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Heather Colicchio is Founder & President of the American Association of Dental Office Managers — the largest association for dental business teams in the country. In this episode of Dentist Money™, Heather shares the philosophies behind her company’s mission to strengthen dental practices by maximizing the talents of office managers. She offers considerations to make when hiring an office manager, explains the types of training you should invest in, and gives advice for empowering office managers to lead successful practices.
Reese Harper: Hi welcome to the Dentist Money Show. This is Reese Harper, your host, and I’m here with Heather Collicchio from the American Association of Dental Office Managers. I’m really excited to have her as a guest because we’ve been waiting for a while to give us a lot of insight on everything that happens up front. I think there are a lot of mistakes that our clients make, and a lot of our listeners make, related to office management. Sometimes it’s kind of like an afterthought. We’d like to welcome Heather to the show!
Heather Colicchio: Hi! Thank you so much Reese. Thanks for having me.
Reese Harper: Let’s go ahead and have you introduce yourself a little bit more than I did. And to the association to get this started.
Heather Colicchio: I’d love to. I’m the founder and president of the American Association of Dental Office Managers. I started the association twelve years ago with no dental background whatsoever. I never worked in a dental practice only went to the dentist to have my teeth cleaned. The way it came about, around that time, I owned a chain of gourmet cafes. Not at all related to dental. It was cool. It was fun. I got a call from a friend of mine from college who was a dentist. And she leaving a group practice to go solo. She had given her notice. She had that entrepreneurial spirit and she was ready to go. Except she called me one day, freaking out, and saying “What did I do?” In dental school they taught me how to fix teeth. I don’t know billing, or coding, or software, or HR, or any of the other things I need to know to run a practice. And I said, well, don’t worry. I’m a member of the Specialty Coffee Association of American, they’re my go-to resource. There’s got to be a go-to resource for office management. And in helping her find one, I realized there wasn’t one.
Reese Harper: You went through the search and you didn’t see anything.
Heather Colicchio: Went through the search and …
Reese Harper: They had one for coffee (laughs).
Heather Colicchio: They had one for everything. It would blow your mind to know what there are associations for. But not one for dental office managers. It was unbelievable. There are associations for the dentist, the hygienist, the assistant, the specialties, but not one for the person who is charge of, pretty much managing the business. I started casually putting some feelers out to find out who the go-to was, and what came back to me was, there is none. But when you find one let us know, please. We are so alone, we have no support, we have no resources, we have no good place for continuing education. So a very long story short, what started as helping out a friend, I saw the need and started the association. And it grew very rapidly. About two years in, I sold the coffee business and devoted myself full time to AADOM, which turned from a habit to a passion. And I’ve devoted myself to growing it and bringing in all the resources that were needed in this particular part of dentistry.
Reese Harper: That’s super interesting. So talk to me a little about some of the things, as you were building the association, about some of the initial challenges or programs you felt like you needed to focus on, cause office administration probably has twelve subject, fifteen subjects. It was probably hard to see all of them right out of the gate and understand the depth of what needed to be done.
Heather Colicchio: Everything started coming at me all at once that I could see them all. It was a little bit difficult to see what I should focus on. What I heard the most from the dental office managers was, I’m so alone. So if you think about it, the dental office managers are the ones who are responsible for, like I said, managing the practice, managing the business. He or she, twelve years ago it was female dominated, and they were alone. If they had a question about anything to do with the practice, about the billing, about the coding, about HR, they have no one to turn to. And that’s really difficult because, at that time, there was no formal education for dental practice management. So they were learning on the fly. They had no one within their practice they could turn to, because the assistants and the hygienists didn’t really know. And they really didn’t want to go to the doctor and say, “I really don’t know how to do this.” So that was probably where I saw they needed immediate help. And so, to that end, I created the AADOM member forum, which is where they started to go, and that’s what really helped to catapult the association because we started to complete this network of support. They were sharing resources, and we were open to do that because we’re a national association. It’s not like they were helping their competition next door.
Reese Harper: It felt like a really collaborative group.
Heather Colicchio: Extremely. They’re extremely collaborative, they’re extremely supportive. They all want to excel. They all want their practices to excel. And that’s where we started and from there we started to bring in more of the formal business education.
Reese Harper: You started with a forum and that forum kind of helped people to collaborate and kind of self-diagnose, or get tips on their own situation.
Heather Colicchio: Exactly. And it helped them know where to go to find answers if other members couldn’t find answers. It’s a secure, password protect, private forum. So they’re in a safe environment. What it helped me understand was, wow, they really need more help understanding insurance, they really need more help understanding software. That helped guide what education we needed to help bring to them.
Reese Harper: Yeah, it’s interesting there’s not really a career path. In most industries, out of a service industry, there are education tracts that start to appear for every position within an organization. Most of the office managers I meet, if you’re lucky, this isn’t their first time around. But a lot of people are getting into this for the first time. A dentist gets out of school, or they’re 3 or 4 years in, and the assumption is, I’m going to bring someone in to help me figure things out, and sometimes there’s not a lot of options.
Heather Colicchio: Well what I saw in the beginning, the pattern was mostly assistants who were working chairs would be the ones who would just answer the phone. And then take on a little more front office responsibility, and then one day, they were the office manager. Which is OK, but it’s not really ideal. And speaking to your point to, about formal education, there was none. Now a decade later there is plenty. I can speak to that later. But there is formal education where you are being tested and you can earn credentials. What I’m seeing now is the best office managers come from outside of dental. So they bring the business knowledge. They come from real estate. They come from banking. So they bring the business knowledge. You can learn the dental.
Reese Harper: It’s interesting. Sometimes I’ll walk around conventions and I’ll see booths where it says, “buy dentists for dentists” no matter what subject it is. The dentist started it, so consequently the dentist must be the expert in it. And I think that can be beneficial in some segments of the industry, I didn’t come into dentistry with a dental background. And you didn’t come into dentistry with a dental background. I think sometimes bringing a different perspective, that isn’t totally shaped by the industry, can add value in ways that you wouldn’t otherwise be able to.
Heather Colicchio: I think it brings objectivity. Whether it’s our association, or an office administrator coming in to a dental practice. Sometimes that clean slate, and not have loyalties to a company, or bad habits they’re bringing from another practice can be a plus. If there’s a fantastic dental manager who has been running a practice for many years, they might be an excellent fit. But dentists need to open up a little bit when they’re looking for an office manager and think outside of dentistry a little bit.
Reese Harper: It’s interesting. Most people probably wouldn’t assume that they don’t have to have 10 years experience in dentistry in order to do a good job.
Heather Colicchio: Exactly. And a little of what we are seeing right now is advanced degrees, MBAs moving into managing practices. I think part of the mindset is, yes it’s a practice, but at the end of the day, it’s a business. It’s a small business that needs to turn a profit, that needs to succeed financially, so you want the person running your business to be really good at what they do.
Reese Harper: I think if you’re competing with DSOs, and you’re trying to maintain some level of independence, if you don’t have competency in that office management position in finance, accounting a little bit, some marketing, HR, compliance. Those are standard business skill sets. If you don’t hire at a standard level of competency, it’s hard to compete with other businesses, other dental offices that have chosen to do that. You really need to invest heavily in that role.
Heather Colicchio: Absolutely! When you get the right person in that role, it’s very, very important for the dentist to give that role authority. We see this a lot, you can’t just give the title, you have to give the authority with the title. If you’re bringing someone in to do the things a dentist, they’re clinicians, and you want to be chairside. No one else in your practice can do what you do. Delegate the HR, delegate the compliance, HIPPA, OSHA, the marketing. Give it to someone who, that’s what they’re good at. That’s what they’re there to do. Dentists like to manage and oversee. I think learning how to delegate, in any business, and they having the right people in the right places, and them allowing them to go and do their job, so you can do what you’re good at, is really key.
Reese Harper: Why do you think that dentists struggle to let go, and they hold on to some of those responsibilities.
Heather Colicchio: You know I don’t know if there’s a right answer to that, I have my theories. I think dentists, like I said, they’re clinicians, and they’re used to working, them and the patient and kind of getting into the zone. Working in that solo way. So I think it’s difficult to turn around and say, “I’m handing this all off.” When they are at the chair, that’s their domain. That’s what they do. They own that. It’s difficult to own one part, and then not have control over the other part. I’m not saying they shouldn’t have control, but delegation is key.
Reese Harper: For me it seems like it’s hard to give up responsibility if I don’t trust the person I’m delegating to. So hiring the right person probably has a ton to do with letting go. Right?
Heather Colicchio: You always want to hire the right person. But when you have the right person in place, and you have to build the trust so you have to start slowly, slowly handing over the responsibility once the trust is built. But another key is to continue to invest in that person. If you have a business manager, you want to make sure they’re up to date. You’re sending them to the shows, you’re sending them to the conferences that they’re getting continuing education.
Reese Harper: Continuing education is so crucial.
Heather Colicchio: I meet office managers that have been in practice for 30 years, and no CE.
Reese Harper: I tell people that a lot. I feel like the salary that you budget for cannot be the only expense when it comes to staffing. Add 10% to the cost of the salary and you’re starting to get to a place where it’s an adequate investment in the person. You need to provide benefits so people can have a secure career. You’re also going to need to invest in continuing education that will improve the quality of your staff.
Heather Colicchio: I’m a huge advocate on continuing education for the entire dental team. For the administrator, for the assistant, for the hygienist. We run into so many times where the assistant, the hygienist and the doctor is hesitant to invents, and that’s the key word, invest in their education. But that investment will help your practice succeed. It’s not something where they are going for personal development. They want to be better at what they do. I have a team. I invest in their continuing education because it’s going to benefit the association. Likewise, investing in a dental practice team there is ROI. If you don’t do it, you can’t keep up.
Reese Harper: I think that’s a really good insight. And from a financial perspective, when we look at the personal financial statement of a dentist, or their personal worth, the value of the practice is anywhere worth 10 to 50% of his total personal worth, by the time his career has concluded. Dentists who invest in their business and in continuing education and grow a solid staff that has a lot of tenure, those practices tend to have much better values. That’s measurable. When you sell a practice, most of you probably don’t know this off the top of your head, but you’re going to pay a lower tax when you sell it, than just earning a salary. On your salary you’re going to pay anywhere from 30 to 50% in taxes on that income. When you sell your practice, you’re going to 15 to 23% tax. So if you can invest in your business and grow the asset, and then sell that. You keep a lot more money than if you were just pumping up your salary. During your career it pays a lot to reinvest in your team so that you can benefit at the end of your career.
Heather Colicchio: I couldn’t agree more. Investing in the team, not only does it bring the immediate ROI, they’re going to have knowledge that they can implement and they’ll be more productive, you’re going to have better loyalty. And you’re going to keep good staff. And you’re going to continue to enhance that asset.
Reese Harper: It’s super rare to see someone value continuing education and that be a forefront of their employee value proposition.
Heather Colicchio: It’s critical. You can’t look long term if you’re not doing that.
Reese Harper: So let’s hit a couple of things, a couple of bullets on the top two or three things you’d put a focus on training an office manager. If you were going to do a check on their preparedness for the job, what are some primary areas that you’d say, we really have to make sure these skill sets are solid.
Heather Colicchio: First I would say, an employee handbook. And that’s not something a dentist should be doing, creating and revising an employee handbook. And it’s so important, for many reasons. It helps your practice run smoothly. It protects you from liability and lawsuits. We have so many practice managers and it’s their responsibility and they don’t know where to start. That’s a key.
Reese Harper: An employee handbook that contains instructions for all areas of the practice …
Heather Colicchio: Job descriptions, all your policies and procedures, time off policies, protocol. Benefits, so they are all laid out, it’s all in one place, everybody signs off on it and you’re good to go. There’s not big huge question marks around that. The employees know what they are supposed to be doing, they know what they are entitled to, they know what to do if they feel something goes wrong. Secondly, practice management software. Every practice has one. This is another place where I think the investment is key. It might be more of a time investment to make sure your practice administrator and your entire team understands your software. Knows how to run the reports. Knows everything it’s capable of. The new software, there are so robust. They’re designed to make your life simple.
Reese Harper: But they’re deep right … it’s not an email you can go check and it’s easy to figure out.
Heather Colicchio: No, but the bigger companies, the solid companies, they have trainers who will come in. And that’s something else I would recommend to the dentists. Let the trainers in. If it means blocking out a couple of hours of patient time, the investment is worth it. We had a member, I can tell you, he was running his practice on one of the big software packages and a tip he learned at our conference, just running a separate report he was unaware of, he came back and told us it was saving his practice 20 hours a month of staff time.
Reese Harper: Manual staff time.
Heather Colicchio: They were doing things manually. And he had no idea that with a click of a button, all those reports and all that data would be right there in front of him. Make sure you understand your software, what it’s capable of, what reports it can run and then what to do with those reports. How to analyze them and what you should do next. I would recommend, once you have a good person in place, is making sure, I’m big on automated patient reminder services. I think if you have a good office manager they are willing to tackle that technology and take that. There are so many things that can be automated. I think if the dentist trusts you, yes go with this, it will make the practice more productive in the long run. The other thing I’m seeing with dentist office managers is social media. A lot of the social media responsibility is coming to the dental office manager. Allowing them to take that over and run that is beneficial. You don’t want to be the only practice that’s not on social media.
Reese Harper: OK we have, in a summary, the employee handbook to kind of master. We have competency in the practice management software.
Heather Colicchio: I mentioned the automated patient reminder, but that’s just kind of blanket for any technology for front office management.
Reese Harper: And then we talked a little about social media and being able to master that and have some level of support. Everyone of those things has a great resource, or two. People don’t need to feel like they’re isolated doing this stuff. I don’t know why I feel this way in my own life, sometimes I’ll go months working on a problem, trying to find a solution, when really it’s a phone call away.
Heather Colicchio: Let’s just say a google away. (Laughs)
Reese Harper: Yeah, it’s funny. Sometimes I think that as entrepreneurs were so used to digging ourselves out of a hole, being the only one that has the shovel, we just keep digging and digging and digging until we find our answer. Sometimes the better response is to have a bunch of people with shovels. Have them come in and help dig the hole with you.
Heather Colicchio: I’m big on outsourcing as well. If there is someone who can do it better, faster, stronger, bring them in.
Reese Harper: The one thing we talk a lot about is dentists have, depending on the survey you look at, they have the second highest income in the country. Certain specialists would be ranked the highest, and some are in that maybe #2 range. But per hour of their day, each hour they can interact with a patient, sit in a chair and do a clinical procedure, there’s almost no service that’s more expensive than that. Even the most expensive lawyers in Silicon Valley earn more than a dentist can make if he’s in a chair.
Heather Colicchio: Exactly. Again, that’s why I’m a strong advocate of being in the chair. There’s no one else that can do that but you. So empower your team.
Reese Harper: This has been a great interview. You did an excellent job. I really appreciate it. It added a ton of value I think to our listeners. Again Heather Colicchio. You said an acronym I hadn’t heard before for the organization.
Heather Colicchio: Yes it’s the American Association of Dental Office Management, or AADOM.
Reese Harper: AADOM! Ok, so we’re going to use that.
Heather Colicchio: ADDOM for short.
Reese Harper: Well Heather, thanks so much. This has been a really great interview. We really appreciate having you on. How would people get in touch with you if they want to learn more, and how do they get involved if they’d like to?
Heather Colicchio: That would be great Reese. If you wanted to learn more about AADOM and what we do and what we provide dental office management, the website is www.dentalmanagers.com . We also have a special promotion for your listeners, so if they wanted to join, or have their office managers join, they would just enter code DA125 at the end. DA for Dental Advisors 125.
Reese Harper: It’s been a pleasure. I hope we have you back on the show soon, and thanks for taking time.
Heather Colicchio: Thanks so much.Practice Management