From the Front Desk to Leadership in Record Time

Andrea Watkins (00:04):
Well, hi there. I am Andrea Watkins, and if you're listening to this while juggling three patient calls, checking in a couple patients, taking a payment, selling skincare, and trying to catch your doctor in between procedures, you might be working in an aesthetic practice.

Blake Lucas (00:18):
And I'm Blake Lucas and this is Practiceland. This is not your doctor's podcast.

Andrea Watkins (00:24):
Today we have some very special ladies With us, we have Heather and Jenna from Dr. Franco's office in Austin, Texas. Heather, why don't you tell me a little bit about who you are and what you do in Dr. Franco's practice?

Heather (00:36):
So my name is Heather. I'm the COO at Austin Plastic Surgeon. I am very fortunate to have been able to kind of go up through the ranks. I was actually hired on as a favor to my sister and she'll go into that a little bit, but started at the front desk and then actually worked my way up through a patient care coordinator role. I was a nurse on the floor, really got a feel for all the different areas of the practice and now I get to really focus on operations, streamlining processes, lots of staff integration and things like that.

Andrea Watkins (01:02):
And Jenna, what is your role with Dr. Franco?

Jenna (01:04):
Yeah, so I am an aesthetic nurse injector at Dr. Franco's office. It's funny, we have very similar origin stories. We both started in L and D. Like Heather said, we're sisters actually. I remember I interviewed Dr. Franco after a night shift and I had gotten no sleep and same thing with Heather. We were like, we'll clean your toilets, we'll do whatever we need to do, just please save us from the hospital. Started in reception and then doing marketing and then some admin stuff and now starting to do some provider, have been doing some provider things. So a lot of really fun stuff.

Andrea Watkins (01:31):
How long have you all been with Dr. Franco?

Heather (01:34):
Yeah, so I'm coming up on my three-year anniversary there, I believe in March and Jenna's been here a little bit longer.

Jenna (01:39):
Started in May of 2021. It's funny, we've grown so much. It feels like we've been here for 10 years, but it's really only been like almost what, four.

Andrea Watkins (01:47):
Have you guys seen any difference between when you first started in aesthetics with Dr. Franco to just even the last six to 10, 12 months?

Jenna (01:57):
It's funny because when I first started I was doing the front desk sales side of things, and so I was doing a lot of the scheduling and that was before the whole weight loss revolution hit. And so the med spa was definitely a lot slower when I had first started and then when we onboarded the wellness medications, there was just this huge skyrocket into the wellness and the med spa and everything grew so exponentially. There's been some things happening with the GLPs and that's why we're really trying to focus on really building up our entire wellness repertoire to really support the med spa and wellness since some of the medications are a little bit iffy moving forward. But definitely seeing a bit more of a level out from that really rapid growth that we saw most recently.

Andrea Watkins (02:34):
The folks that we're talking to through this podcast are really the roles that we've all done in a practice, which is everything from sitting at the front desk to being a patient care coordinator as you guys have gone each notch up on the ranks of the administrative and sales roles, I'd love to learn a little bit about what you look for when you're hiring to replace yourself. What are you looking for, especially those soft skills in the folks that you're recruiting for your practice?

Heather (03:00):
The thing that I love most about our practice is that we really invest in our employees and so we promote within most typically. Now, there are occasions when we do hire out, especially as we're replacing people that are moving through different ranks, but what we look for really is people that care about people. This is aesthetics and it's fun and exciting, but really when you get into the practice, it's a medical practice and there are people coming in with major concerns that they wouldn't normally talk about with strangers. Of course they talk about it in their inner circle, so people that can really tap in and make a connection with people quickly and show that they care, that's really the biggest thing. You can train so many other things, but to have somebody that really cares about the people you're bringing into your practice from the front desk all the way up to your providers, to your sales team, to your MAs, that is the key component and I think that's something that we have really stayed true to and why we have honestly such a great team.

Jenna (03:52):
I completely agree with that. The part where there's a lot of things you can teach, you really can't teach that level of care if somebody doesn't have that as part of their really innate sense of self, and that is what really cultivates the morale. That's what helps them see the overall view of the practice. But I think when it comes to hiring, the biggest thing that I've learned is knowing, making that decision in the first 90 days of, okay, was this a good hire or was it not? Because that's the hardest thing with hiring from the outside is so hard to tell from the interview. It could be great and it could be not the best employee or vice versa, but making that decision in the first 90 days is the best thing for you and that employee because then you can both move on towards a better endeavor.

Andrea Watkins (04:28):
So in that first 90 days, what would be a couple of red flags that we're going to throw in the air that would make us maybe reconsider the decision that was made?

Heather (04:37):
The very first thing that comes to my mind, and I think it's different practice to practice, of course, the culture that you have here, but what we really need in our employees on top of caring about patients is flexibility. The ability to pivot, to take on a project, see when it's not working out correctly, collaborate, bring team members in, and making sure that we're all getting towards that end goal. There's so many different ways to reach your goals, but if you have someone that is so just

Andrea Watkins (05:02):
Inflexible?

Heather (05:03):
Exactly, exactly. It can really throw a wrench in things. So that, and then also just making sure that people are showing up to work positively. A good attitude is one of the biggest things for us. Again, we said there's so many things that are teachable and trainable and coachable, but when someone gives a great interview and they put on their best face and they're so positive and they're so happy and they're just really want this position, but then they get to the job and maybe it's not the best fit showing up and just really struggling through it. So it's really just connecting with your employees, in my opinion, that really makes that first 90 days so valuable. Making sure that you're checking in routinely that it's a good fit for both of you because it is okay if the employee comes in and they're like, whoa, this just isn't it.

Jenna (05:45):
I think that's why it's so important to really have that 90 day evaluation. You can actually look at and see, have there been any problems? There may not be any problems with that employee. It could be like, Hey, they're doing fine, but are they meeting expectations even? Are they slightly below it? And then if you are having problems, I think the biggest thing, and this is where I learned from my little pain point story, I tried everything over and over. I wanted to prove that this was a good hire. I thought so hard that it was, and so I really went above and beyond to try to solve all these things that were popping up of her, just not catching on as quickly. And she was a great person, but it just wasn't the best fit and I was trying to do everything I could and then just really evaluating, okay, is this an issue of the person just truly not being the right fit for the company? Is it something you can fix or something that you can't? And if they could be the best person in the world, then sometimes they're just not the right fit for that role or the company in and of itself.

Andrea Watkins (06:35):
And you guys have a huge team from what I've heard. How many folks are on your team again?

Heather (06:40):
At this point, I think we're pushing close to a hundred. We've hired on 60 within a year, so very rapid hiring.

Andrea Watkins (06:46):
Wow.

Heather (06:46):
But yeah, yeah, very, very big.

Jenna (06:48):
And that's why we really had to focus on, gosh, that 90 day for a while we were just warm bodies, warm bodies, warm bodies. We got to get people just for this immense growth. And then now that we got that structure in place, it's like, okay, now we don't need just warm bodies. Now we really get to redefine and kind of filter out exactly the perfect right employee. And I think that's part of it too, defining what is your, Heather calls them avatars, what is your ideal avatar going to be for this role? And then I think that helps so much when she's doing the hiring. Something else that I love that she does, just like a little hiring note is we were talking one day about how many interviews you've gone through. When I was in nursing school, I would go through all these interviews and they would just kept telling me, no, no, no, no, no.

(07:27):
And so I was like, I really wish somebody would give me feedback. What can I do better so I can get this next interview so I can be able to improve? And so I was listening to her do an interview the other day and similar to how Dr. Franco was doing at this conference, you're listening and asking these individuals questions and you give them feedback. Nobody will do that and an interview, nobody will give you feedback of like, I heard what you said. I don't think you're the best fit for this company, but moving forward, this is the feedback I have for you in your next interview. This is what I refined and that is so invaluable to that person, that extra step to take to be able to, even though they're not going to work with you, they still leave with that positive impression of you cared enough to give me feedback, so that way this next job I can do better and maybe I'll land that one or maybe in the future I'll take what you said and maybe I can come back to you then.

Heather (08:12):
One of the things that we didn't originally do is working interviews. We would do a Zoom interview, they would come in, kind of meet in person and then we would hire them on. We didn't have as much success as we wanted to long-term. There was a higher rate of turnover when we did that, moving into doing some working interviews, having people coming in and shadowing and clearing out their day, showing that they really cared and that they really wanted to come in and experience with it, I think has been such a game changer in hiring. It really weeds in the people that you want and weeds out those that maybe aren't the best fit. The other huge pearl that we've kind of, I think probably most people know it, but employee referrals. If you have a great employee and they want to refer someone, that should be top of your list, don't back burner them. Maybe they don't have the best resume and you wouldn't normally pull them in, but if their friend is willing to vouch for them and say, Hey, bring them into this company. Those have been some of our best hires.

Andrea Watkins (09:05):
Warm network definitely. Have you had to let anybody go of those hires? And what were the indicators in maybe the first 90 days or even if it was beyond that that was just these are non-starters? Does it all go back to their work ethic and how they're showing up or were there specific things and how did you handle that?

Heather (09:25):
We have had some people that we had to let go. I think we're lucky and the fact that at this point we've really trained our culture so much that people that don't really fit tend to let themselves go. They come and let us know and we're totally cool with that. We're happy to give them a recommendation moving forward, keeping that door open, but confrontation sucks. It was one of the biggest things that I struggled with moving into a leadership role is having to have those tough conversations, but changing your mind frame from confrontational to clear is kind. Talking with someone, giving them that opportunity I think is so important. If there's a mistake made, letting somebody know directly and then if you continue to have issues, that's when you need to do performance improvement plan or if it's something bigger, just let them go. Don't hang on to someone over and over and over, mistake after mistake just because, I mean Dr. Franco has such a big heart and has a very hard time letting people go, and so he's let us kind of step more into that and just being very clear about expectations, giving someone the tools that they need to meet them and if they just can't, being very clear that it's time to separate and part ways.

Andrea Watkins (10:26):
So when we actually have someone that's on our team, we pretty much love them most days, they're doing a great job. We're glad that they're there. What is your guys' performance evaluation process like?

Heather (10:40):
We have a wonderful clinical educator that has promoted up through our team. She started as an MA with us, and she is so process oriented and implementation, she's just phenomenal. But she has created an entire timeline of tracking so that people know when they're going to be evaluated, when they're going to have checkoffs, when that time is to have those discussions so that you don't have people constantly knocking on your door saying, Hey, it's time for my evaluation. Hey, I want to talk about a raise. Hey, I want to do x, y, z. We have a clear system that people know is coming and what their timeline is, and so it's self-evaluation that people do first and kind of tell you how they're feeling about the practice, how they're feeling about their place in the practice, where they see themselves going, where they see themselves fitting, and then they sit down with their direct lead and our HR person to kind of go over how the leadership team has scored them and how that may match or differ from their own. They talk about that together and then we go into career pathing, which is my very favorite thing to do here, someone's goals and dreams and how they see themselves growing in a practice because if you can get buy-in from your team member and it matches the alignment of the practice, everybody flourishes. So really putting all those pieces together, giving everybody time, put in their own input and then making that path together, it's been wonderful.

Andrea Watkins (11:58):
What advice would you give someone that maybe doesn't have that structure in their practice, but they do have goals and aspirations and they show up every day with a great attitude and they think they're doing a great job, but maybe they just don't have that structure, because you guys didn't have it. You've implemented it recently. What advice would you give them as far as going to their direct lead or their direct report and getting that figured out?

Jenna (12:21):
This is something I feel very passionate about. Heather and I both have a very similar way that we went about this because like we said earlier, we both started at the front desk. Heather and I are very much so, you know what? I'm going to look at what's going on. I'm going to find a problem and I'm going to provide you a solution on my own time without you asking me and I'm going to present it to you to show you I care. I'm willing to put in the effort and this is what I can offer you. You didn't ask me to, but I want to go somewhere and I'm not going to go to you and be like, Hey,

Andrea Watkins (12:48):
What do you want me to do?

Jenna (12:48):
Yeah, what can I do to help you? Dr. Franco hates that. Oh my god, he hates so much. He's like, you're not helping me if I ask, like figure it out. Of course he would never say that, but it's not helpful to be like, Hey, what can I do for you? What can I do for you? And so when I was in the front desk, basically what I did is we had 12 employees at the time. We were very small, there was no training protocol, there wasn't really anything, and so as I was figuring things out, I was documenting it. I was creating a resource binder doing all these things. And so one day I went to him, I was like, look, I made, isn't this cute? He was like, oh my gosh, I love that. And then from there I wasn't asking for anything. I was like, I saw this problem, I feel like this will be helpful. I'd be happy to implement it. I can continue doing it. He said, I love it. And then I got the opportunity to be able to be the front desk manager and to kind of help lead people in that way.

(13:30):
Same thing for Heather. She basically looked at the PCC structure and was like, Hey, this is a mess. Let's fix it. And it came up with this whole new really neat structure to be able to implement, and then she got the opportunity to be a PCC, then be the lead PCC, and then management and just really grew from there because each tier that she was at, she saw a problem, she created a solution, she implemented it, and then it was recognized and valued. I think that if you fight for yourself and you show the value that you have in that higher role, that is the key to really exceeding, but it's ask them what you can do for them, show them what you can do for them, do it. If it's really valuable to them, then they'll let you do what you're wanting to do.

Heather (14:04):
I would say the one caveat to that is you have to excel where you're at before you try to make leaps and bounds. We have so many people that are like, I want to do what you did. I want to do exactly that. How do I get here? They're not necessarily performing the best and they're not putting in the effort to figure out where they might be lacking and they just want to make that jump above it, and so it's really, like Jenna said, it comes down to a little bit of character. Are you willing to put in the work, maybe some on your own time to really develop and grow in what you're doing, exceed in what you're doing, find a solution that is not fully out of scope, fix it where you're at, implement it with your team and go from there. The hardest part is making sure that when you go about this, when you're wanting to grow, that you're making sure you are looping people in that you are within your scope and you're being careful with it. Especially in a medical field. There are so many times when you can have such great intentions, but just step a little bit out of your scope and then it becomes dangerous.

Andrea Watkins (15:00):
What else do you look for within your team and their behavior that's going to make you pinpoint, you're like, wow, this person really cares. We really need to keep an eye on them.

Heather (15:10):
Truthfully, we have so many wonderful employees, but if everybody was going to be the lead of an area, we would have nobody doing the day-to-day need, the stuff that needs to get done, and so working on your team to be an example, showing other people, how can I help you? How can I coach you? Do you need help figuring out how to reconstitute this? They're that person helping everybody else on the team really showing and guiding, and then they're also taking on the extra scope.

Jenna (15:36):
I think the biggest thing from my perspective is their coachability, I guess is a good way to put it. You can have someone who has the best intentions and you really think is going to be a perfect fit to grow in the company, but if they're not going to be moldable and they're not going to be open to constructive criticism, then that is going to be your biggest stop point for them to be able to grow in the company and be a leader.

Heather (15:58):
I would say I like to give everybody one opportunity to not receive feedback well, to let them know, Hey, I'm giving you some feedback right now. It's very clear that obviously it's a little bit frustrating or this makes you a little bit upset. This is how I need you to receive feedback moving forward and give them that opportunity. It sounds a little bit micromanage, but that's what I think is kind and clear. Again like what we were talking about earlier, that it's okay to not have it that first time, especially when you're coaching and promoting within. People do need to be developed. They need to feel safe, and so giving them that opportunity to have that one time of like, Hey, I didn't really love how you responded to this. This is what I expect moving forward, and if they can meet that, that's the one piece that I would say that's totally okay.

Andrea Watkins (16:37):
That's a surefire sign of professional maturity that I think sometimes is hard for some of us to swallow our pride and to say this is not just for the practice or because someone's being mean, but it's really to help elevate and they're trying to help me be empowered instead of just focusing on throwing up the defenses and being in a leadership role.

Heather (17:03):
I've taken that really as a core value for my personal self of getting feedback when I have these conversations with people, not necessarily when I'm giving tough feedback, but when I'm having meetings, I always like to end it with asking, how do you think this went? How do you feel our conversation went? And if you need some time to think about it and come back to me later, that's totally cool too, but giving somebody the opportunity to then turn around and verbalize, okay, I hear you. This was a little bit of a tough conversation, but I get it. I can't do X, Y, Z. I need to be showing up on time. I am telling you that I have life issues and it's hard to get my daughter to daycare, but I should have come in and talked to you about it and not just started not showing up at time.

Andrea Watkins (17:43):
Oh, weird. That's crazy.

Heather (17:45):
Exactly. Giving them that opportunity though to then verbalize it back to you, they then get that buy into. It's not that you just sat there and told them all those things and then they're angry that has decreased

Andrea Watkins (17:56):
And then you're like deuces.

Heather (17:57):
Right. Exactly.But that has decreased, when people go out and are upset about the conversations afterwards, that has happened so much less since implementing that. And so I love feedback from all areas even after the tough conversations, then getting it back from them. I think it's so important.

Andrea Watkins (18:14):
Last thing that I want to ask is obviously you're working with lots of people now, you're promoting from within doing a lot of different things. Can you give me one example, and I just like these to be tidbits for our listeners to be able to think, how could I maybe do this in my practice? But what's one time when somebody just wowed you and you were like, hot, damn, this is incredible. Tell me about that.

Heather (18:39):
We have so many, honestly, so many employees that absolutely do that. The one that comes to my mind is really not that big of a thing, but I was sitting in our nurses station area, which is also kind of a call center. It's just a little private area that has computers and phones and things like that, and I was sitting working on something and I heard one of our phone operators really credentialing our practice going above and beyond that I ever thought that they would be having this conversation, really caring about them and getting into their life. Now, obviously when we're on the phone, we're wanting to get them connected to where they wanted to go, but this was an upset patient and she just took the time to hear her out and be like, I get that. I understand why X, Y, Z would be frustrating.

(19:16):
You missed your appointment and there's this no-show fee. And she went above and beyond to hear the patient out, have that full conversation, and then she went to the patient care coordinator to be like, how can we care best for this patient? I understand we have a no-show policy. I understand X, Y, Z, but this is her first time ever coming to our practice and this is what happened. How can we best take care of her? And then the patient has been coming back consistently, never misses her appointments anymore, but that care that was there from someone that's just sitting on the phone trying to connect people to the right location, she just took the time to care for somebody. And that's really getting back to the core values, people that care about people. I love seeing it in action and I like to call it out when I see it. And so we do shout outs in huddle, and so we brought attention to it and she's a little bit shy. So it's tough to have everybody smile and clap at you, but those moments are so important and so pivotal because it always highlight when your team is just like that's meeting expectations, but it's a modeling moment.

Andrea Watkins (20:15):
Absolutely. What about for you?

Jenna (20:17):
Heather always says that you have to protect your peace, and that's what this really reminds me of because I think in the clinical side, things can get very, very stressful. And so we had a day where we had a very full clinical load. Patients were waiting for a while. Dr. Franco is in the office, so his schedule's always, oh my God, he would be, it's crazy looking at his schedule when he's in the office.

(20:36):
And so the MAs were running around a little bit crazy, and so there was this one MA who just was very calm. People were asking her, Hey, can you flip this room for me? Can you start this patient? And every single time someone asked her, I was even frustrated. I was like, Hey, I really need some help. Can you please do this? Yes, absolutely. I'll get right on it. And just the way that she was so calm and so receptive and such a team player in an environment of high stress, and usually in those environments, people aren't asking very nicely. They have a little bit of angst in their voice when they're saying things. But the way that she handled it and the way that she was able to compose herself, it immediately diffused the frustration from the person that was asking her. They weren't frustrated at her, but the fact that someone was so ready to help, like, yes, I just got to finish this note real quick and I'll be right in there. And it's just that immediate offer of support. It's such a hard thing to do and such an invaluable skill to be able to just really support your team. But that was the moment I was like, wow, how do I do that? Because how do you have that self-control to be able to just relax and protect your peace and not let these outside environmental things of control you with stress? How do you get to that point?

Andrea Watkins (21:36):
She wasn't just protecting her peace, she was projecting peace.

Jenna (21:40):
Exactly.

Andrea Watkins (21:40):
Onto the rest of everyone just based on her energy. You guys are just lovely, and I think that everybody on your team should just be really, really thankful to work with such, you guys have been there, and that makes such a difference in the way that you show up as leaders and show up for your patients. So I really appreciate it.

(21:58):
We like to end off our interviews with a little segment we like to do. It's called "She Did what?" So it could be good, bad, or indifferent, but something that maybe a patient did or a team member did. You were just kind of like, huh? What?

Jenna (22:15):
Oh, I have one. I have one. Okay. So when we had the medications, the GLPs that we had onboarded for the beginning phase, I remember we got a call from a patient one time and they were like, Hey, my medication, something's wrong with it. And we're like, okay, well walk us through what happened. Yeah, took it out of the fridge. It's been there for a couple of weeks, and all of a sudden it turned blue. And we're like, it turned blue? I'm like, yeah, I don't know what happened, but it's blue now. So I just thought maybe I can come in and get a replacement. Obviously something's wrong. We're like, okay, yeah, bring him in and we'll see what's going on. And so of course we replaced her medication. We want to make sure she has the best experience possible. We're looking at the syringes and we're like, what the heck is going on? We squirt it into a little container. It was Fabuloso. They took their medication and pulled up Fabuloso and brought it back in to be like, it turned blue. I don't know, to get some free meds. And I was like, you did not.

Andrea Watkins (23:10):
She did what?

Jenna (23:11):
Exactly.

Andrea Watkins (23:13):
Oh my gosh. That is incredible.

Jenna (23:16):
And ballsy, very ballsy. I was like, well, I mean, there you go.

Andrea Watkins (23:19):
How did you test it to know it was Fabuloso just from the smell? Somebody knew or?

Jenna (23:23):
The smell, and it was very bubbly.

Andrea Watkins (23:24):
Okay, you added water and then threw your towels in there and you were like done. Oh my gosh, that's incredible.

Blake Lucas (23:34):
Got a wild customer service story or a sticky patient situation? Send us a message or voicemail if your tail makes it into our "She did what?" segment, we'll send a thank you gift you'll actually love. Promise no cheap swag here.

Andrea Watkins (23:46):
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