What lengths would you go to to fix a problem that’s affecting quite a few others within your industry?

In this episode of Beyond Bitewings, Ash welcomes Dr. Joseph Hull of Hull Dental Health. Dr. Hull is a dental practice owner in a more rural area of South Dakota, and discusses the problems with finding qualified staff, especially after the pandemic. 

Instead of accepting things as is, Dr. Hull decided to find ways to improve the situation by finding new solutions and seeing what he would do to make his own state change laws and offer further training. This law would teach dental assistants to provide coronal scaling or scaling of the teeth above the gum.

This would help alleviate some of the problems with staffing he’s been experiencing in his practice. After seeing other states have been allowing this for quite some time and other states are just passing their law allowing it, Dr. Hull is trying to push for more states to do the same. He has now talked to his association for the state of South Dakota and is working on other ways to help figure out how they can implement this. 

This is an excellent example of leading and trying to have an impact on something bigger than just what’s happening in your office. It’s also about helping others in an impactful way. 

If you have specific questions about any of these topics for your practice, or if you'd like to have another question answered on a future podcast, please reach out to the Edwards & Associates team. Please also contact us to find out more about Ash's financial course.

Visit us at: https://EandAssociates.com

Hello, and welcome to another episode of Beyond Bitewings. My name's Ash. And within the studio, we have a very special guest. His name is doctor Joseph Hall. He hails from Gregory, South Dakota, and where he also has his practice, Hall Dental Health. In today's episode, we decided to talk about, basically, the employment landscape in the dental world, specifically in the rural parts, because it brings its own niche challenges. And we figured, why not have someone operating, in a part like that that could share his experiences. So without fur further ado, doctor Hall, how are you

I'm very good, Ash. Thank you so much for having me on the program. It's just an honor to be asked, to participate. So thank you.

Oh, no. Absolutely. Absolutely. So, tell us I mean, tell our listeners a little bit about yourself and your practice and what you do.

Yeah. So I'm a general dentist. I've been in practice, graduated in 2001. So I've been in practice for a little bit now, which is hard to believe, those years have gone by. Yes. We're in Gregory, South Dakota. Whole Dental Health is the name. Small town in south central South Dakota, pretty close to the Nebraska, South Dakota, state line there.

Mhmm.

Nice little rural community. It's a community of about, let's say, 1400 with a with a surrounding area. Let's say about 4,000, 40 maybe 44100 in the county.

I see.

So rural rural America. So it's farming. It's ranching. It's you know, there's some small business, It's, you know, but just rural America. So, yeah, we're so we have a general practice. We do, you know, general dentistry, a lot of different and that's been our calling card to offer a lot of different things. It's you know, my wife is the office manager, Kara, and so it's It's it's kind of a, you know, husband and wife family, operation, which is it's not super unusual to see that. But yeah.

So our dream was to, you know, can can we bring world class dentistry to rural America? We're both small towns. And so, yeah, love big cities like, you know, Omaha and things like That's kind of the largest city. Lincoln, Nebraska, of course, where I went to school. Great to, you know, visit, live there, but we We wanted to kinda make our life in a smaller town because of the things that you can do in a smaller town, you can be part of a community, you can make a difference. So yeah. We had an opportunity need to look at this practice here, an older doctor selling the practice. It's kind of a fixer upper practice, so we bought it. There were some student loan, incentives to, locate in rural South Dakota.

Actually, at the time, South Dakota was doing a student loan Repayment program in shortage areas for dental personnel, and I was actually the 1st one to, to do that, go through that program. Really? Yeah. And so that was a nice thing, and that helped me out. It helped us out, get a start, Help out with some student loans. So the practice kind of, you know, we we took over a pretty, I would say it It was outdated practice. I mean, looking back on it, and, you know, we built it and built it and built it and added this and added that and added capabilities And built it up and we faced a decision point, you know, what to do, should we continue or should we leave and go somewhere else, and we decide to, just go all in and build a new new office, 6 operatory office. We we built that in 2010 and opened that in 2011. And so we're we're in a really, really well designed office facility, Really nice office.

Doctor Mike Unthank out of Lincoln helped us do the design. Mhmm. Pretty great office for a small little town. And so our our goal, our purpose was to be attractive enough that it's worth not only the the people in our community to come see us, but actually, to survive, we need to draw from a pretty significant area around us. Right. And so that's that's kind of our our strategy. Mhmm. And, yeah, that's that's been working, and is working.

But, you know, I I think since 2020 and beyond, I think the I think the landscape's changed. I don't think that's an exaggeration. I think things have changed, and and that's a whole, you know, a whole separate topic. But, yeah, Workforce, finding good, good people to work in the practice is it is a challenge. It absolutely is a challenge. Right.

And that's always been a challenge. It's just it's presenting some unique, additions to that Yeah. Challenge, I feel like, especially after, you know, 2020 and beyond. Right. And, like you, and I'm sure, other people have faced similar challenges. And if you don't mind sharing with our audience, what were some of the, unusual challenges, or out of the ordinary, so to speak, from your prior years that you were facing, post 2020.

Yeah. Post 2020, you You mean? Mhmm. Yeah. I think big picture wise, You know, I would love to have a discussion with somebody, and you're dialed into this as, you know, you're far more savvy and knowledgeable than I am about the macro But, you know, like, what happened to our workforce big picture wise? Well, that affected my small business as it did lots of small businesses

Mhmm.

And continues to do so at this at this time, and people decided to leave the workforce, and then all of a suddenly he had, you know, the work from home

Right.

Opportunities crop up. And I didn't think that would touch us in the dental biz because I thought, well, you know, You need to be present in dentistry, and that's what you do. You that there's you know, dentistry tried to do teledentistry a little bit, but that's It's okay, but it's not as quite as like telemedicine. But, anyway, so there was work from home opportunities that actually did take employees out of our market with with I can give you examples right now in our in our area of people who I would love to hire, but they are working remotely from a company that they may be a 100 or 200 miles away from, but they can do their work remotely.

I see.

So There you know? So let's say a really, really good dental auxiliary. This this absolutely did happen. Here, we'd like to to bring you on board because we need, we need some good dental auxiliaries. Well, no. She's perfectly happy working remotely for a, kind of a DSO type organization and doing doing computer management of inventory and some some schedule management on the computer online. Okay. That those those types of things happened. And and then just our situation, there's just not that many people who draw from.

And most of the people that we've hired, we've kinda built up from Basically, very little or no knowledge in the dental field and kinda built them up. And that's that can be very good. They They can some of the best auxiliaries that we've had have gone that through that path. We just don't have that many people to draw from.

I see.

And and that is that can be difficult.

Yeah. And I'm sure it's time consuming as well. I mean, as much as fruitful it may be for, you know, the mentor, it takes up precious time.

It absolutely does because as you can imagine, You know, with, with a trained experience auxiliary

Mhmm.

The practice is more capable and and the workflow is just more efficient Putting in the effort to teach and demonstrate and, you know, step by step show, I enjoy that, But you have to slow down a great deal to to do that. Now the hope is that eventually that pays off and you end up with somebody that's, You know, well trained and and is happy to do what they do in a good relationship that that lasts a long time. But it's always a bit the risk that somebody would, you know, a year or 2 into it, say, no. This is this is actually not for me, and I'm and I'm gonna go somewhere else.

Right.

And then you start the process that's over. So that that has also happened too.

Right. Right. Right. Right. And I know that some DSO type entities have implemented something like, you know, training on the job, where they bring in people from other industries and train them in this field so they can do their job. And it may have had good results for quite a few of them just because, you know, the starting pay could be less than what the market is. And even though there's additional time spent on them, it kind of makes sense. But, again, a DSO type entity will have the right resources, all the people that are there to just do that.

For a small practice like yours or others, you know, in rural parts, it's either going to be you or the office manager, right, who already has a lot on their plate.

Right. You're precisely right, that all the All the individuals in the practice already have their plate pretty full. Mhmm. And so in order to accomplish that, yeah, everybody us to, you know, shift a little bit and, you know, take on part of that part part of that responsibility. Yeah. Sure. A a a large large corporate office type situation. Yeah.

You've got the resources, you've got the time, And you've got the, you've got the financial wherewithal to to work through that. The smaller the smaller are just gonna find that a little bit a little bit more challenging. Mhmm. Yeah. So

Right. Right. And that's when I feel like, you know, small business owners have to come up with creative ways to mitigate some of these challenges, you know, with minimal resources and with utilizing what they have. I mean, of course, the that is there. Right? The, top, level The management people are putting in extra time, to do that. Train people, maybe cross train people, come up with various systems to to form a cadence and then, you know, kind of to have a very efficient, running system. But, again, hard work takes time, effort, energy, takes time away from the family and other things. Right? So then you also have to think of okay.

You know what? We still need more people. What do we do? So initially, maybe, you know, you would stick to looking for people only only within your city, but now you're like, you know what? I don't see anyone who's really looking for a job within my city. Let me expand my search. So you're having to filter through maybe other neighboring cities to find, you know, someone to help you out. But then they have these other demands, which are unique because they didn't apply within your city, but there are other competition in other cities that are probably offering those things.

Right. Yeah. You're you're exactly right. So we're currently searching for a hygienist, for example.

Mhmm.

And there As you know, there's there's a there's a shortage of of hygienists throughout the nation, but particularly in the rural rural Rural states, particularly difficult.

Mhmm.

So, yeah, we're having to expand our search radius And even go, you know, quite a long ways. We're looking now, you know, essentially a 100 miles in any direction for, a hygienist that would want to locate here and be a part of our practice. Again, we've got a beautiful office, really nice Nice practice, great people. But, yeah, attracting somebody into a rural setting

Mhmm.

Not the easiest task. And and, yes, the best Option is to find somebody from your community or, you know, we're we're talking to High schools and and and, you know, seniors in high school and and asking, hey, have you ever thought of dental hygiene as a career? And maybe that will produce Somebody who wants to partner with us and let's let's say, let's, you know, let's help you with your school and let's let's Let's, help you get through the program, but that's years away. So what do we you know, what can we do in the short term? Well, yeah, we have to look We're, you know, we have to cast a wide net. And so, yeah, we're we're reaching out, like I said, probably a 100 miles in any direction, and seeing if there's somebody who would like to to join our office, join our practice. Now we did have some success just, attracting a Expanded functions dental assistant reach recently or or I believe I I I think that's gonna go. I shouldn't mention her name, And I and I hope I don't jinx myself. But anyway, the, the ad was seen by a person who let this other person know, and She was in a different state and thinking about maybe locating here maybe, and, looks like that might work out, but that's somebody From quite a long ways away that we're that we're hoping to bring back and say, this is a nice place to be, and and why don't you come with us and And, do what you love to do, and and we wanna be we wanna help you do that. So, yeah, definitely having to get creative, definitely have to having To look at, being persistent and and trying to be competitive, you know, of course, with with wages and things like that, which that's the most amazing thing really post COVID is that, you know, yeah, your your workforce has has shrunk, and Some people have left the dental industry or taken other like, we were talking about, like, kind of connected to dental, but not really in Dental office, that's happening.

But then, you know, the the salaries that you, as a business owner, are needing to look at to, bring people onto your team, that's significant. And that's been That's been something you know, we've I've always felt like I wanna be a a good employer, and I want people to be feel like they're being Paid well and they're being taken care of. That that's important to me. I I that I want to I want the people who work in the office to feel good about where they work. But now when you have, just across the board, wages going up, up, up, Okay. That's that's for a smaller practice. That's a little bit harder to deal with because you You have to compete with that. Mhmm.

But maybe your your business model wasn't wasn't really, taking that into account previously, but now you do have take that into account Mhmm. And how we're gonna now work with that. Well, you're gonna have to raise you're gonna have to raise fees, which Mhmm. Again, Don't like to do that really, because the public already is pretty sensitive to dental fees, and they feel like dentistry is expensive. But There's not really a whole lot of, alternatives really, at this point. You kinda have to in order to keep in order to keep or attract For keep your staff, that's what we've felt found that we have to do.

Right. Right. Right. And there may be other alternatives, you know, that may apply to some other dentists tree is, you know, like dropping out of certain PPOs and going completely fee for service. But even those kind of changes, they take time. It can't just happen overnight. However, the increase in staff wages that kind of did happen overnight. So

Yeah. Yeah. And you Would have, you know, really good insight into that too because you talk to a lot of different practices and and what they're seeing, but, man, You know, we we feel like we've we feel like we are a good place to work. We've got good wages, good benefits. A it's a interesting job. There's pathway to advancement. So there's a lot of things, but then when you see you know, you just go go look around And you see, McDonald's or Wendy's, and they they they are starting at 19 or 20. Well, Okay.

Okay. That's that's just the landscape that we're in. That's true. So that's, you know, it's just different. It's just different.

Right. Right. Right. Right. Right. Now speaking of coming up with creative ways to go about this, you actually decided to do something about it. Take matters into your own hand and take on this new initiative.

Yeah. You're right. You're right. So we have been looking for a hygienist for all of 2023. K. We've been out without One since January of 2023. And so that's obviously changed how our operation works. And then that was a big shock, and that was, you know, there's a lot of lot of emotions connected to that, which which we don't need to go into, but we started to think about, okay, what are we gonna do? What are we gonna do? What's our options? So Just happened to be reading.

Mhmm.

And I saw that, Illinois passed a provision that would Allow expanded functions, dental assistance to provide, coronal scaling or or scaling of the teeth above the gum line on teenage patients.

Wow.

And I thought, wow. That makes a lot of sense to me. That is super interesting. Why is that interesting? Well, because you could take a a trusted Auxiliary that you have in your office and send them through a training. Mhmm. And it's, think Illinois, it's a it's like a 32 hour course plus an exam, and then you get a license to Do that, and then so it's not it's not replacing a hygienist. I would never ever say that. And and honestly, I if There's hygienists listening.

I I don't want to infuriate because there is a little bit of, maybe hard feelings associated with that. But in the absence, like a practice like mine, in the absence of a hygienist who who we can't necessarily attract a hygienist or haven't been able to. I believe it makes a lot of sense to to take a trusted, good auxiliary

Mhmm.

And send them through That type of program and then say, okay. Now you can help do some of these appointments and and take a little bit of The backlog of the doctor who is, you know so literally just, like like, we're trying to make the practice, you know, keep going.

Right.

Let's find ways to use the people that we have to accomplish that. So that's not legal in South Dakota. So Illinois just passed that.

Kansas

has been doing that for a long time. Missouri has that. California has that. So there's some other states that working on that. So I brought that up to our executive director of the South Dakota Dental Association, And he was very interested in that, and turns out there are some other dentists independently in South Dakota who have come to that conclusion that that could be a good thing. So I started having some conversations, and people started to say, yeah, that maybe that makes sense for for us. And then so then there was a, oral health coalition, a task force that was put together, which I was Very kindly asked to be a part of

Right.

That's looking at how could how can South Dakota utilize the personnel in dentistry better? And that's one of the ideas. And the other ideas are, you know, let's look at what it means to be an expanded Dental assistant. Let's look at what what, dental hygienists are able to do. And maybe there's some things that they can, that they can be doing that can improve our workforce development a little bit. So I I'm encouraged by it. I think it's something that would really help somebody in my situation. It would help, I think, a great deal. And I know for that there are other practices, especially rural areas, that are in the same boat.

And I just think it's maybe a creative idea. Like I said, it would never never, take The place of a hygienist. In fact, if I had that provision Monday Mhmm. And then on Tuesday, I had a hygienist Say I'd love to, to put in my application to work at Whole Dental Health. I would absolutely absolutely hire a hygienist. But In the absence of that, I I think it could be a good thing. So I'm I am hopeful that maybe we could do something like that, and And that could help out, at least be one little thing that could help out. So we'll see what happens, but So far, we're still talking about that, and we'll see if we can maybe put that into, In fact, maybe next year.

I don't know. We'll see.

That actually sounds amazing. I mean, I remember the first time when I heard this from you, I thought, wow. What a great way to go about this. And I'm sure there are people out there listening to this that's thinking the same thing. I guess my next question It would be so to actually make it happen, what would be what would you need to achieve or, you know, by next year to actually make it happen?

Yeah. So we're we're working with there's 2 colleges that provide dental assisting programs

Mhmm.

And working with the directors of those programs

Mhmm.

Because they would need to format their own program.

I see.

And and so you'd be able to you would need that. We would also need the state board to well, first of all, the dental to say, yes, we wanna do this, and then the state board to agree that, yes, okay, we we are gonna do this. So so there's some There is some politics involved there. Mhmm. There is, you know, obviously, some some voting and some approvals, And and the dental community in the state needs to agree that, yes, we think this is, a, safe, and b a b, a reasonable idea and and free to do that, create the permit, create the program, and The the awesome thing about that, though, I think is because you already have dental assisting programs that are we have really we have 2 really good programs, and we have The programs are good. The people who who, administer those programs are really good. You could you could make this change happen with kind of, you know, pulling a few levers here and there and produce this Change, I think, in a pretty cost effective way, pretty cost effective way. You know, there's been talk about maybe, you know, the, so there's 1 hygiene school in South US University of South Dakota in Vermillion.

That's on the eastern part of the state. There is talk about maybe putting a dental hygiene program in the western part of the state, maybe in Rapid City.

I see.

That's awesome. That would help our state a great deal. But to create an entire new hygiene program, a new facility, new faculty, new, you know, new curriculum. Okay. That's obviously expensive and that takes time to do. That could take, you know, 5 years, 6 years, 8 years. Who knows? This, what we're talking about, the beauty of it is, I think you could put this together with fairly limited cost and fairly short time frame, and I think it could be a win for essentially everybody involved. But the biggest obstacle is getting people to understand the need because not everybody understands the need.

If you're in a If you're in a metro area

Mhmm.

And you have the staff that you need and everything is running along great and your numbers are great and everything's great and, you might not see the need for this. And you might think, well, why why should we Why should we be making changes and do things like this? Excuse me. Because, you know, I'm fine. That's our probably our biggest, our biggest hurdle is to convince Dental offices who are fine, but there are other offices who could benefit if this change would be made. And the change Would be safe to implement because that's always, you know, the, really big concern is that Are what are you gonna do? Or is what excuse me. Mhmm. Is what you are proposing going to be safe for the public like in general, there's not going to be any compromise of, you know, the the dental healthcare if we let This pass or if we if we introduce this. And and my position is that, it would be safe because You would have a doctor's exam at the conclusion of that appointment to make sure that that's safely done.

So it's not so a so a dental hygienist can operate independently, but if we had an expanded functions, Auxiliary who is providing coronal scaling. Mhmm. 1st of all, it has to be cleared by the dentist and then there's a dentist exam at the end to make sure that that was done So I think the opportunity for, harm to come from that or or or substandard care to be Provided, I think it's it's it's low. So I think I think it has has fairly low risk, fairly low cost, And fairly high benefit to the practice associated with that. Also also, I think it's good for the auxiliary who would go through that because more training, more education, more responsibility for them, more job satisfaction, and higher wage because of of increased, responsibility Mhmm. And increased, efficiency to the practice. So win for the auxiliary, win for the practice, also win for the patients because, if the practice isn't backlogged and struggling to meet those needs, they can be seen, sooner. So I see pretty low downside to it.

That's I I think it could be good. I and I hope it I hope that can move along. I hope the, I hope people can see why it could be good. It's listed.

Right. Right. No. And I'm completely on board with your cause. I mean, the precedence has already been set by other states. Right? So it's you're just trying to see if it can also be implemented in South Dakota.

Yeah. And, you know, I've reached out To, the dental association in Illinois, I would love to know what what triggered them to go in and look at this and to do this.

Mhmm.

I haven't been able to have communication there, but I have to believe that it's similar types of things. So maybe I'll be able to have that conversation at some point. But yeah. And you know what's amazing? So they're the most recent one. Kansas has been doing this Since the late nineties, I believe, which is pretty amazing as I started to look into this at Kansas, figured this out quite a while ago and seems to be doing pretty well seems to be doing pretty well. So yeah. Interesting that that I yeah. I had not heard of it.

I had not heard of it prior to earlier this year. Mhmm. And I thought, yeah, you know, hey, that that could make some sense. So we'll see.

Yeah. Yeah. And again, from a safety standpoint, as you said, there will be oversight by the dentist, right, before the patient is.

Yeah. Yeah. Absolutely. I mean, there would be certain patients that that probably is not a a suitable thing to do or a good thing to do or not, you know, not maybe not, the right type of circumstance to utilize that.

Mhmm.

But there absolutely would be patients who, who that would be appropriate for. And that could be helpful helpful for and useful for, and they still have, Like we were mentioning, like, so there's there's still a safeguard of quality care in place. So they're not being shortchanged. They're not being, they're not being mistreated. Right. It's just a different way of doing it, maybe. Mhmm. And because, you know, because the landscape has changed like we were saying, so so then we need to change maybe a little bit to, to adapt.

Yeah.

Oh, absolutely. Absolutely. Yeah. And I'm also thinking I'm like, you know, it's not like they're going to be doing anything periodontal. That's still the hygienist's, you know, It's just anything above the gum line.

Right. Absolutely. Yeah. And and, you know, anything that's beyond that, in my circumstance, so that would be my responsibility. So then I'm going to I'm going to handle that, and I'll have the discussions, and we'll Well, you know, we'll do the charting. We'll do everything that's appropriate, everything the way it should be done, but then I'm gonna handle that. In an office that who has a hygienist, well, then that is his or her responsibility to handle that, and the auxiliary can handle their of that. But yeah.

Basically, from the from the gum line up, okay, that's the coronal scaling and anything, below, then that's We're gonna we're gonna have to do something different. Would never argue, anything beyond that, because, You know, there's there's some there's some good reasons, for that.

Mhmm.

But I think it could be something in in A lot of people's situation, a lot of patients, I think it would work well for.

Yeah. Yeah. I would imagine so. Absolutely.

Yeah. Yep.

So at this point, you know, I feel like the people that are fine with the way things are, they have a louder voice than some of the other practices, you know, that are not so fine.

Yeah. True.

So that's where you come in, I feel like. And I feel like, you know, you've taken that initiative, that step. And, you know, Today, we're using this platform to kind of put the message out there, and I'm sure we'll try to find other platforms where, you know, you could put your voice out there as well Be heard. Right? It's like, no. It's not fine. There are some people where this would make a big difference.

Yeah. Exactly. You know? Yeah. There's There's offices who will say, you know, I don't I don't wanna get into those changes. I don't wanna change these permits. I don't wanna create that because, you know, We're getting along. We're getting along, and we're we're good. But you know what? I I think what I've been told in And even more, the urban areas is there's a lot of competition for staff and there's you know, what I would say Is that you're you're just 1 Monday away from coming into work and and having the conversation that, your hygienist is leaving For another office and being poached.

Oh, absolutely.

I don't

I don't like that word, but you're being your hygienist is being drawn away into another office Or, you know, maybe a tiny little amount to pay more or something more, just who knows what, which is kind of what happened with us. So you're you're just you're just one day away from that going on, and then and then you'll be in our shoes. And then you might wish that you had that's been in favor of this because it it could make a difference. And and if things are fine, great. I'm I'm happy for you. Awesome. That's that's great. But there are seasons in business where things aren't great.

You know? We We want the graph to go from left to right, up, up, up. Everything is green arrows up. That's not the way small business always goes. Yeah. That's right. So, you know, one thing I will say though is what what it's done It's it's allowed us to focus on, you know, who we are

Mhmm.

What our culture is, what matters to us. And so, yeah, I am acting as the hygienist now. And honestly, that's fine because I'm getting to spend more time with My patients, I'm getting to talk with them more, interact with them more, communicate that we want that relationship present. So it it's been negative in a financial sense, but then there's been other things that you know, other maybe Non financial things that have been positive

Right.

And just just getting to, I guess, relate to our patients And, I think that's that's been that's been that's been good.

Mhmm. No. Absolutely. Absolutely. And you've spoken like a true a seasoned business owner that, you know, we can't just focus on the quantitative part. What makes a business last is the qualitative part. Right? Like, focusing on the relationship dentistry side of it and allowing our hygienist the time to do that by allowing this, you know, auxiliary dental assistant that can do more. So no.

I'm all for it. I mean, as you mentioned, I speak with many different clients from different parts of the country and, You know, the staffing issue, the employment landscape has been the big topic of conversation the entire year. And, People think that it's gotten better since, you know, 2020. And in a way, I Yes. Maybe in some areas, but there's still, as you mentioned, issues. And it's just I feel like whatever you read online, Those are the remarks of the people that say, we're fine because the voice is louder.

Right. Yeah.

But, of course, there are other businesses that are suffering.

What do you think happened? And honestly Mhmm. I would love to know, but I've been paddling so hard keeping my own business afloat that I I don't really have time to dig in and research, which shame on me. But What do you think has happened to small business workforce or or actually in particular, dental workforce In the last couple years, like

It has well, from what I've heard and seen, starting off with the hygienist, it was mostly the great resignation. Right? Yeah. When COVID kicked in and people were forced to stay within closed doors, for some people, it was a nightmare. For others that were like, oh my goodness. I never realized how fulfilled I feel feel when I'm with my family. Right? I haven't haven't spent this much time with my kids and whatnot. I feel like my work is taking out so much of my precious time that, I should be able to, you know, cut my hours so I can do that. And what they they've done is a lot of them, they actually decided to downsize.

They said, you know what? I don't feel like We need 2 incomes for this family. Maybe just 1 person can work and the other person can just stay home, spend more time with the kids, have a more fulfilling life. We'll moved to a smaller house. So a lot of that has happened where they just completely left the workforce. And then for others, what I've seen is, the rise of DSOs really. You know, they've been there for a while, but I feel like they've really taken advantage, the past 2 years of buying out a lot of practices. And what they typically do is they have, like, this, benefit plan, payment, the wage paying system that's pretty much the same all across the board. Again, different DSOs have different business models, but I'm talking about the ones I spoke to.

And oftentimes, what we see is that that package, the compensation along with the benefits, Sometimes will outweigh what, let's say, a single practice owning independent owner is able to provide. And those little, changes, and the way it's marketed to them also seems like, wow. What have I been doing? You know? Let me move somewhere else because I feel like I deserve better. I should be getting paid more. I should be getting all these benefits, and I hear my friends getting all of these things. So I'm not I don't want to feel left behind. So then they move. Yeah.

Now the other factor, and this will depend on the demographic. Right? We sometimes do surveys with even the people we hire. Here that they would look for in employment would be compensation. These days, however, it has shifted to culture.

Yep. You're right.

So, you know, the company culture is also another thing. Now I know your office has a great culture, but unfortunately, I don't think I can say the same for all the people I work with. So even in though they're giving out good money, you know, market rate or maybe even a little bit higher, proper benefits. They're just not liking the culture. Maybe there's drama on the front desk area or with some other people, and they just feel like, oh, nobody's addressing the toxicity or this. I'll just move somewhere else, you know, or they just want a clean slate. I feel like a lot of realizations happened with, the workforce in the past 5 years. And they may have had these before, but they decided to take a stand for it because I think COVID was so real that you may just not be there sometimes.

I think you you made Yeah. You know? I think that was so real that people decided, okay. You know what? I need to do something about this. Time is so little. I don't know what can change. I need to do whatever I've always wanted to do right now right now.

Right. Yeah. I think You're I think you're right on. I think you're absolutely right on. Yeah. And it it affected I think we're Seeing the effects of that carry on, you know, here we are. We're at the end of 2023. Yeah.

But the effects from that time frame is still kind of carrying on, at least in the small business

Mhmm.

Realm. And you're right, you know, that a small practice like us, You know, we have advantages. We can be more relatable. We can be more personable. We can provide, a different feel Then the big practices. But, yeah, the the big practices, the big certainly the big corporate, the big DSO, yeah, they have an unmistakable advantage over that. I feel like I feel like what I'm doing is kind of going away. I feel like I'm kinda watching, like, you know, the the single sole proprietor

Mhmm.

Practice kind of going away and everything kinda shifting into into that world. And and maybe it was hastened by COVID. Maybe you're right. Or maybe Maybe it's just kind of a kind of a parallel track that was happening, and we're just kind of bumping that together. But, yeah, it's, Yeah. It's the landscape is is definitely different, but We're gonna continue to do our best. Yeah. Let's start with

it. Yeah. Yeah. Absolutely. Absolutely.

We can do. Right?

Yeah. And you're doing it. I mean, honestly, you're like a symbol of Hope right now. I remember when I first heard that, I'm like, oh my goodness. I love this idea. And he's actually doing something right. He's just not talking about it. He's doing something about it.

Well, Thank you. Yeah. I mean, we were kinda down now, you know, kind of having a pity party, but then, yeah, we said, okay. Well, Mhmm. What can we do? You know, what what can we do? This is the reality, so gather yourself. Let's, you know, let's get over the let's get over being pouty. Let's think about what are we gonna do. And there's some basic there's things that you can do.

There's things that you can do. So we're we're trying to do what we can, and, you know, we're trying to bring new services available. One thing that we it's been my dream to be able to provide, sedation for the practice. And fortunately, I did take that training in 2022.

Mhmm. And

now that's paying off so that we can do the IV sedation to provide those types of services and that leads to, you know, hopefully some, some revenue for the practice. That's made that available. So looking at different services, looking at a different mix, and, you know, just getting back good old customer service. I I tell my staff,

you know Mhmm.

This world doesn't do customer service anymore. You know that. Now you Yes. You are you are a wonderful example of customer service. I've been so so impressed with how you conduct your business and Edwards, conducts themselves. But, generally, this world doesn't do customer service anymore. So that's my message to our to our office is that we're gonna do that. We're gonna do that.

We're gonna make people feel like they've been taken care of. And we're gonna do that one day at a time, and hopefully, that will, you know, Make a difference, and cause people to see a difference. So

Right.

Yeah. That's that's one strategy.

Yeah. And I applaud you for that, sir. Absolutely. I wish you all the best, really, from the bottom of my heart. And, we're towards at the end of our episode. So, if there are any some I mean, any final notes that you would want for our listeners to, you know, pay extra attention to or maybe, you know, recruit some people to your cause. This would be a good time for your plug?

Yeah. So, I mean, I think I think making use of the people that we have in dentistry Currently

Mhmm.

In the you know, without trying to attract people from wide range or wide geographic area.

Mhmm.

If we can make use of the people that we have currently and expand their abilities, Do that in a safe way, a reasonable way, and and let them help do what they can to help the practice. I think it's good. I think it's great. I would love to see that go on more. We'll see if South Dakota can do that. I hope So, but my message to people who are struggling is, hang in there, take a real, Real close look at your culture, provide really good customer service, take care of your people, take care of your employees, take your patience and hang in there and keep going and look at what you can do, because there's almost always an or or there's almost always a, a way that you can work, a strategy that you can implement, or something new you can Try and and, yeah. That's that's what we've tried to do.

Oh, yeah. Great tips. No. Absolutely. I agree. Well, thank you, doctor Hall, for being on our episode. Really, really appreciate that you were able to take out some of your precious time to be here on air with us.

Ash, it's my pleasure. Thank you so much for asking me. It's been a great, great experience. I've enjoyed talking with you.

Absolutely. Same here. I look forward to doing another episode with you.

Yeah. Who knows? It could happen. Maybe I'll have, some exciting news, a little bit down the road we talk about.

Oh, absolutely. I can't wait. Thank you.

Thank you.