00:00:04:13 – 00:00:40:03
Jay Shorr
Welcome to Shorr Solutions, the podcast, and I’m your host. Jay Shorr. CEO and founder of Shorr Solutions. We are a team of national and award winning practice management consultant with experience running a multimillion dollar cosmetic, dermatology and plastic surgery practice. We’re here to share strategies and insights that will help you grow your practice efficiently and profitably. In each episode, we’ll explore the steps and actionable insights to guide you through your journey to increase efficiency, boost revenue, and decrease costs.

00:00:40:06 – 00:01:21:23
Jay Shorr
Tune in and discover how to improve your patient experience and take your esthetic practice to the next level. Well, hello again and welcome to another episode of Shorr Solutions, the podcast. And I’m your host, Jay Shorr. Today we’re going to be episode number 129 The Power of People and what practice managers wish you knew. And I have a special guest on today, Erica Vega, who is the practice manager of running Facial Plastic Surgery, a very, very well known client of ours in Frisco, Texas, which is in North Dallas, Texas.

00:01:21:26 – 00:01:28:09
Jay Shorr
So let’s get started. Welcome, Erica, and thank you for being a guest today on our program.

00:01:28:12 – 00:01:32:26
Erica Vega
Thank you so much for having me. I’m super honored to be here. I really appreciate it.

00:01:33:03 – 00:01:53:06
Jay Shorr
Well, great. Erica, you and I have known each other for quite a long time. Yet just a little bit after Doctor Rana opened up his practice. And now it’s been a couple of years. Let me ask you a question. I know your history. I know your background. But why don’t you tell the audience what led you to become a practice manager in plastic surgery?

00:01:53:07 – 00:02:20:05
Erica Vega
Sure. So I was working in a completely different industry. Kind of different, but similar in some ways. And it was also an esthetic industry. So I was working for a cosmetic company on the sales and education side, and I always had an interest just in beauty in general, whether it be through makeup. I thought plastic surgery was, you know, very interesting and appealing.

00:02:20:05 – 00:02:49:06
Erica Vega
And so I was working for a company that dissolved. Basically, it was going online only. And so I was that kind of a transitional period. And so I just kind of took a gamble, and I knew of a plastic surgeon who was looking for someone. And I reached out and I knew, you know, I had no experience in that world at that time, but took a gamble, and I absolutely loved it from day one.

00:02:49:07 – 00:03:00:11
Erica Vega
So it just it kind of spun off from there. And I’m 17 years in now with plastic surgery and it’s all I know and I wouldn’t, wouldn’t do anything else.

00:03:00:13 – 00:03:17:08
Jay Shorr
So tell me we’ll get into a little bit more of this guys, but in like 1 or 2 sentences, what do you think has changed over the years, 17 years in this business? What do you think has changed from the time that you started until now? Because you’re in facial plastics, facial plastics, plastic surgery to me it’s all the same.

00:03:17:11 – 00:03:18:15
Jay Shorr
It’s surgery.

00:03:18:18 – 00:03:40:27
Erica Vega
Right? I think the biggest thing is social media. Social media has made such a huge, huge impact on the plastic surgery world. It’s, you know, brought the attention to so many people that otherwise wouldn’t know about these procedures. And it really has just boomed ever since, you know, social media became a thing and it just continues to keep growing.

00:03:41:00 – 00:04:03:02
Jay Shorr
Yeah. That’s wonderful. And, you know, I own a practice back. I hate to say this before the turn of the century, right unfolded, you know, in 2013, those listeners who know my story know the of the reasons. But I only do that now. And, you know, my social media was yellow pages, $12,000 a month in yellow pages.

00:04:03:02 – 00:04:37:13
Jay Shorr
And I think about this now and I cringe. I’m gone, like, oh my goodness, you know what? $12,000 is organic and SEO with you today. But it worked. All right. So one of the things that to me has doesn’t really change in any business is a human resource. We can talk about social media all day long. So let’s talk about how you lead a strong team, building a team that works well together and how you keep them motivated during these busy and stressful times, because these are some stressful times that we deal in.

00:04:37:15 – 00:05:01:18
Erica Vega
Absolutely. I think one of the biggest or most important things you have to find personalities that are going to mesh well and that are going to work well together. So when I’m interviewing people, I always, always try to get a good read on personality. Just to find out if they’re someone, you know, if they’re allowed personality, if they’re kind of quiet and shy.

00:05:01:21 – 00:05:29:18
Erica Vega
And I know, you know, you can’t get ten loud people together. You have to have a balance. And so I think, you know, work experience and all of that plays a factor as well, course. But you have to find people that work well together. And I feel like that is a game changer. And so I’ve worked at practices that have 25 people I’ve worked with, some that have three, and getting a group of women together tend to be primarily women.

00:05:29:18 – 00:05:51:22
Erica Vega
And it’s it’s not easy to get women who all will get along well all the time. No catfights and things like that talking about each other. And I’ve managed to do it for quite some time where I’ve, I’ve been able to kind of cultivate people that I know will mesh well together. And it really makes a huge, huge difference.

00:05:51:22 – 00:05:55:08
Erica Vega
If you’ve got a team behind you that that works well together.

00:05:55:10 – 00:06:18:13
Jay Shorr
Interesting that you say that because I wouldn’t, you know, it wouldn’t be socially acceptable for me to say that. But you as a woman can say that. And I know because I had 29 females in my former practice, and I totally understand it. All right. So what do you think is more important when you’re hiring, getting along with you, or getting along with the doctor?

00:06:18:16 – 00:06:31:12
Erica Vega
I think getting along with the doctor for sure. I mean, they absolutely have to connect with him, get along with him. It’s all about, you know, keeping the doctor happy. So definitely that that would be first and foremost.

00:06:31:12 – 00:06:51:05
Jay Shorr
So Erica, let’s talk about keeping your staff motivated. And then more importantly, how do you deal with the conflict of a fractured team? I know your team pretty well right now, and there isn’t a whole lot of fracture in it, but there’s always some kind of conflict. So let’s talk about how do you keep a motivated and then how you deal with conflict.

00:06:51:07 – 00:07:14:21
Erica Vega
Well, as far as keeping people motivated, donuts always help. But basically I just really try to give some positive feedback when I see that people are doing a good job. I do like to point it out. I think oftentimes, you know, in the workplace, it’s forgotten about to tell people you appreciate them or good job or you killed it today or whatever the case may be.

00:07:14:21 – 00:07:25:08
Erica Vega
And that appreciation, a little goes a long way, and it really does keep staff motivated and excited to be there. So I think that that definitely helps.

00:07:25:10 – 00:07:30:14
Jay Shorr
When you were referring to you, you killed it. You’re speaking to the team, not to the doctor, correct?

00:07:30:14 – 00:07:32:12
Erica Vega
Yes, yes, definitely. Yeah.

00:07:32:17 – 00:07:35:21
Jay Shorr
Earlier listening, that was a joke. Even if you didn’t think it was funny.

00:07:35:29 – 00:07:37:10
Erica Vega
Yeah, yeah.

00:07:37:13 – 00:07:49:29
Jay Shorr
So the when we’re talking about hiring and and retaining great people, you know, you spoke about the mash and the qualities that you go for. What are the common hiring mistakes that you and I have all made.

00:07:50:02 – 00:08:17:21
Erica Vega
And the there’s there’s many of them I know we had hired people not here, but other places. I’ve been hire people who are inexperienced to get them in at a lower, you know, lower cost. And that sometimes doesn’t always pan out. And especially if you’re at a fast pace or busy or practice, you don’t have the time or manpower to be able to dedicate to, you know, really train from the ground up.

00:08:17:21 – 00:08:41:08
Erica Vega
So that I think is definitely a big one. And there’s people, you know, I spoke about people not people personalities that don’t mesh, but just people who have very, very strong personalities and general I’ve kind of tried to shy away from you don’t want somebody who’s going to come in and try to change everything, call all the shots, upset the doctor, upset the flow.

00:08:41:11 – 00:09:07:23
Erica Vega
So and that’s another important one. I just think you need to be very, very careful when hiring and very strategic about it with experience, personality, connecting with the doctor, connecting with the manager. Introduce them to the rest of the staff as well. And I am a fan of doing working interviews. I think that’s always helpful. Just so you know, people can say whatever they want in the interview.

00:09:07:23 – 00:09:22:05
Erica Vega
Let’s face it, a lot of people sell themselves well, but then once they’re actually on the job, it’s a whole different story. So we we’ve been implementing that. And I definitely think that has helped things tremendously as well. So you can see.

00:09:22:07 – 00:09:27:08
Jay Shorr
See outside of donuts, how do you how do you retain top employee’s.

00:09:27:10 – 00:09:47:04
Erica Vega
So as far as retaining employees I just think that, you know, appreciation of course goes a long way. I do think, doing things such as team outings, making it fun, it’s it needs to be business at the end of the day, but you have to have fun while you’re doing it. And that that makes people want to continue coming and work and stay there.

00:09:47:08 – 00:10:11:13
Jay Shorr
Yeah, I can share that. You know, I know I’ve known Doctor Ron, since fellowship and this is several years out is and who opens up a business during Covid all right. Other than Doctor Rana. And it’s amazing because, you know, even though we’ve had challenges, you know, I’m proud to say that I never expected that he would get to where he is in such a short period of time.

00:10:11:14 – 00:10:22:14
Jay Shorr
It’s always a running joke. All right. The type of employees, the type of management. And, you know, he is one of the more generous physicians that I know.

00:10:22:14 – 00:10:23:06
Erica Vega
Absolutely.

00:10:23:08 – 00:10:48:00
Jay Shorr
And most people like to keep an eye on their staff. And, look, you want to retain good staff. Money is an incentive. That’s great. All right. When it’s for the pay. But when it comes to commissions, when it comes to bonuses, I have to tell you that Doctor Rana, he just doesn’t worry about it, you know? And he’s willing to pay for a good performance and good talent.

00:10:48:02 – 00:10:59:15
Jay Shorr
And he’s not when he’s not. All right. Because I believe don’t try to buy your employees and your staff who aren’t worth it never fares. Well.

00:10:59:17 – 00:11:48:03
Intermission
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00:11:48:05 – 00:12:02:05
Jay Shorr
So what do you do when a new hire isn’t a good fit? Because you just mentioned that anybody can sell themselves during an interview. I’ve seen it a million times, but what happens when the rubber meets the road? What do you do.

00:12:02:07 – 00:12:55:22
Erica Vega
When it’s not a good fit? I really do believe you just have to cut your losses and just part ways. And there was a time when I had, front desk, you know, receptionist. And she just, I mean, was clearly not getting it. And I’ve never let someone go within a week, but I had no choice. It was so, so terrible. You know, she was hanging up on everybody, transferring people to the wrong place, not providing good customer service was borderline rude to people. And when that things like that occur, you just you got to cut your losses and just, you know, in the words of Doctor Rana pull the ripcord and just be, you know, be done. Of course, if somebody has some things you need to work on, you always want to give them a chance to work on things. But if it’s not a good fit from the start and you recognize that, I do think it’s best to just cut your losses and and part ways, I really do.

00:12:55:23 – 00:13:59:14
Jay Shorr
So as a manager, you know, I always say when you hire a warm body, you’re always going to be taking the heat because all too many times practice is hire somebody to fill a void, not to fill the future. And I always hired to fill the future, not to fill a void. So I’m not suggesting that everybody does this, but I always have intentionally overstaffed to leave room for growth. Do you ever think that maybe it’s just our fault that sometimes a new hire doesn’t work out? We didn’t set the expectation down from the very beginning. We throw them into a job with minimal training. I’m not saying that you do, but in the industry, in your professional management experience, different think that we’re the problem. And maybe, you know, you hire a new employee and you hear the same thing. Well, at my former place, we did it this way. Well, you’re not there anymore, okay.

00:13:59:16 – 00:14:20:29
Erica Vega
Absolutely. You know, 100%. I think that exactly what you said sometimes new hires aren’t given the proper training. And it could be that people are, you know, stretched too thin. It could be, you know, a number of different reasons, but the proper training is if they don’t get that, they’re not set up for success. And so it’s almost a guarantee they’re going to fail.

00:14:20:29 – 00:14:44:02
Erica Vega
And, and especially an experienced person coming from somewhere else who is, you know, used to doing something a certain way. And every practice it can be, you know, it can all be facial plastic surgeons. They can all be body plastic surgeons. Whatever the case may be, and do things entirely differently. So you have to learn, you know, each each practices way.

00:14:44:02 – 00:14:56:17
Erica Vega
And it’s up to the practice manager, the you know, OR director of the staff to get people trained. And if they’re not properly trained, it’s 100%. Yeah, it’d be my fault.

00:14:56:21 – 00:15:36:07
Jay Shorr
So, Erica, do you ever think that beyond the knowledge that we try to train an employee, do you ever think that maybe we just don’t give them the proper tools? Let me give you an example. We don’t have the proper social media set up already. If we’re hiring the marketing manager, we don’t have a great phone system. We don’t have a great EMR. We you know, I call it quote unquote, try to cheap it out. All right. And you go with low rent photography systems and you go with low rent EMR. And we’re setting them up for failure from the very beginning. They get their job. We don’t have a proper CRM system.

00:15:36:08 – 00:16:12:13
Erica Vega
Yeah, I definitely think you do have to set them up with all of the proper tools in regards to pretty much every aspect of the office, but it’s it’s a failure on the practice. If those things aren’t in place prior to hiring somebody, but it’s not fair to you. If we were to hire, you know, a social media marketing person and things are in disarray and we don’t give them a clear expectation of what, you know, what our plan is, what we’re wanting, and they’re not going to know what to do with anything. And so when they don’t meet our expectations, it’s our fault for not being clear with those expectations on the front end.

00:16:12:16 – 00:16:26:20
Jay Shorr
All right. Let’s talk about the patient experience and relationships. Because at the end of the day, it’s all about the patient. I always made a joke. If it wasn’t for the patients I’d get a lot of work done. Yeah.

00:16:26:22 – 00:16:28:02
Erica Vega
Right.

00:16:28:05 – 00:16:41:07
Jay Shorr
So how do people shape the patient experience? Because isn’t that like one of the most important things? The patient doesn’t have a good experience. Guess what? They’re not coming back.

00:16:41:14 – 00:17:37:05
Erica Vega
Right. Exactly. Yeah. No, that is extremely important. And I really, really appreciate that about Doctor Rana. He is very big on instilling the values to every team member that from the moment a patient walks in the door, they need to feel like family. So from the second they walk in the door, it’s would you like some coffee? Would you like some water? They’ll come in, we will, you know, talk to them more than just a patient. It’s not just handing them paperwork here. We’ll get you back, okay? Doctor Rana’s coming in the room. It’s never, ever like that. You want to be warm, friendly, have a smile on your face all the time. And they just want to feel welcome. And we really, really strive hard for that. And I think we do a pretty good job of that. And patients comment on it all the time. And I think they love, love, love that. And that can set you apart from other practices.

00:17:37:07 – 00:17:42:08
Jay Shorr
Great. So what good practices do better when it comes to patient relationships?

00:17:42:10 – 00:18:01:15
Erica Vega
I think sometimes just slowing down a little bit. I think, you know, everybody’s in a huge rush to get the patient rooms, then get the doctor and get them out, get the next patient back. And I think if they just slow down just a little bit and take the time to just have, you know, a small conversation with the patient, it makes all the difference in the world.

00:18:01:15 – 00:19:07:14
Jay Shorr
You know, I’ve always had a theory and I’m a patient at many practices. All right. Whether it’s my family practice or whether it’s my aesthetic/ cosmetic, you know, to get my neurotoxin. I’m still a patient. Right. You know, the hardest thing is nobody likes to wait. All right, so. And you don’t want to get somebody back in the room and then just come in and do the procedure and have a leave. You know, we want to engage that patient. We want them to feel like you said, family. That’s really important because we want them to keep coming back for more. You know, what role do you believe the actual facility plays? Because I was blown away when I came to visit your brand new office in December. It is absolutely beautiful now. True. It’s brand new. But I know the Rana family and ten years from now it’s still a brand new brand. Right. What do you, what role do you think the employees take in keeping that brand new facility for the patient engagement? I think that that has a lot to do with it.

00:19:07:15 – 00:20:04:12
Erica Vega
Definitely. I think, you know, everybody has to work hard at keeping things clean, tidy, looking, brand new. You want it warm, inviting and, you want things in their place. You don’t want a huge mess and you want things organized. And there’s nice little touches throughout that make it feel like family. Doctor Ronnie’s got some pictures of his new baby in the rooms. The exam rooms, patients love that. But yeah, the employees definitely play play a part in keeping things looking exactly as they should. And you don’t want boxes laying around. You don’t want trash. You know, mud streaked throughout the place, all sorts of things in it. It’s a constant battle, I will say, to keep things tidy, but I do think it definitely is important to make sure things look super presentable, that rooms are always stocked. Organize. You’re not fumbling for things. All of those things make a big, big difference.

00:20:04:15 – 00:20:29:21
Jay Shorr
I’ve always said that your office and your exam rooms at three and 4:00 should look like they do at eight and 9:00. Yes, there has to be body constantly going around and making sure you don’t have copy paper boxes. The delivery from the vendors that they came in and dropped all the medical supplies are just hanging out. It just it looks kind of unkempt.

00:20:29:22 – 00:20:41:18
Jay Shorr
All right. And then as we wrap things up, what doctors and owners should know if a provider is struggling with staff turnover or team morale, where should they start?

00:20:41:19 – 00:22:11:16
Erica Vega
I do think a lot of it starts with just speaking to the staff. You know, talking to them and finding out what seems to be going on. Just go directly to the source. And I like to talk to people two different ways. I talk to them separately. First and then kind of as a group later. But I do like to get everyone’s feedback just just to find out, you know, what’s going on. If team morale seems down, tell me, what is it, something with you in another employee member? Is it something with the schedule? You know, myself, the doctor. What could it possibly be? Getting to the root of the problem. And I just think that having clear communication really makes makes team members feel heard. They want to know that they are understood. You’re hearing what their concerns are. And so I think communication and listening is huge. And then coming up with a solution and a plan to rectify the problem and figure out what you can do to make things better, and then meeting with the entire team to make sure everybody’s on the same page. Because chances are, sometimes if it’s, you know, an issue with one person, it could be same issue with a lot of people there. So you want to make sure that, they know that it’s an open door policy. They can come to you with concerns. But if I if they don’t come to me, I will go to them because I want to nip it in the bud and figure out what we can do to resolve it, move on and move in a more positive direction.

00:22:11:19 – 00:22:27:28
Jay Shorr
All right. So since this is a practice manager podcast, I already know the answer to the question I’m going to ask. I already know. All right. How often you meet with the doctor. So how often should a practice manager meet with the doctor?

00:22:27:28 – 00:23:50:21
Erica Vega
I think if there if time allows for it every day at least once a day. Truly. So I know for myself it’s multiple times a day, every day. But I think at minimum at least once a day, I’m pretty much anywhere I’ve worked. It’s a minimum of once a day you’re meeting, meeting with the doctor. There’s always things to communicate and so you want to, especially if time is limited. You want to kind of have everything condensed, ready to go and just go through the bullet points of, you know, x, y, z. These are all the things we need to cross off the list and then start a new day, you know, fresh. The following day. But I, at the end of each day, send doctor on an email with basically all the all the happenings of the office throughout the day. And so he is in the loop. There may be, you know, something that I miss, as I’m telling him at the end of the day, or when we touch base at some point. And so as I go throughout my day, I just add to this list of everything that’s happened. That way. He knows everything that’s going on, and it’ll be a reminder for us to touch base, you know, the following day or whenever on on any issues. But communication is key because they’re going to be in surgery. They’re going to be seeing patients so they can be out of the loop. So it’s basically your job to make sure they’re in the loop and they know everything that’s going on.

00:23:50:23 – 00:24:09:28
Jay Shorr
We know that things don’t happen the way we want them to every day. And, you know, we try to report back to the doctor things that happen, whether they were beyond our control or not, beyond our control. What should we do when something happens, you know, to prevent it from happening again?

00:24:09:29 – 00:25:37:26
Erica Vega
You definitely want to address it immediately, first and foremost. And, whether you’re grabbing an employee or handling the situation yourself, you want to make sure it’s getting taken care of immediately. You also want to make sure that other team members are aware of what a mistake was, so they’re not going and making the same mistake. Also, we try to, when a mistake happens, create protocols. If they aren’t already in place, and create new protocols to basically prevent these same mistakes from happening. So we’re, you know, a growing practice and we’re hiring new people and, you know, changing procedures and things just how we do things, just as we’re adapting to scale, basically. And there’s always going to be changes. So we have to adapt accordingly. And there’s definitely plenty of mistakes that happen along the way. More than I’d like. But it it, you know, it can happen, but you definitely want to address it immediately. Create, policies or protocols that are need to be in place if they aren’t already. Make sure the entire team is aware so they’re not making the mistake. And if it’s something that’s more serious, you may need to follow up with that team member and have a set plan. We’re going to speak on this again in two weeks to see if something has improved. And and and just always have, you know, a next step planned.

00:25:37:28 – 00:25:41:25
Jay Shorr
To communicate that back to the doctor or business owner.

00:25:41:28 – 00:26:34:29
Erica Vega
Yeah. So I mean, some of it of course goes in my email. But things that are, you know, going wrong or something, a mistake or something that of importance, it definitely needs to be brought up to him. So I try to bring it up real time. It’s not always doable, real time, but just as soon as he has a moment to bring it up, then bring it up and just rip off the Band-Aid. You got to just, you know, say whatever happened and figure out, you know, come up, come up with a solution. I try to when I present a problem, have some sort of solution behind it, but it may not always be the solution that he wants. And so you gotta adapt, roll with it and at the end of the day, it’s always going to be, you know, the physicians practice. So you have to go with what they think is best for their practice and adapt and change accordingly.

00:26:35:02 – 00:27:34:13
Jay Shorr
And so final two questions. As a seasoned practice manager, what advice would you give to another practice manager or somebody that wants to become a practice manager? Let’s give me two pearls of yours that just have gotten in your crawl that you think I’m not going to say you’ve mastered, because I don’t ever think we master anything at life. There’s always room for improvement. What advice would you give to a practice manager? And then lastly, what advice would you give to a practice owner about managing people? Because I don’t know. One doctor that taught was taught that in medical school, right? I teach doctors, I’m on faculty at a major university here in South Florida. I have to tell you, I have a lot of doctors in my classes and they have a lot of future doctors in my classes, and the only bit of information that they get.

00:27:34:15 – 00:28:04:02
Erica Vega
For a practice manager, I would tell them a few different things. I would say, always do your best to keep the team motivated, because if you have a motivated team, they’re going to be hard working, happy. They will adapt to whatever it is you need. Secondly, it’s not your practice, it’s the doctor’s practice. So you always, always need to follow their lead, go with their direction and pass. Pass along the message to the team.

00:28:04:05 – 00:28:08:07
Jay Shorr
But should you treat the practice like it’s your practice?

00:28:08:10 – 00:28:21:04
Erica Vega
I think that you should treat it like it’s your own practice. You want to be respectful of it, mindful of it, and you want to act as though it’s your own. And you want to do do your best as if it’s your own business.

00:28:21:05 – 00:29:04:16
Jay Shorr
Yeah. I mean, at the end of the day, if you don’t, you won’t be in that business because let’s be honest, the practice owner, whether it’s the doctor or anybody else, wants to feel like they have somebody in that position that’s going to treat it like it’s theirs. I share with you that when I have conversations with Doctor Rana and things aren’t always perfect in any business, even in my own, but I want my staff to treat this like it’s their own business and things will go wrong and it’s okay. All right. Look, the front and foremost, it is the safety of the patient and safety of the team, bar none. And as long as we don’t compromise that, everything is fixable.

00:29:04:18 – 00:29:05:06
Erica Vega
Right.

00:29:05:08 – 00:29:34:21
Jay Shorr
All right, so, in conclusion, Erica Vega, I really want to thank you for spending a part of your day representing Doctor Nik Rana board certified facial plastic surgeon in Frisco, North Dallas, Texas. And I would like to take a shout out to Doctor Rana for allowing you to become part of our team today and part of episode number 129 from Shorr Solutions, the podcast. Good luck and God bless.

00:29:34:24 – 00:30:13:01
Jay Shorr
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