0:00:01 - Mark Henderson Leary

It's a great question, so yeah, so it's great to have you back. Let's talk about that, man.

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0:00:05 - Dr. Michael Neal

How's your? How's your? Yeah, we're live, yeah, we're doing this. Man, like I said, let's do this. That's great.

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0:00:12 - Mark Henderson Leary

How, how well. So the running has been going very slowly. I have been dealing with plantar fasciitis and Achilles tendonitis, which has put a massive obstacle into yeah, I hoped to have you know epic summer training and it's just been epic summer like recovery, so I'm hoping that things turn around fast.

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0:00:35 - Dr. Michael Neal

Yeah, that's rough. I had that for about a month turn around on me, thankfully, but that affects just regular life too.

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0:00:44 - Mark Henderson Leary

Yeah Well, I'm also pretty sensitive. It turns out, cause like the people who work on me, like, hey, this is the. This is like the most minor case I've ever dealt with. We'll have you back in no time. And I'm like, yeah, it still hurts and it's still, and it's still when I run it, it aggravates it and it's. And so, even though it's not bad, it's not getting better and you can't train through not getting better or you definitely can't train through getting worse, which is definitely what's been going on.

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0:01:08 - Dr. Michael Neal

but I think we might be turning the corner.

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0:01:09 - Mark Henderson Leary

I'm hopeful because now it's kind of the last stretch to train strong for a January marathon. So, yeah, well, good for you. I have. I have since then revised my expectations for myself, from Boston qualifying to having fun well, yeah, yeah, good for you.

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0:01:28 - Dr. Michael Neal

Well, so how have you been? Good yeah, on the running side of things, tomorrow is a big day for me. I am going to attempt a 12-hour race.

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0:01:41 - Mark Henderson Leary

Wow, and so I'm guessing it's more to it than just like sitting there for 12 hours. What are you going to be doing for 12?

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0:01:47 - Dr. Michael Neal

hours running a mile, over and over and over again. It's a mile loop or not a loop per se, but the course is a mile and it's just as many of those as you can do in a 12-hour period ah, okay, so it's distance for time.

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0:02:01 - Mark Henderson Leary

My first ultra.

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0:02:03 - Dr. Michael Neal

Um, the furthest I've run is a marathon, and that's the first time I'll be trying something longer than a marathon. So yeah, wow.

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0:02:09 - Mark Henderson Leary

So I guess I said that backwards. It's timed for distance, Uh so wow. So how many miles do you think that will be?

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0:02:18 - Dr. Michael Neal

Well, the goal is a hundred K, so 62 and change Um. The B goal is 50 and c goal is no ambulance so hopefully we hit the c goal. Yeah, I don't know. I really don't know. Um, I don't. I I mean, I'm sitting here drinking a milkshake, uh, because I'm carb loading and trying to hit 800 grams of carbs in a day 800 grams of carbs in a day.

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0:02:47 - Mark Henderson Leary

Yeah, and this is tomorrow. Tomorrow yeah, oh my gosh, this is insane. So 12 hours, what time does it start?

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0:02:53 - Dr. Michael Neal

9 am Eastern.

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0:02:55 - Mark Henderson Leary

It finishes 9 pm. 9 pm I can do that, man or sooner.

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0:02:59 - Dr. Michael Neal

It could finish sooner, but it won't finish any later Wow.

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0:03:03 - Mark Henderson Leary

So what's the longest you've run?

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0:03:07 - Dr. Michael Neal

27-ish. Oh, so you're looking at more than double Hopefully yeah, yeah, I'll be able to report back on the efficacy of eating mashed potatoes out of a cup while running, so I'll let you know that's insane to me, thinking about, wow, just getting to a full marathon from a half half, you can kind of at least for me I can kind of do it.

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0:03:31 - Mark Henderson Leary

It's like it's a thing just by itself, self-contained, conceivably in the right temperature you wouldn't even need much, or if any, water and fueling is not a thing. But when you double that it's like you really have to think you have to actually manage your fuel and you're going twice that.

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0:03:47 - Dr. Michael Neal

so well, I'm attempting to go twice that. So we'll see. Yeah, we've got a pierogi cook-off tonight um mashed potatoes, and then there's just going to be it's, it's basically, as I'm finding out nutrition, so we'll see how this goes this nutrition in the form of mashed potatoes mashed potatoes and uh, pierogies and stuff.

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0:04:08 - Mark Henderson Leary

Yeah so we'll see. Is it the polish festival? It could be it.

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0:04:14 - Dr. Michael Neal

It might be what. You know what it's going to be.

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0:04:15 - Mark Henderson Leary

Whatever festival gets me through this, that's what it'll be amazing well, I I'll be curious if, in our conversation, the ultra marathon turns into a metaphor.

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0:04:29 - Dr. Michael Neal

Yeah.

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0:04:30 - Mark Henderson Leary

How have things been going in the world of optometry and hiring people and all that stuff?

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0:04:37 - Dr. Michael Neal

Well, optometry doing okay, that I can't complain about. Obviously, the goal is to help as many people as we can and I think we're doing a great job of that. On the hiring side of things, same thing. We've expanded into 10 different healthcare professions. Now that is it's going well. It's frustrating how there's a good chunk of people in this country who would prefer not to work, and that has changed since COVID, and I think anybody who owns a healthcare practice or even a small business is finding this out. So that's a little bit different. But in terms of the quality of people that we're able to get into practices, what we're doing is focusing on the A players. The A players always want to work, so b plus players as well. It's where you, you trail off very, very quickly past that. You know, the c, the d's, although we won't have anything to do with bringing those folks into our practice. Their ideal is to not work so so.

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0:05:43 - Mark Henderson Leary

So, at the risk of being shamed here, I just gave a talk, actually at a conference. As you may know, it's SPARC, which is part of OptiPort, the conference right before Vision Expo West, and so I was speaking to a bunch of high-growth optometrists or optometry practice leaders, rather some of them very large, like thousands, and I did a breakout on hiring.

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And I was doing it from a more strategic. Well, it's a little bit of tactical level, but one of the big metaphors I was driving for is you know, we know it's hard to hire, but the reality is it's always hard to hire, no matter what. You're always panning for gold and and I drew this metaphor well, it's a metaphor, it's an actual diagram of it, of their, of their practice in terms of the whole accountability chart. And imagine, like all the people in the organization right people, right seats and then I kind of stripped it out.

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So imagine this how it is today and you're trying to pan for gold, metaphorically, and you can get some gold, but then how do you keep it? Because you lose it. And the reason I'm telling the story is that the approach to this is that you have to have this endurance mentality. Maybe that's the tie back to the metaphor. You're going to pan for gold and get lots of sand, and just because you get a bunch of sand doesn't mean you stop paying for gold, but what you do need to do is figure out how to keep the gold.

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And that is literally in the form of creating great managers and great leaders and looking at your organization and figuring out who the great leaders and great managers are who are going to retain and cultivate and grow these people and be sort of an attach point for this gold that flows to the organization. And I know your model is to pick people with the right DNA and then train them into that Same kind of thing. You get these people in the door. You don't always know who's going to turn out to be an amazing person, but you're definitely never going to know if they show up with potential, have a terrible manager and leave. So you have to have great leadership and great management to sort of cultivate these potential.

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I mean to mix the metaphor terribly. It's like gold in the rough, it's like diamond in the rough, but there's a gold in the rough. People who look like they could be okay or terrible, I don't know, but you put them with the right leader or manager, they blossom. Wrong leader, wrong manager, they're out. And I think that makes the calculus very complex. So just kind of, you know, has that formula changed?

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0:08:09 - Dr. Michael Neal

given what you're saying, or what does it really mean? Well, that's a really interesting question. I would say that the A players are less dependent upon managers than perhaps the B players are. In some senses there's a caveat to that. It's a pretty big caveat.

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The A players require managers that give them a goal and give them the resources to achieve and then get out of their way. So you know, an A player is just not going to be the type of person that wants to be micromanaged or have anything to do with that. They'll simply leave the position if that's the kind of environment they're in. So I would say that perhaps could be getting a little bit more stringent in terms of those types of requirements. Simply put, the A players have more opportunities recently than they did before.

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There are fewer people in the workforce there's, I mean, in the panning for gold side of things. The nuggets, uh, have perhaps changed in size and you know you have to pan a little differently. So with the build, my team approach, of course, we're bringing people in based upon their natural strengths and talents. That's the dna that you mentioned previously, and when we bring those a players in who have those natural strengths and talents for the position. They do an amazing job, but the tie-in to the manager is that the manager has to realize they've got somebody the right person on the bus, the right person in the right seat on the bus. Now it's time to give them the goals that they need to achieve the resources and get out of their way.

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0:09:39 - Mark Henderson Leary

So I want to dig into this A player concept, because my immediate gut reaction was well, a player to me is somebody who's formed and ready to go. In that definition, you know the kind of people where you just you do love to have them and they immediately take the load off you, as opposed to somebody entry-level, who has maybe desire or willingness, but maybe not the contacts and the education information, who, when paired up with somebody who could say, hey, I know where you worked before. It was acceptable to do this, but this is a more professional environment and we don't do that anymore, and that person goes oh, totally makes sense, my bad. And I think those are the ones you really have to look for in these entry-level positions where you don't feel like you can afford to compete at a super high level in terms of cost and salary.

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0:10:27 - Dr. Michael Neal

Yeah, and for the cost and salary side of things, remember, by bringing people in with the natural strengths and talents approach, they might not even be aware that they're A players. I don't think most of them are. What is very important is the fit between what the practice needs and what the natural strengths and talents that they're bringing to the table are. So what would make them an a player in that particular case is a really tight fit, whereas if they're in a role that is not a tight fit, they might not be an a player. It's not necessarily 100, always the person, although that's a huge part of it. It's also the person plus the fit to the role.

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0:11:07 - Mark Henderson Leary

I like that. The theory is that they fit the role. But oftentimes there is a challenge where maybe the organization feels unique or they feel like they can't get people who are not well. They're getting people who are not well-formed yet and they're like what do you believe? Well, I don't know, I don't know yet. I mean, do you believe in a work ethic? I think so. Well, what is that? And I've really especially maybe it's industry by industry. I mean certainly blue collar. It's a different deal.

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For sure you forge people, you don't train them in some circumstances, and so how much wiggle room do you have in that to have somebody that kind of walks in the door and how do you sense? Like you don't know which way is up, but I bet I could get you on the right path. Or like you gave me all the right answers and there's no training here. Well, training isn't. Obviously it's training, but giving you the right answers and you're a tight training here. Training there obviously is training, but giving you right answers and you're, you're, a tight fit from day one. What kind of latitude do you do you see between those two?

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0:12:11 - Dr. Michael Neal

well, I I think you're probably referring to more of an interview process.

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0:12:17 - Mark Henderson Leary

I mean, I'm talking well, I guess it does affect the interview process. I'm talking about the type of candidate, because because what I see in real life is when we, when we inform and pardon me create cultural change, we say we feel like the organization's not very strong as a culture.

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We got a lot of non-performers, bad performers, bad actors, whatever we got to transform and what I experience is his will could say it's a hundred people in the organization and you think, man, 50, 50 percent of these people this are terrible, and I said, well, maybe, but you might not know which 50 percent. When you get clear on what the objectives are and the objectives start with culture, these are the core values. We work hard, play hard, we're fun, we do the right thing, whatever the core is in end up being, but in your clear roles, you set a great accountability chart, so you've got great expectations and you get out there to these people and you, for the first time, really set strong expectations. I think there's three types of people you find. One is like the first group, which is the one you expect to see. Oh, yeah, we knew that that was my role, or that tweaked it a little bit, but that's always been the culture. Happy that you've confirmed it. Yeah, I'm right there with you.

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There is a second bucket, though, and they're the ones who are like I really didn't know that's what you wanted, and so I was just kind of doing whatever, and now that I know that those are the rules, I I think I can do that and they do kind of adapt into that, learning either higher discipline for the work or how to behave in the culture, or both. And then of course, there's the third category who's like, yeah, this sucks, this isn't fun, and hopefully they leave before you have to move them out, but that's the thing. And so I'm really trying to make a distinction between those first two categories. The first one, who shows up lights on absolutely I came from a place where everybody was lazy. I want to be in a place that works hard and you sound like your place that works hard. Let's do this.

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And there's a second category who's like I'm figuring it out, like, and I'm really talking to those entry-level folks who you know the front office coordinator types and maybe and I don't depend on states you know opticians can be very entry-level at some point, really understanding like that, hey, you know you may have an expectation what the industry is, but try working hard for once and you might like it. And oh, you know what. It is amazing.

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0:14:31 - Dr. Michael Neal

The reward benefit is amazing when you work really hard I think you just described um quite accurately the difference between an a player and a b player. Okay, I think that the the a player just shows up with the batteries included. The batteries are not sold separately like kids' toys. The B player who needs to be reminded to work hard? That's probably.

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0:14:56 - Mark Henderson Leary

B See, no, that's totally different. I'm not talking about reminded, I'm talking about instructed for the first time. Okay, because I think that and I've experienced that. I remember, when I was coming up, that I was ignorant.

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I wanted to do a good job. I didn't know what a good job really looked like in terms of, like, some of the how, like how do you greet people, necessarily, how do you format a document? In terms of you know, how do you? How do you enter a meeting, how do you go through a proposal? These were things that I wanted to do well, but it took somebody to say nope, that was not it. Things that I wanted to do well, but it took somebody to say no, that was not it. Mark, it's not how you do it, this is how you do it and they all. I don't have to be told once, but once I knew it, I was great to go. But I'm sure, and in fact I've had job interviews where people long, millions of years ago, some somebody telling me, like, where you know, where do you want to be three years from now, five years?

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0:15:42 - Dr. Michael Neal

yeah, I don't know.

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0:15:43 - Mark Henderson Leary

And the guy was like look, look, dude, you got to have answers to these questions, Like you're not going to work here, but let me tell you how the next one needs to go. And I was so like I was writing it down and next one went better, you know.

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0:15:54 - Dr. Michael Neal

Sure, yeah, well, I think from from our standpoint, we build my team. It's limited to private practices, right? So when you bring in these folks who are the a players and then the b plus players, there is a, there is training required. They're not going to come in with experience. So you're going to your team generally for practices we work with, does the training. But these people are picking it up really quickly and that's kind of what you alluded to before. You're not going to have to train these folks and say the same thing over and over and over again. It just doesn't work like that. They're go-getters, they want to please, they want to do a great job, they want to take care of people patients, of course and also fit in with the rest of the team. So I think that's naturally baked into these types of folks when they're brought to the table. And part of the reason reason, mark simply is that we're rejecting you know, depending on the position 95 97 of people.

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0:16:49 - Mark Henderson Leary

So those, the folks that aren't going to be a good fit, just don't get through that far into the process yeah, I guess to put a finer point on my whole tirade, I think knowing the difference between the already trained and the ignorant but truly coachable, yeah, yeah, the well the already trained in in this model would come in with experience, right, yeah, we're not looking for that yeah because in well, in my practice and my practice and the high performing practices that I've studied, regardless of whether they're in eye care or what what uh healthcare profession, you come in with the ability to do those, uh, you'll be trained.

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0:17:39 - Dr. Michael Neal

You'll be trained very quickly and that's it, you're off to the races. You know, there there's not, there's not that coddling feature in in these roles anymore. Right you're, you're not going into an optometry practice or any type of private practice where it's uh, vastly overstaffed. I mean, those days are gone as well. So you just don't have somebody who's going to be the nursemaid, the, the proverbial hand holder, spoon feeder. Healthcare in America just doesn't operate like that anymore. It doesn't have the ability to do that.

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0:18:14 - Mark Henderson Leary

Yeah. So how do you match the coachability like the untrained or not yet fully trained coachability to, by the way, you're going to be the deep end of the pool fast. How do you find that? What's your response to this? I mean, I think that probably brings us full circle to this. Hey, it's harder to find people now. It's just a lot less people who are motivated. Okay, so we've got to really know how far the leap, how far can they jump from where they are to where they need to be. The gulf is wider.

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0:18:52 - Dr. Michael Neal

Well, that's part of what we measure with Build my Team. We're measuring how they interact with team members, how they like, all the way down to granular stuff Like how do they like to be communicated with from other team members and from their manager, communicated with from other team members and from their manager? Are they quick communicators, slower communicators, all of those types of things? And when you get that granular, you've essentially it's like a legend for a map. It will explain exactly how to work with these candidates in order to get them to be successful very, very quickly, and all you really need is a manager who is, or a supervisor who can take a look at that data and say, okay, so this is the shortcut, this is how I can be successful with this candidate. I have to do things a little bit this way, a little bit this way and a little bit this way, and we should be off to the races. And it works Because you're meeting the candidate where they're at Right, the races. And it works because you're meeting the candidate where they're at right.

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So on their first day of the job, you can take a look at the, the insight report from build my team, and it will tell you here's how to communicate with this person. Here's how they like to be managed, here's how they like to contribute to the team, here's xyz, all kinds of that stuff. So, rather than spending the first X period of time you know, usually measured in weeks, to dance back and forth and figure that out between two people, you're getting that before the person shows up for work. Now, if you ignore it, mark, well that's on you, but the information's there. So, in that environment, with that amount of information, aren't you getting the shortcut that you need?

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0:20:35 - Mark Henderson Leary

Well, I guess. I mean, I guess there's two things that come to mind. First is you've got to assess that they're even workable, nevermind style.

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0:20:45 - Dr. Michael Neal

Right.

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0:20:46 - Mark Henderson Leary

And then there is how much of an adaptation are you asking the hiring company to have, because I do think there's a balance between maturity of an organization. How much leadership sophistication and management sophistication do they have? Which? Is somewhat equated to how much time do they have? Okay, we're small, we got to go right and our folks are all kind of junior and you just got to do with what's going on, or there is a cultural alignment, like you know. Hey, this person really likes, you know, soft, friendly conversations.

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Well, we're a very tough edged organization. Our culture is very much about direct feedback and so like well, that's not right, that's not a fit from the get and so that all combined with you sort of seeing if they've got the raw materials, let alone style. I guess I'm you know. There's three questions baked into that. Let's go to like raw materials when you're assessing, what are you assessing for? To assess for raw materials.

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0:21:41 - Dr. Michael Neal

Oh, all kinds of stuff.

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So one really easy way that we can all relate to is stress tolerance. You're bringing in a person for front desk in a super busy practice. They have a really high stress tolerance or they have a really low stress tolerance. Which do you think is going to work out Just right off the bat? No other characteristic to be judged upon which works out better. You know what I? What I think is quite obvious if they have a low stress tolerance, it will never work right. Exactly right doesn't matter if they're a terrific fit in every other way, they're still going to leave the job.

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So I utilize that because it's an extreme example in that particular case. Um, it can go the other way too, where if you have a position that does not require, like, let's say, a technician, a dental assistant, an eye care assistant, whatever it might be, works directly with patients one patient at a time, generally not a high stress position, that type of person it wouldn't be a big deal, no big deal at all. If they're high stress tolerance, low stress tolerance, they're going to. That's one of the minor criteria in the algorithm, if you will, for fulfilling that type of position.

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0:22:55 - Mark Henderson Leary

Okay. So I guess you know I don't know if this is an important question or not how much of your raw material selection is based on the position, as opposed to like I just, you have to, you have to want to work, I can't, I can't place you anywhere if you don't want to work. And is there like a handful of criteria, that sort of binary period like we just not, I don't want you in any of my jobs. And then there's like other ones, like yeah, I gotta know, like you're, this is high pressure, this is low pressure, it's selling, it's not selling, and so there, and then there's cultural aspects of that. So how much of your assessment is sort of broken into those three tiers?

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0:23:32 - Dr. Michael Neal

Well, that's customized by the practice, right? Because in a really high volume practice you're going to have different requirements of your team than you would in like a lower volume concierge type practice. You might want patient team members who can schmooze patients like crazy in a concierge practice Spend all kinds of time with them. You might want the team members that really like to enjoy longer conversations with patients In a high volume practice. That's going to be tough, right. It's a different type of algorithm essentially for what we're looking for in those particular candidates, based upon the type of practice, and it's not just volume-based. That comes out in the discussions with the practice owner or the practice manager, just like when you bring on a new client for your consulting practice, there's all kinds of questions you're going to ask to find out, quite simply, what type of practice you're dealing with. And that's the same for us.

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0:24:35 - Mark Henderson Leary

So I guess one of the things I tell my clients is assessments are really important and helpful, but they don't replace judgment but they don't replace judgment If there's a history of a success and the assessment says they should never have been successful that's notable, but that shouldn't override your judgment.

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If you get somebody who shows up who's never been successful and the assessment says they're perfect for this job, do not hire that person if they've never been successful. And so you really need to kind of start with real clear sanity check approach. Do we know what we need? You have a track record for having successfully done that and then using assessments. But it sounds like you use your assessments a little earlier in the process, and is it a different approach?

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0:25:23 - Dr. Michael Neal

Well, the answer is both, actually, and I got to roll back a little bit on this. So we're not trying to find the best candidate, like you would during a normal interview and resume-based process. What we do instead is we rule out the people that we know cannot do the job, and then we look very closely at the ones that are left. It's an upside-down hiring model and that sounds like a small difference, but it's all the difference in the world. What we're also doing by using these assessments is we remove those people we know who cannot do the job. They simply don't meet the criteria and by the way?

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0:26:01 - Mark Henderson Leary

if they, what are the things that you eliminate on?

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0:26:03 - Dr. Michael Neal

Well, for example, if you're only hiring a front desk position, then stress tolerance is a requirement. You have to have it. You can be the best candidate in the world, but if you don't have that, you won't last in the job. That's what has been proven time and time again. So we know that that is a hard and fast type criterion. But past that, these assessments do a wonderful job to a certain point. And what we added years and years ago was a video interview, and that is bang on to your judgment side of things. So you've got the proverbial. You know the assessments on the one hand and then you've got the video interview on the other hand.

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And the way that we use the video interview, it's not well. First of all, it's not used in the way that a lot of folks would judge that it would be used by. It's different. We ask all candidates a fixed set of questions. It doesn't matter what role they're applying for. These are fixed questions. What we're looking for is how they answer the questions, not so much what their answers are. That's a component of it. But there's a big component as well, another like imagine a pie graph, if you will, a huge slice of the pie. It's all about how. So, for example and this is a this is a little bit of a longer example, but when we first started the video interview process, believe it or not, we had this is almost all young women doing these video interviews, dressed up in their best outfits, standing in the shower. Now follow me on this one.

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0:27:49 - Mark Henderson Leary

I think you and I have talked about this. Yeah, but I keep going, for sure, yeah the judgment blew us away.

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0:27:54 - Dr. Michael Neal

This took a little bit to get our arms around, but they were doing that because it's the best lighting in the house, or the best lighting in their apartment. The door shut. Whatever's on the other side of that door is nice and quiet. They look great. They were putting their best foot forward in spite of every single obstacle you can possibly imagine, and it turns out those are the types of people you want to hire. Bang on, that's a no-brainer. If you have very little in the way of resources and you have utilized all those resources to put your best foot forward, you look fantastic. You're taking this super seriously, down to the detail level, where you make sure your lighting is fantastic and the acoustics are great.

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Well, that's the type of person you want to hire, because when they roll into a practice, they can be completely comfortable in situations where they don't have it all spelled out. They don't have every single resource imaginable. It's like a small business versus a corporate job in a lot of ways, like You're going to get a lot more resources with a big corporation than you will a small business, but on the other hand, it's a completely different role. So when we see that type of person, and it doesn't matter what they look like. None of that is all that's irrelevant.

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But when we see that type of person in a video interview, it tells us that this is a person who's going to approach this job in a completely different way than somebody who, let's say, for example, we had somebody do a video interview while driving a car it was not a self-driving car, this was a person that was literally holding the phone in one hand and you saw the background going like oh my goodness, so you want to talk about judgment, mark? Yeah, you know, just chop. That person's gone. You're an idiot, like you know. You might have passed the assessments and we know your strengths and talents, but at the end of the day, you're an idiot. That's just irresponsible and ridiculous.

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0:29:51 - Mark Henderson Leary

So you got two ends of the spectrum to me having a conversation with a surgeon who was in surgery. It's wow, all right, it's okay, and so we're doing recruiting and we're doing a profile. It's like well, sorry it's just a really busy day, and so three or four or five people on the call, including one surgeon in surgery well, maybe it's closing up.

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0:30:09 - Dr. Michael Neal

You never know, right?

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0:30:10 - Mark Henderson Leary

yeah, and you're really you're out of the experience, I guess.

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0:30:14 - Dr. Michael Neal

Yeah, and that's the thing. You hit the nail on the head with the judgment side of things. We have team members who are reviewing these video interviews that do this. That's their job, and so you very quickly, when you compare one after another, after another, you very quickly know what you're looking for. It's that X factor and it just pops out with neon lights in these types of situations.

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0:30:37 - Mark Henderson Leary

So I know we've talked a lot about assessments. How big of a role do assessments play in this? Is this something that everybody should be including and really understanding at the nth degree, or what's your general take on assessments?

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0:30:55 - Dr. Michael Neal

degree, or what's your, what's your general take on assessments. Well, if I put it back to the medical side of things, the way I would kind of describe this is you can ask a patient what's wrong with them and they're going to answer in a couple of sentences, and then you could do a whole bunch of different tests on the patient. Like you know, comprehensive blood work you could do in eye care, you could do a refraction and figure out what the prescription, you name it, all kinds of different stuff and at the end of it, when you have all that information in front of you versus, a patient just says you know X, y, z, three sentences as to what's wrong with them. That, to me, is the way that you compare a resume to, let's say, assessments. A resume is going to tell you whatever the person who writes a resume wants to tell you. Nothing more, nothing less.

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And nowadays you can't even check references on virtually anybody because they're not going to tell you. They're just not going to tell you anything. Everybody's so afraid of getting sued. So that model just provides a monumentally low amount of information about the person and it doesn't tell you anything about what they're good at. It just tells you their work history. That's all it is. So, on the other hand, through the assessment route, we don't necessarily look at their work history, because in the build my team model, we want people based upon their natural strengths and talents and if you are a terrific fit for the role, we know you're going to be successful. We've proven that over and over again. So that's kind of the difference between the two and I think that, having gone through this not only in our own practice but seeing how this works around North America, I would not touch a resume with a 10-foot pole at this point.

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It's literally the last thing that we look at, and it's only looked at by my team because of experience. If we have somebody who is a terrific fit and they have experience, then that right there, believe it or not, is a red flag, sometimes a yellow flag, but it has to be investigated Because we could be putting a person in a role where they have a terrific fit but now they're coming to the table with all kinds of habits that have to be undone and then retrained, and that's very challenging, yeah, interesting. Or they're a unicorn and they're coming to the table with everything that you're looking for. That happens too, just pretty rare.

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0:33:22 - Mark Henderson Leary

So what are the key ingredients? Assessments it's not like you use the assessments two ways. It's sort of a pre-filter just to kind of screen down to a handful. You've got the video interview and you've got further assessment, analysis or what's the rest of the DNA? I mean to get this right. What are the critical ingredients?

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0:33:41 - Dr. Michael Neal

Well, first thing we measure as soon as the candidate applies for one of the job descriptions, they get a text within five seconds. So we're measuring their mindset, to begin with.

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0:33:53 - Mark Henderson Leary

So you're going to slow this down, so you don't pull out of a database of possible candidates you always post fresh for everything okay, yeah, brand new.

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0:34:04 - Dr. Michael Neal

Our team writes the job description for the practice after a consultation with the practice usually it's about half an hour.

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0:34:09 - Mark Henderson Leary

Let's get invited to look at new, new positions or, if they want to it's up to them to apply.

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0:34:15 - Dr. Michael Neal

Okay, so do you email to them.

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0:34:19 - Mark Henderson Leary

Okay, so they don't have any idea and that you posted this new thing, unless they just kind of go back and check exactly.

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0:34:24 - Dr. Michael Neal

Yep, they weren't, and and a lot of people do apply again, this happens all the time. Um, so the first thing we're measuring is a mindset. Do they have a health care mindset? Do they want to help people? Do they have initiative? Are they, you know, honesty and integrity? They like to learn? There's a whole bunch of different factors associated with that, and then, by that point in time, about half of the applicants drop off and a lot of practice. Oh, my goodness, we're losing half the people.

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Yes, thank goodness you are, because those are the folks who can't possibly do any work to try and get this, get this role, like they just want nothing to do with it. This is a very serious interruption to their xbox time while sitting on the couch or playstation, depending on the console. But you see what I mean. I mean that's that's the, the type of person that they just don't want to. Interruption to their xbox time while sitting on the couch or playstation, depending on the console. But you see what I mean. I mean that's that's the, the type of person that they just don't want to do this. They're going to move on to apply for a job where they don't have to lift a finger and so it's just the size of the lift for them to get this uh assessment done well, it it's, it's very easy, but it's not the size of the lift.

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It's that there is a lift, okay, we're asking them to take an action of any type whatsoever, and that contrasts to jobs that don't require they take an action. So, right off the bat, we are eliminating the super lazy people that just don't want to lift a finger, and that's huge.

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0:35:52 - Mark Henderson Leary

How big a lift is that assessment? 45 minutes, 10 minutes? Oh no, no, no, no.

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0:35:57 - Dr. Michael Neal

If they go soup to nuts through the whole entire thing. You're looking at about 15 minutes, so it's not long at all. But after the mindset, we're also measuring their speed of learning and we want to know how fast these candidates learn, because if they learn slowly, that's not going to work up. If they learn super quickly, it's also not going to work out. A little counterintuitive there, because those people aren't challenged and they leave the practice. You have a terrific person, they're fantastic, they learn super quickly, you're in love with them. Boom, they resign. What happened? Well, it's that this type of position is not challenging enough for them. So there's a sweet spot and past that there's a whole bunch of critical performance factors.

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I've alluded to some of those how detail oriented they are, do they like routine, not like routine, how they follow up, how they make decisions, all kinds of those types of things, and that's, of course, part of the, the particular algorithm. How they're motivated, what type of environment they like to work in. And then, something we didn't talk about these are just simple questions. We ask them 10 different questions that are more like nuts and bolts types of things Like, for example, are you currently employed? Well, if the answer is yes, they're going to have to give their employer some notice right Now. If the answer is yes, they're employed and they don't give their employer notice. You don't want anything to do with that person. We all know that. We've been there, done that, got the t-shirt right. Are you looking for full-time employment? What hourly income are you hoping to receive at this place of employment?

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So they're throwing out the first number. For example, if your practice is willing to pay 20 bucks an hour, terrific. If the candidate wants 25, it'll never work. If the candidate wants 10, that's not going to work either, because you need to drop like. You could offer them maybe 11, even 12 bucks an hour. They're going to be overjoyed, but if you offer them 20, that's not going to work. They're going to be overjoyed, but if you offer them 20, that's not going to work either. So it's too big of a spread for that type of thing. And then we're also looking at things like this. This is, believe it or not, so simple. Our office is open, is typically open the following days, all the days are listed and all the times are listed. Are there any days or times that you are unable to work? So if they answer yes to that question. The system automatically eliminates them. They're out, they're gently off loaded from our process. Simply put you don't ask what's what they're?

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0:38:26 - Mark Henderson Leary

what do you mislead them? Hey, yes or no uh no? If yes, then what are they?

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0:38:31 - Dr. Michael Neal

yeah, I mean this might shock you, mark, but we're not looking for candidates who want to work 10 to 2, tuesday and thursday, with a two-hour lunch. I mean we're we're not looking for that type of person. We want somebody. A health care practice is open um, almost all of our clients are are busy practices or open most of the time. You know, maybe four to five days a week and folks got to show up. You just, healthcare is an in-person position.

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0:38:59 - Mark Henderson Leary

Yeah, I totally get that. I guess my mind goes to like what if there's somebody who has like a Saturday morning obligation with their you know something, and the practice opens on Saturdays and, like you know, every every time they can, every time else they can work just fine, but like, ah, you know, this person has like a church commitment on Saturday mornings and they can't go, and so you would say, nope, they got to move along.

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0:39:19 - Dr. Michael Neal

We just bring you people that can do what you're asking them to do. It doesn't mean that that that's a bad person. It's just not a good fit.

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0:39:25 - Mark Henderson Leary

Okay.

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0:39:27 - Dr. Michael Neal

Yeah, and so these are types of automated questions that it's why the process eliminates so much time and headache and hassle, because it's done automatically and otherwise, if I contrast this back to the resume process, you're simply, you're going to ask a whole bunch of these questions, you're going to be told a bunch of stuff and then how many hours do you have into that candidate at the point where you realize they can't work in the practice? Yeah, and that's a question that varies depending on the candidate, of course, but the answer is not a couple of minutes. You've got some type of serious time commitment into them and that's just time that the practice owner, practice manager, could be building the practice instead of wasting it on this type of.

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0:40:14 - Mark Henderson Leary

BS so true. So, building on the ingredients, lots of interpretation of the assessment in several different ways. The video interview. I don't know if you want to dig more into the video interview in terms of what you want to get out of that or add to the recipe. I mean, you've got some pretty good candidates to start bubbling up. Where do you start digging in? You start looking at these video interviews. We start, you have some in in-person individual conversations.

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You introduce them to the client you know and give them some questions like what's the is you know what's the rest of the recipe in terms of the 80 20 of high impact than 80-20.

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0:40:51 - Dr. Michael Neal

It's about 97-3. So when they go through the automated assessments, what our software will do is it gives literally a thumbs up. Those are the candidates that pass the assessments and then from there they're sent the video interview and then the video interviews are viewed by our team. So the finalist candidates that pass the video interview and usually it's not pass, that's not the right word Our team will be like boy. These are great.

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Those folks are sent to the practice immediately and then the practice has to move on them, meaning they have to reach out to these folks within 48 hours. Now why do we specify 48 hours? Because guess what, mark A players are gone. After that they're out there. They didn't apply to your practice and your practice only. They might have 10 different interviews going on at the same time, same week type thing. So those folks are approaching this completely differently and the one tip for all listeners that I would pass on is the days of hiring slowly are gone. They're done. They may come back who knows if they'll ever be resurrected, but they're gone. If you're taking your time to hire, you will be automatically turning off the A players. They want to work for a manager or a boss who's decisive? If you are indecisive, it's time to fake it, because you literally can't do that anymore. They're gone. What you'll be doing is inviting C players to the table in droves.

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0:42:25 - Mark Henderson Leary

Yeah, I think we talked about that before. It's no longer hire slow, fire fast. It is hire fast, fire faster.

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0:42:32 - Dr. Michael Neal

It is.

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0:42:33 - Mark Henderson Leary

Which is unfortunate because that is. That is one of the skills that is hard to develop and painful develop and really not even humanitarian to develop is just it's a shorter leash but it is. It is a necessity to to do that for exactly what you're saying yeah, and it's.

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0:42:48 - Dr. Michael Neal

It's always tough for docs to do that because we like to have all the data in front of us before we make a decision right. And in the hire I mean through the build, my team model you can have a tremendous amount of data for hiring, so that's straightforward. But on the fire fast. Well you know, should we really fire the person, should we not? And then there's all this back and forth fire the person, should we not? And then there's all this back and forth. I can't think off the top of my head where I've ever had to let anybody go, where I sat there after the fact and said, boy, I really should have put more thought into that. It's almost categorically the opposite, where the person's let go and I scratch my head and my team scratched my head and the the great team members that we have are like what the heck took the guy so long?

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0:43:35 - Mark Henderson Leary

yeah for sure you know, yeah, I've rarely encounter encounter somebody who fires too fast, but it's not never, though it's actually interesting that I because I'm just much like you- I'm like I'm always teaching people three strikes rule and all that process yeah occasionally somebody says why would I slow it down at three strikes?

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I'm like, okay, well, tell me more. But I think you're the exception, because 99 out of 100, I'm telling people like you've got to speed this up, You've got to create a process to make sure you get these people off. And occasionally there's somebody who has a little of that feeling, part of their brain that's turned off, either through genetics or I don't know some form of abuse that they're like no, absolutely Right, I just let them go as soon as I don't like them. All right, okay, well, let's add a little process to make sure we're firing people for consistent reasons.

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0:44:21 - Dr. Michael Neal

Yeah, that's not happening a whole heck of a lot in my experience. That would be very rare, yeah, yeah, so I don't know what exactly is powering that person, but it's almost always that, yeah, a little sociopathy, a little something you know.

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0:44:36 - Mark Henderson Leary

Psychopathy A touch of psychopathy you know the side of sociopathy yeah for sure it's something like that. Actually, to be truthful, I'm thinking of one person in particular who I think it's a neurodiversity. I think the individual just isn't quite so empathetic by me and he's just sort of like can get irritated by a lack of performance and some things going on.

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He just goes right to like I want the pain to go away and doesn't feel it the way that you or I might well suffer over it yeah practical in that sense, but it also can kind of be a little random, and so that's the kind of person, right, coach, let's, let's make sure we've got a process that is fair and and uses the same set of rules for everybody in terms of culture and behaviors and gwc and scorecard metrics. So make sure that, yeah, I'm not saying slow it down, I'm saying do it logically and rationally and consistently, so right, you don't set any precedents that are hard to keep up with yeah, that's.

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0:45:27 - Dr. Michael Neal

That sounds like good advice, that's for sure.

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0:45:29 - Mark Henderson Leary

Yeah well, good, we've covered a ton, so covered a ton. So I mean, what else is? I mean I think we're hitting our time. We probably shouldn't need to let you go, but is there anything else we need to talk about that has changed since we last talked and really we opened up with it's. You know, there are less people who want to work, but the formulas sound like they're still the same.

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We have to lead well. We the same. We have to lead well. We have to pan for gold constantly, keep that gold and really drive into the root behaviors of folks, not get enamored by their resumes or the things they kind of say. What else did we miss?

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0:46:05 - Dr. Michael Neal

Well, I think that, since the applicant pool is smaller than it used to be for healthcare positions, that being decisive and moving quickly is even more important than it was before, because you're not going to have the ability to make these longer decisions like we all used to and, let's face it, it would be great to have that additional time, but we just don't. So we've got to dive in, make these decisions quickly and get these A players on the team and then get them rocking and rolling.

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0:46:41 - Mark Henderson Leary

So I love that this is really the double down on what we've been saying the last couple of minutes, but putting this crystal clarity of what you're saying. I love this is a way to end, because, as much as I agree with you, my fear goes up immediately Because I say it too. I say hire fast, fire even faster. We have to have both, because what I see a lot of people do a lot of very loving, visionary practice leaders yeah, yeah, I can hire faster.

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Well, okay, I took my eyes off you and you hired a bunch of terrible people and you've not fired them yet, so you have to have that discipline to move them in and out if it doesn't work, and if you're not the kind of person who can do that, or maybe who will ever be able to do that, then, thinking of what we learned through eos and other things, we have to have a practice leader who can.

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And if you're going to get one person on the team. If you're that founding provider, founding health care provider, founding physician, founding doctor, whatever and you just love where this organization is going and you're a loving, kind individual and you're always going to be the teddy bear, you need somebody who can be data-driven and say I love them too, but they can't work here anymore because they're not doing the job. And you need that yin and yang together, and if you can't do it, you must get there.

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0:48:01 - Dr. Michael Neal

Couldn't agree more. And that's where Build my Team helps the docs get the right people in in the first place and get the right people on the bus. Now, as far as firing people goes, sometimes it just has to be done and, like we talked about doing that, sooner than later is always the move.

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0:48:20 - Mark Henderson Leary

Yeah, for sure, and I like to tell people kind of a generalized number percentage. That really great hiring nails it two out of three times, which means one out of three times. You got to fix that at best Now maybe your hit rate's way higher but, I, like the message being don't get comfortable that you're never going to have to fire somebody again. That's not an option.

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0:48:43 - Dr. Michael Neal

Right, I mean build. My team is comfortably higher than that, for sure. But at the end of the day, we're still dealing with people, and sometimes people change and sometimes people's roles in their lives change. Sometimes, uh, a spouse gets transferred like no matter what you do in health care, you are going to be dealing with some level of turnover. It's the nature of health care in america right now, for sure what's the nature of business?

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0:49:06 - Mark Henderson Leary

even if you nail it, your business is going to change and the role is going to change and what you're gonna. You're gonna nail hiring somebody to this seat and they're gonna realize, ah, gonna nail hiring something to this seat and you're gonna realize we really don't need the seat.

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We thought it's really a problem somewhere else in the organization, or it was a problem last year and it's not a problem this year, and you're gonna have to deal with that right and even if you have somebody you love that you really think is amazing, a perfect culture, fit, and if the seat they're in is now, you're trying to find a home for them, you can't let them suffer you got to let them go maybe hopefully into another seat in your organization. But if you realize you have an amazing quarterback, absolutely world-class quarterback, but you're a baseball team, you got to let them go find a football team.

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0:49:47 - Dr. Michael Neal

That's a great way to describe it. Absolutely yeah.

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0:49:50 - Mark Henderson Leary

Yeah, and that happens a lot, it happens a lot.

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0:49:53 - Dr. Michael Neal

It does. We had a position where a person was working our front desk Wonderful person, absolutely fantastic, terrible in the role Moved to a patient coordinator where all of her empathy was taken, focused on doing the right thing for the patient all the time, and she's perfect at it, absolutely perfect. So I've seen the transformation that a person can do when they're moved from one seat to another on a bus same bus, same direction, same driver, same everything, but all it was was moving from one seat to another and it made all the difference in the world.

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0:50:29 - Mark Henderson Leary

Yeah, absolutely Great way to end. Anything you want to passionately express, please. I worded myself into a corner. What's your passionate plea for healthcare leaders, right?

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0:50:41 - Dr. Michael Neal

now Quite simply to remember you're not in this alone and you are. You know you have access to, to a process that will get you and will produce the A and the B plus players reliably over and over again From there, getting them into your team, integrating them into your team, getting them productive. It's so much easier when you have this level of talent. So give us a call, absolutely happy to help.

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0:51:12 - Mark Henderson Leary

So that's our time for today.

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0:51:15 - Dr. Michael Neal

I'm grateful for the time together and, uh, as always, exciting good luck on your race tomorrow thank you I guess it's technically a race, even though you don't exactly win yeah, I don't know how to describe that exactly, but uh, yeah, thank you commitment and adventure, uh self, you know. Punishment, I don't know yeah, a midlife crisis, perhaps I don't know which way to describe it, but we'll see.

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0:51:36 - Mark Henderson Leary

I hope you can walk 48 hours from now.

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0:51:39 - Dr. Michael Neal

That's probably unlikely, but we'll see yeah I'll get around, we'll be fine all right.

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0:51:46 - Mark Henderson Leary

Well, dr michael neal, I'm so pleasure, uh, so privileged to have you. We will see. See you next time.

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0:51:52 - Dr. Michael Neal

Thanks so much, Mark.

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0:51:53 - Mark Henderson Leary

So, for those of you listening, if you like this content and you thought it was valuable, useful, please get it in the hands of your friends and folks who can use it, share it and give us the likes, subscriptions, feedback, positive and negative. Give us some positive or negative feedback. In the link, we got that little voice memo option. You can communicate with us that way. In the link, we got that little voice memo option. You can. You can communicate with us that way.

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And also, if, for some reason, you're envisioning an amazing high-value practice for yourself, for their fear of patients, where it really delivers for your patients and everyone loves it and it's giving you the life that you deserve, but for some reason you're stuck getting there and you can't envision what the next step is, please reach out, don't stay stuck. Reach out to us at practice freedom comm slash schedule and we'll't envision what the next step is. Please reach out, don't stay stuck. Reach out to us at practicefreedomcom slash schedule and we'll talk about what a first or next step could look like for you and we'll see you next time on Practice Freedom with me, mark Henderson-Leary Boop. There we go, cool. Thank you, sir.

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