35. Ways to build an elite team and launch a successful startup
With Maritza Duran
"Only fools rush in."
It's not just a wise dictum about falling in love.It's also great advice for startup dental practice owners about hiring the right people.
In today's competitive employment market, it's more important than ever to align your values with employees, offer them competitive compensation packages, and create room for them to grow.
How do you make time and build a plan for this amid all the other work of opening a new practice? That's where today's guest comes in.
Meet our guest
Maritza Duran is the founder and CEO of MDent Consulting Services. With over 20 years of management experience, Maritza started her career as a dental assistant and worked her way up to regional manager of the group. Since founding MDent, Maritza and her team have focused on helping dentists successfully start or acquire practices, from securing financing to filling schedules and everything in between. She is also a certified body language trainer, leadership coach and adjunct faculty professor at Temple University.
In this episode
- How your vision and core values should drive your recruitment efforts
- How to attract and retain top talent
- Why self-awareness is an important part of building a team
- How to ensure a practice runs smoothly on opening day and beyond
- What is the best way to onboard employees at a startup
My advice to every dentist when it comes to starting a team is start early. It's like dating. And so you don't just start getting to know people the moment you're getting ready to just get married, you want to make sure that they share your same values.
Welcome to the Path to Owning It podcast by Provide, hosted by me, Corey Brown, a marketing leader at Provide with over a decade in the healthcare industry. If you've found us, you're likely an aspiring or established health care practice owner looking for tools and advice to begin your journey or take your practice to new heights. And you're not alone.
So to help you achieve your practice ownership dreams, twice monthly we’ll tap into our unparalleled network of industry experts who will join us on our quest to provide the answers to your most pressing questions. Like what you hear? Follow us on Apple Podcasts, Spotify, or wherever else you listen. Today, we're here at the Greater New York Dental Meeting in Manhattan, and I have the pleasure of interviewing Maritza Duran.
Maritza is the founder and CEO of MDent Consulting Services. With over 20 years of management experience, Maritza started her career as a dental assistant and has helped with the development and expansions of 15 startup practices, becoming a regional manager of the group. Since founding of MDent, Maritza and her team have focused on helping dentists successfully start or acquire practices.
From securing financing to filling schedules and everything in between. She is also a certified body language trainer, leadership coach and adjunct faculty professor at Temple University. When she's not helping dentists launch and grow their first dental practice, you'll find her spending quality time with her VIPs, her husband Edwin, and her two kids, Thiago and Dalia. Maritza, thanks for joining me and welcome to the show.
Thank you so much for having me.
Absolutely. I mean, we're here on the trade show floor in New York. Tell me what you've seen, anything you're excited about that you've seen at the show so far?
It's been such an incredible opportunity just to connect. And you connected with so many people virtually. It is that in-person connection that I think pre-COVID we've lost. It's just so rewarding to be able to put faces to the names that you see on social media and all the changes that are happening are very rewarding. Just last year we didn't have a podcast and here you are and recording this live from the Greater New York. So really excited to be here.
Yeah, we're super excited to be here too, and to connect with all of our great partners. So thank you for joining me. I want to know how did you go from Dental Assisting to opening 15 startup practices?
Well, I will tell you, I didn't really plan. It was just something that happened. But it had to do with me owning the fact that no matter who signed my check, I always felt like I worked for myself. From that very entry level position as a clinical dental assistant, I really took a lot of pride in every patient that I had the opportunity to interact with.
And whenever they were opportunities available, I really shined through all of these opportunities. And so starting in 1998 as a clinical dental assistant, two years into me working there, I was pulled out of the office to become a front desk of a location that was a complete start up. And then five years from me running that dental practice, I was pulled out to help with an expansion. We did a strategic partnership that led to the expansion of an additional 13 locations and I became regional manager and oversaw 15 practices where I had the opportunity to learn and add a lot of value to a lot of the people that work in the practices back then and still at this point.
Yeah, that's an incredible story. How did you then go, I guess from managing and being a regional manager to deciding that you wanted to kind of do your own thing with MDent?
So that self-development, right? Like I always felt that individual self-development leads to collective growth. And so knowing that I had already learned the clinical skills and I was able to take that into the front desk and better communicate with patients. And then I developed relationships with vendors, with agents from different dental related companies. I was able to network and realize that, hey, there is so much more.
And so it sounds like you were looking for more.
I had a sense of ownership in everything that I did. And so, like, I was always that person that wanted to learn more and do more and teach more. Like I used to cross-train all of my team members. And so I developed this passion when I got the opportunity to start the expansion. That whole experience of going to one location and really building it from the ground up, the first employees, the entire process of coordinating with vendors.
And we need to do the plumbing and we need to get permits and we have to do all these things and let's get the marketing up and going and let's post ads to see what kind of results we're going to get. And let's do some of that, you know, networking with other referring providers and so on. I just developed that drive and I loved going from office to office office and just, you know, developing every team member for the different practices.
It was just the dynamics, the different types of cultural backgrounds and the patient mix from all the different locations. It was very rewarding. A lot of the associates, to your point, about when and how did I decide to start on my own, had to do with the fact that I was beginning to start my own family and I was running around between locations, driving hours to go from one practice to the other.
And we turned our multi group… We had 15 practices at the time into a DSO. Right? And I went through the entire transition of systemizing things and getting things situated. Some of the associate dentists were just like me starting a family, but also had this dream of not being an associate forever and starting their own practices.
And so I noticed a difference between my employer then and how we were able to build so much success and start so many practices in comparison to these new dentists that were just getting started. Like and they had all the clinical skills, great clinicians, but they really didn't have that edge, that business understanding on how to save money, how to optimize things, to be able to make it where the start up process would work towards helping them thrive instead of just merely surviving in the industry.
So as a young mother myself, noticing that a lot of the dentists that were working as associates wanted to also start their own businesses, it gave me that kind of ownership bug inside of me that I was like, I just want to do more. I want to help dentists. That is not just another practice in their portfolio. But something where it's their very first baby.
They feel that ownership that you felt too. You know, with all of that experience and opening all of those practices, I know that you've kind of developed an approach that you've summarized in kind of five pillars, right? So from developing your vision to people to knowing your numbers, training and systems and what I really want to pick your brain on today is ways to build an elite team and how to launch successfully, right?
So let's start with building your team. I'm confident, let's say with my vision, I know my numbers. I have the home for my practice. How should I go about starting to build my team from scratch?
You have to first start with that vision of the practice that you want to have your core values, your mission statement. Once you have that and you surround yourself with the right people, you're going to be able to understand the qualities that you're going to want to look for on these individuals. Then you also need to take into consideration how have you managed your numbers pre-opening so that you can be able to compete in the marketplace salarywise and obviously have the training capacity for yourself to understand what is it that I need to hire for and systematize that right?
So understanding that we have those five guiding principles when it comes to people closer to the time when you are under construction, right? Ideally, and you've worked with the right people and I have this concept always that I share with my clients, which is we have tangibles and intangibles. The tangible is the quality individual. In the case of the people that we hire that are sharing our mission and values.
But before then, right, we have the intangibles, the things that happen pre-opening. So you cannot wait until a week before you open just because you're thinking, I have payroll and I don't want to set it up, and I just want to make sure that I'm getting closer to the time where it's going to be financially feasible for me to do that.
And so for all of you listeners out there, just pay attention to the fact that what you do behind the scenes before it's as important as the end result or is going to be directly related to the outcome that you're going to have. And so work on the intangibles first. And your question was how soon should they start looking to putting an elite team together?
I say you can start by having already your job descriptions and the roles that you want them to have. Then you are going to start potentially posting an ad and there are different avenues and places that you can doit. I was having a conversation yesterday during our lecture together with Provide about employment agreements and how we should handle soliciting from our current practices and how that's not okay based on your employment agreements.
But there are other strategies and things that you can do. And my advice to every dentist when it comes to starting a team is start early, right? It's like dating. And so you don't just start getting to know people the moment you're getting ready to just get married, you want to make sure that they share your same values.
But you have had to done some of that due diligence and work yourself. So I do highly recommend that as far as timing, they start some time three months prior to them deciding to open, and a lot of you are going to think, Oh my goodness, but does that mean that I need to hire them? Well, from my experience, when we start that process early enough and the candidate, you follow the right process.
Some of these employees may stay at a job just because of that promise. They resonate with you. They are also looking for the same values that you're looking there to offer. And they just didn't know that they had it from their current position or they never were presented with such tangible values and ways that they are attracted to working with you.
And so I would say three months prior to open, you start to work on your recruitment strategy. And you start drafting your ad, you can post it in all the different, you know, platforms out there.
Is there one that's more I'm just curious, more successful that you've seen as far as like where are we finding these the right people, quote unquote, right?
So it depends. I mean, different areas. And I think, you know, nationwide there are a lot of platforms that come through like Ziprecruiter or Indeed, or, you know, sometimes Craigslist. A lot of people used to use that before there is dental match. There are a lot of platforms. But the most important piece is based on your area, what has worked.
But at the same time, the way that you present your ad. That is extremely important and maintaining kind of like the word of mouth, you still want to be able to say, Hey, given that you can have these conversations and being very cautious about soliciting people from your current associate position. But the best part of starting a business is when you can potentially help improve somebody else's life that you've already had a connection with that you know is going to be morally committed to your vision.
And is going to help grow with you because let's be real. Startups are totally different ball game than an established practice. Yeah, because you don't have all of the resources that a lot of these other established practices have already. So you cannot be that competitive perhaps on the salary. But a lot of people are seeking opportunities for their own self-development and the opportunity to grow and build something themselves as well.
So if you structure it in a way that it's appealing to someone, you're going to be able to attract the right candidate.
Yeah, I think that's great advice. You know, we've discussed a lot in previous episodes on the show how practice owners are really having a hard time recruiting and retaining employees, especially maybe in a startup where things may not always run smoothly off the bat. Right? What advice can you offer to those that are maybe having a hard time attracting and retaining people?
Do some introspective work, right? Go back through those five pillars and guiding principles. Are you clear on your vision or what it is that you want? And to be fair, we can only give something that we have. And so the qualities that you're looking to have on another individual, you have to make sure you possess yourself, right? Otherwise it's just not going to be in alignment.
Once that person comes in, there's going to be that friction. So really work on that first. If you surround yourself with quality people, they know quality people as well. And you have to stay competitive. One of the things that really frustrates me a lot about dentists is that they overspend a lot on equipment…
And other categories, right?
And other categories, and then they have no working capital and they just feel like, oh, I'll just hire someone to answer the phones or they're not as competitive in terms of what they can offer or they don't set themselves up for success and they are unable to compete in terms of providing a full time employment opportunity for these candidates because they are still holding their associate positions.
And let's be real. The marketplace, we have a lot of DSOs, they offer benefits, they offer full time positions because they are already pre-established. And you need to set that foundation for yourself as a start up business. I'm a start up business myself, right? And it is scary because you want to make sure that you have enough money for payroll, but we need to choose our battles and understand that, hey, you need to, as you're building the practice, make sure that you have all of your ducks in a row so that when the time comes in order for you to attract the right candidates, you have the right branding that it's attractive to them and you have the competitive salaries and you have a game plan, you have your blueprints where you can tell this individual, this is where my practice is going to be six months from now, and this is where you come in. Should you help me get to this point? Because I'm clear on my vision and I have my goal set up.
We're going to be able to do this together. Like 95% of my clients or more are able to break even within three months, add second team members within six months of practice ownership because we developed this blueprint together. And so for them, it's easy to know and predict when they're going to have them add more days in the practice.
In contrast, I have conversations with dentists a lot of times, and they're two years into their startup practices, still holding an associateship and then they're complaining about, I cannot sustain my team. Well, if you're not offering them a fulltime employment because two years into your practice, they don't see that security, right? Then that is what's scary for the candidates.
And so you as a business owner have the responsibility to ensure that you have a game plan to make it where they know that it is going to be a longterm commitment should there be a good match. I recommend that before getting into the recruitment phase and strategy as part of that self assessment to do personality…
Yeah, there's different sorts of tests… quote unquote tests, right? That you can take that talk about how you process information, how you approach a project, that sort of thing, right?
Yes. And so I've done this for myself. The one that really resonated the most with me is the Kolbe.
Which I've done many times very familiar with.
Five, seven, four, two.
Okay, So I am three, three, eight, six.
I was gonna say, your quick start is probably very high, right?
Yes, my quick start is very high. But for my first hire, knowing that I'm a great person to get things started and I struggle with the follow through, in some instances, I needed someone to balance me. As business owners, we also need to understand that we tend to attract and like people like ourselves, but we need to have balance for our business.
And the dynamics of okay, I'm very charismatic or I have a lot of dentists that are not very, you know, social butterflies. So you need someone that has more of an outgoing personality, right? And so for me, knowing and having done this introspective work myself.
I knew that I needed to hire that balance, someone that can help me keep things organized and follow through and make sure I get so that email. And so a lot of dentists don't know this, but it helps. Everything is about training that's kind of like linked to you being trained on the things that you need to know to prepare yourself for the role of being an employer, and that comes with training yourself on how to successfully hire and retain people.
Well, you've given us some excellent points on that so far, and I can't wait to talk to you after the break a little bit more about how we go about turning this into a successful opening. Just taking all your advice and making it go. So more with Maritza right after this.
I'm Corey Brown and this is Provide’s the Path to Owning It podcast. We're back with Maritza Duran, CEO and founder of MDent Consulting, to discuss how startup practice owners can rest easy, knowing that opening day is going to go smoothly. I can imagine Maritza, that this is probably the biggest worry or concern of new practice owners, right when they had this vision to start their practice, and that day is slowly coming upon us. So how can you ensure a smooth opening?
Well, we discuss systems as being one of those five pillars when it comes to the recruiting piece of it, we have actionable steps that we follow. And when we come through the process of, let's just say, selecting the candidate, screening them, meeting them virtually, scheduling them, asking them the right questions, it has all been pre-established. We have gone through the process of giving them a verbal offer, which they accepted.
Then we draft that offer letter and then we start the onboarding for payroll. Then we start the onboarding process and we have to ensure we have an orientation planned out. As the saying goes, if you fail to plan, you are planning to fail, right? One of the biggest challenges I see dental startups go through is the fact that during their first three months it is very overwhelming because you have a lot of moving pieces, right?
It's like moving into somebody’s new home, cooking in somebody else's new kitchen, and this individual that recently met you that is coming in has a clean canvas where they're coming in and they're trying to help you. But if you don't have the processes and the orientation already laid out for them, they're not going to be meeting your expectations.
But it is you have to set those expectations and provide that guidance for them. So what we do with our companies is we help create and map out an orientation week. So we take all of the different vendors that are part of the startup process, testing equipment, going through trainings on your software, understanding the insurance participation. All of these things are mapped out and planned out ahead.
So these individuals come in and they know what their tasks are and the importance of this task. So it's less overwhelming for everyone.
So these orientations, are they in one group, everyone that you've hired, or is this very much like one at a time, what do you recommend there?
So this is specific to every practice, right? Like I currently have a client we're opening up. He's getting his CEO the second week of December. We've already drafted our ad. We already made the selection of the individual. We are drafting the offer letter so that we know when payroll is going to be set up, when they should expect to start getting paid.
How are we going to based on installation such as software in I.T. within the practice, there are so many contingencies for us to do this, but once we know this ahead of time, we're able to time it in a way that makes sense for you because you're going to start tapping into that payroll. But you're getting things taken care of pre-opening, and the process is going for your newly hired individual.
Yeah. A lot of people that we've talked to on the show… you mentioned insurance earlier… are maybe going away from that. Some are not. There seems to be kind of this internal battle about should I navigate insurance? What's your suggestion to startup practice owners?
So one of the very first thing we do for our clients as we are in the planning phase, right? Like they're just thinking about where I want to open. And so we do a lot of the demographic analysis and market research based on the providers, services, clinical expertise and the market itself, right? Like when we come out and we start a business, we start a business because one, there is a need for the services that we want… two, we need to figure out how they can afford those services, and then we need to find a way to attract them to be able to receive our services.
And so that second piece, if you're opening in an area where insurance is prevalent, then it makes sense for you to enroll with the insurance company. So we do a lot of market research to determine which insurance companies, based on reimbursement, based on the business model of the provider and based on the relevancy we do incorporate that fee negotiation because is how you're going to get paid in perpetuity in your practice.
So it is important because, again, you're hiring your first individual. You don't know where the money's coming from. The first goal or biggest milestone is for you to break even. And if they come in and they have no patients in your fee for service practice, it is very difficult for them to just get engaged and understand like, how am I going to promote this practice?
And there's so many other strategies I wish we had more time.
I know, I was just thinking the same thing, you could go on and on about this, but I really want to get into this question because I know you talk a lot about your profit first strategy, right? So can you tell us a little bit more about what that is?
So as part of the framework that I develop, we create this revenue blueprint for all of our clients where we take their overhead hourly expenses, we calculate everything. We help them manage their budget. So once we have our operational costs situated, including salaries, we help them navigate how many patients they need to see to cover costs, break even and then be profitable.
Once we know… And thank God we've been able to get our doctors within three months, break even within the first six months be profitable. I love to use the concept of profit first, which is a book by Mike Michalowicz, and he talks about once you have, let's say on the monthly basis or bi-weekly basis, I encourage my doctors to set up separate accounts.
So you have your operational account, which is where all the money that comes in from the insurance companies, directories or patients pay you, that is your operational account. Then you have sub accounts such as payroll to be able to divide and conquer, because if you've done your due diligence, then you know that there is a ratio or a percentage of your overhead that goes and gets allocated to your payroll.
And so you set up that account and then you set up another hour checking account for your taxes, right? Like Uncle Sam is going to want a piece of everything that you have. And so you want to be able to start thinking about at least start off with those three. Okay? And then eventually, as you progress and then you can have your own owner's compensation account once as you're gradually growing the practice.
And then from there you can divide and conquer. That's kind of like the idea. But I would like to get my dentists to think about this because they're thinking profits, right? Their biggest concern is breaking even or just getting patients through the door, but thinking, what's the goal that we want? And just reverse engineering that it just starts to spark in their brains and create those ideas that are fun to start working and looking forward to?
Yeah, and you mentioned benchmarks. Is there a certain percentage that we should be thinking of as our human capital as compared to our revenue that you would recommend?
So there's no such thing as a cookie cutter approach. I think the benchmarks of about 20 to 25% should be allocated to your payroll, but eight or 10% goes to your rent and marketing. And so they have this overhead where it's, you know, ideally they want to have that 40 or 50% overhead where the rest of it, it's kind of like your profit margin.
But understand that you cannot go to third grade without going through first and second, right? And so you have to go through this. Yes. You want to have that long term goal. And we help our doctors map out what their two year yearly revenue potential is based on all of the things that we've incorporate into their businesses.
But we focus on the first milestone and that is let's cover costs, make sure that our office is efficiently running where you don't have to tap into your personal savings or anything, and that the team, it's working towards helping you reach those goals. And so...
And that’s probably a really exciting day when they realize, Hey, my practice is actually profitable.
I had a conversation not too long ago with a dentist that started her practice in February, and by June she was like, I'm hiring my second dental assistant. And we went through like her first quarter, like or three months post opening. And she was so excited because I was like, okay, we had determined that for your practice we were going through her breakeven analysis, you needed to see 39 patients for the first month.
Did you accomplish that? And she's like, Yes, I did, Yeah. You know, and it's just very rewarding. But again, success is where planning an opportunity meet, right? And so you have these opportunities to get lending from Provide and so you want to be able to make that opportunity to get that financing in place to finance your dream of practice ownership.
But you need to plan in order to ensure that you're bringing back to your family that has supported you...
The whole reason you probably went and did this in the first place….
Right, Exactly. And those employees. Right. We're talking about quality people and they're out there, but they have the same fears that you have about being an owner. They have as an employee about their ability to stay at a job unless they can sense that you are collected and that you are a leader that they can follow and trust because there's opportunity for them by associating themselves with you.
Yeah. And Maritza, I don't want to end our conversation, but I do want to end on one note. So can you give our listeners one must do and one Oh, my gosh, please don't do that, when it comes to starting their practice, their first practice.
So a must do is surround yourself with good quality people. Yeah, I cannot stress this enough. We want to get married and have a great successful wedding. We hire a wedding planner, right? We use guides all the time. Like if you go to a new place and you want to really maximize your experience, you hire a tour guide.
So it is important that you understand and you invest on getting the guidance and the support that you need to lower the risk and maximize your opportunities for success. So that's the must be sort of reach out to myself or any consultant out there that can help provide that guidance because it's going to pay off. What they should not do, it's follow noise.
Do not follow the noise. Get references. Understand that a person giving you advice that has opened one or two practices, it's not going to be the same advice that is applicable for you. So don't follow the noise and compare yourself to other people that are doing more or that are doing less. Stick to what is true to you and develop your own blueprint for success.
That would be what I don't want them to do it to get too scattered around and follow too many people.
No, I think that's excellent advice. And you mentioned consultants, right? So if our listeners would like to employ MDent for their consulting needs, how would they get ahold of you?
My company website is MDentCS.com. I am also in social media… Maritza.E.Duran. You go to my website, you can schedule a complimentary consultation and we can start by drafting your vision, whether you're acquiring an existing practice or thinking about launching a startup practice from scratch. I will love to be your guide.
That's awesome. Well, Maritza, thank you so much for joining me here in New York at the Greater New York Dental Meeting. This is a lot of fun. You've given us just invaluable information for startup practice owner. So thank you for joining us.
Thank you for having me.
Thanks for joining us. Because you've listened to this whole episode, we assume you're entertained or at the very least, learned something new. If so, leave us a review on Apple Podcasts or Spotify. Have a topic you'd like to discuss in a future episode. Drop us a line in the comments section or send us a message on social media.
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For Provide, I'm Corey Brown. Thanks for being on the journey with us.
Provide is a division of Fifth Third Bank, National Association. All opinions expressed by the participant are solely their current opinions and do not reflect the opinions of Provide, its affiliates, or Fifth Third Bank. The participant’s opinions are based on information they consider reliable, but neither Provide, its affiliates nor Fifth Third Bank warrant its completeness or accuracy and should not be relied upon as such. This content is for informational purposes and does not constitute the rendering of legal, accounting, tax, or investment advice, or other professional services by Provide or any of its affiliates. Please consult with appropriate professionals related to your individual circumstances. All lending is subject to review and approval.