of your day right what are all the things that you want to be doing and what are all the things that are keeping you from that and every office is very different some are like you know what I just need I hate doing verification so we take that out
Right? Some of them, like, gosh, I don't have time to do my hygiene and re-care calls. And we pull that out. But it really depends on the office and what their goals are. So typically we'll work with a team saying, Hey, what are the things that you're doing on a day-to-day basis? What can we pull off site? Right? That can be done really well. And will that help you move you towards your goal? And again, it really depends on what kind of team they have. So I'll just give, I'll do one example. I have an office with a really amazing office manager, right? She's fantastic.
She might not need a really heavy offsite team. She might say, hey, Christina, I just need someone to help me answer phones, take a message two hours a day, that's gonna give me enough time back. But what if an office manager in another area says, hey, you know what, I'm gonna be leaving for two weeks and there's no one at the front desk. They might need a really senior offsite team member because she's gone or here she's gone. So they might say, hey, I need someone really, really experienced. So the offsite team is very reflexive to the onsite team. So it depends on the kind of talent that you have. So really we build the team set together.
we create a full team. But typically anything not patient facing can be done offsite, it doesn't mean that you should. It just depends on kind of what the team needs. And so that's where we really work with them to say, hey, start off small, do just one or two hours. It doesn't need to be a full time. Maybe it's only three hours a day for 10 days a month, right? We have a startup that only works with us five days a month. So, you know, I think we kind of just allowed them to build trust in the model. And sometimes like...
Maybe once a week, three hours a day is enough, right? And if they need it, they can always build on and always add on more team members.
Alec Goldman (13:18.87)
Cool. So, I know that there's, I guess, if you were to think about the different ways that you can optimize a front office team member's time, there's really the people adding resources, there's process and improving, and then there's certainly tools. So when you're thinking about tools and recommending tools, I guess, can you give me a little bit about how you think about recommending, given that there's such a wide variety and just
Alec Goldman (13:47.454)
of software systems for the dental space? How do you think about which ones are great, which ones are not so great? What types of questions do you recommend practices to ask or to speak with?
Yeah, absolutely. I think one of the things that's really important for us, obviously, because we're emoting it, they have to be a digital office, right? So they need to have some kind of practice management software that they're actually using. Now, it always helps, especially when we're an offsite team that we have things like, you know, obviously like NexHealth, right, where everything is in one place. It's easy for us to communicate with patients, things of that nature. All of those tools I think are helpful because like we talked about, staffing is already scarce, right? Like what you don't want is you don't need someone.
spending three hours doing outbound calls when you can use tools like NexHealth that can do 300 outbound emails and text messages in 10 seconds, obviously that is gonna be the best way to use that team. I think sometimes we have the technology and we don't know how to use it and we don't use it efficiently. What I found is like, let's talk about what are the things that need to be done, what can be automated, and then anything that's not automated, that is what we're gonna use the offsite team member to do, right? Then we can manage it, we can streamline, we can identify opportunities.
But I think for us, we are big proponents of using digital tools to streamline and automate and just make things more efficient. It's by far, I think one of the most important renaissance I think in happening in the dental industry is like all of the tools are now becoming available that used to have to be done by people. And the reality is let's just use online scheduling which you guys have an amazing tool on. You know, we don't need to spend, pay someone 20 to 30 bucks an hour calling patients about their hygiene appointment when.
We, people are busy. They don't wanna talk to you, Alec. Like, just send me the link. I'll, I know my schedule. I will schedule it. But before what we used to do is like, we'd call, we'd spend 15 to 20 minutes with a patient trying to figure out what their schedule looks like. It's just not a good use of their time. So I think for us, we're always looking for opportunities to be able to say, hey, where does technology fit in and how do we really utilize it so we can maximize kind of human capital?
Alec Goldman (15:49.45)
It's incredible to see how much software has been helping dental practices, especially in such a tough time where to, you know, what you were talking about just earlier on in regards to the labor challenges, that there are tools that really should be making their life easier, even if trends are not necessarily falling in their direction. I wanted to give you the opportunity. I know we're at the 60 minute mark. What is a final thought that you have for kind of just for our
Alec Goldman (16:17.266)
our audience, all the dentists, all the office managers who are listening in, in regards to ways to optimize a front office manager's time.
Yeah, I think, you know, just closing thoughts. I think, you know, one, they're not alone. If you're, if you are an office that's having staffing issues, you're feeling, you're, you're, you're sensing that your team is kind of overwhelmed or stressed that you're one of those where you close the door at the end of the day and you're like, man, I didn't get everything done. Think about.
that there may be other models like an offsite team member that you might want to explore, right? This might not be for everyone, but it does work. And if you can be open to the idea that like, hey, how do I really use this to get a little bit of joy back to get to hit my financial goals? I think that's where we want all of our practices started. It's just like, let's just have a conversation, right? It's nothing you have to be committed to long-term, but maybe just helps you every now and then. And I tell you, I think for me, that's enough because we're losing a lot of not only dentists, but people in the dental industry because they're burning out.
And the idea is like, it doesn't have to be that way. And I think the book of goods that we were sold operating at dental practice 10 years ago is not the standard operating way that we can do that now. There's so much more technology. There's so many new ways to kind of tap into the labor market that they might've not been, you know, been able to really utilize before. I think together we can kind of figure out, hey, how do we bring a little bit joy back? How do we reach our goals? How do we maximize all the talent that we have? So yeah, that would be my little closing statement there.
Alec Goldman (17:42.274)
Christine, thank you. I think what you're doing with fractional labor, specifically in the dental space, is much, much needed. And for those who have not met Christine or have spoken to her, please reach out to her. I think it's a massive opportunity for you to figure out a really unique way to get more resources at your office that scale up and down without needing to bring somebody on full time. Christine, it was so nice speaking with you today.
Thanks, Alex. I appreciate it. Have a good day, everyone.
Alec Goldman (18:09.206)
You too. Thanks.