COO/VP People & Culture Paula Fontana on the Role of Human Resources in Recruitment

DSOPro: Tell us about your background.

My career developed in an entrepreneurial way. As a recruiter, 30 years ago, I was involved in building a national employment agency. I was buying temp agencies and rebranding them under our company name. We were building a scalable organization that could be expanded from one location to another, which is exactly what we now do in the dental business.

The agency was doing full-time as well as temporary placement in everything from administrative work to project management. Later, I branched off with a couple other people to start my own agency with a national footprint.  

DSOPro: How did you get involved in dental?

I was introduced to Vincent Cardillo about 4 years ago through a common friend who works with me in the leadership development space. We had been working on some similar projects and he thought Vin and I should meet because he was doing some leadership development work for Vin’s company and some of their clients. So, it was a six degrees of separation situation.

At the time, Vin Cardillo was building an organization with a national footprint. He was talking about scaling dental practices from one location to many, which he had done before when he built the first DSO in Massachusetts.

The process was very similar to what I had done in the agency field. I understood how to create an organizational blueprint and then use it to scale. It was also a time when healthcare was, and certainly continues to be, a considerable area of focus and concern for many people. I thought it would be a great opportunity to bring more healthcare services to people around the country. 

Vin had started a company called Dental Management Innovations about 8 years ago. We rebranded about 2 years ago as Maeva Dental Advisors.

DSOPro: What is your role at Maeva and what are your various COO functions?

Initially, I joined to develop the Human Resources offering. We knew dental practices needed support, guidance, and direction around issues related to the employee life cycle: recruiting, retention, employee engagement, and employee relations. And they needed benefits and compensation structures.

There wasn’t really anybody out there with the background in HR to bring it forward or anyone that was doing it to scale. I had worked in Fortune 500 companies as well as small entrepreneurial startups where we did this all the time, so it seemed like a perfect fit.

The first thing I did was create some plug-and-play HR services that we could offer. As I continued working with Maeva, my role grew to include marketing, business development, client success, operations, accounting, and HR. I oversee all those functions for our company.

DSOPro: From your perspective, what is happening in the DSO space in terms of growth and shifting priorities in terms of staffing?

Well, the DSO space is not unique in that we’re all in the same market for talent. Since the pandemic, there is a tiny pool of people available to compete for. Many people who were laid off early on during the shut-down did not return to work, so the pool of qualified candidates continued to shrink. Consequently, dental practices are learning they need to do some things very differently. We’re seeing them adopt some of the best practices that have been in place for many years within other organizations and vertical markets, such as sign-on and retention bonuses. 

There’s certainly a greater shift to focusing on employee engagement and retention. More practices are exploring how to create a culture of sustainability and full engagement where employees are advocating for their practices. Dental practice owners are asking us how to evolve their practices from an HR standpoint because they understand the value and cost of employee engagement and retention. It costs more to hire someone new than to keep someone good.

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There has also been a shift to using technology in recruiting. What used to work in the market is no longer enough. You can’t just post a job and get great candidates. You need a strategic sourcing plan and to optimize every social media avenue possible. You need to do targeted, aggressive recruiting and use technology to remove some of the manual labor from the process to be efficient. 

DSOPro: What kinds of technology are recruiters using?

We’re starting to see more DSOs adopt HR platforms. That technology is very similar in its framework to practice management software, where it acts as a repository for all the employee data from the time you start talking to a candidate until they leave the company. HR information systems, or HRIS platforms, have been around for over 40 years, but dentists have been a bit behind in adopting some of the technology assets available. They didn’t necessarily need them because most practices were so small. Now that larger groups have all these people to manage, it takes a lot of manual labor to create job descriptions, recruit and onboard someone, and track performance, training, and licensing requirements. Now you can use technology to make that a much more efficient, seamless process.

DSOPro: Can you walk us through that process? 

Picture this: A company would like to offer you a job. Somebody writes out the offer and emails it to you. Say you accept, sign the offer letter, and send it back. Then you must go through onboarding, which is enrolling in your benefits, providing your tax information, etc. That used to be a lot of paperwork. They’d snail mail you a packet and you’d fill it all out and send it back.

Now, everything is done online. When you accept an offer, you get a link and use an online system to input your personal information and upload pertinent documents. Then the hiring manager receives a notification that you have completed your onboarding. You don’t have to deal with all that paper, and we save a few trees. It’s a better experience for the employee who is more tech savvy than 30 to 40 years ago. 

If DSOs aren’t using technology to make this a simple process for them, employees may already be having what they perceive as a negative experience. They may not own a printer to print out copies, and they don’t want to fill out multiple copies or take the time to mail them back. That doesn’t give people the feeling that they’re joining a very modern organization.

DSOPro: What are some tips for both sides, the recruiters and the candidates?

I love talking about that! Because when you’ve done everything wrong in your career, you have this wonderful advantage of being able to correct it and share insights with other people so they don’t have the same problems.

Recruiting really starts when you create a job ad. The first thing I recommend is to be very clear about what you want. A job ad should be simple. It will hold somebody’s attention for only about 30 seconds, so they don’t need to see the full job description. They need to know what they must have to be considered to work at your company and why they should even apply.

The ad should be a paragraph. It should be simple, but there should be some non-negotiables in there. If you need someone with certain experience, certification, or licenses, you have to say that. Be very clear about the characteristics, qualifications, education, and experience necessary. It is important to spend time up front deciding what you want. And you can create these non-negotiables in the screening questions, which are also online.

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The same is true for a candidate—put the time into thinking about what you really want to do, what you love, and what you’re good at.

This pre-planning is important because you’ll have a much better chance of getting someone who meets your requirements. If you put something too broad out there, you’ll get a whole bunch of different kinds of candidates. 

The other critical part is knowing how to conduct an interview. It needs to be behavioral based. You want to know their history and what they’ve done before. For example, ask about a time when they had to solve a problem at work. What was the specific problem? Why was it a problem? What did you do about it? What was the outcome? What did you implement as a result of solving that problem?

Those are all very open-ended questions that target what someone can do. This is important because past performance predicts future performance. Often interviewers just ask, “Can you solve problems?” All the candidate has to say is, “Yep. I sure can,” which tells you nothing about them. You need people to demonstrate they can cope and think on their own.

You can teach the technical parts of a job or send someone to school to learn it. But critical thinking is really important in the healthcare field. We need people who can solve problems, take initiative, act on their own, all that stuff. To me, that’s the difference between hiring “some body” and hiring a superstar.

The candidate should be prepared to share examples of things they’ve done that separates them from the rest of the pack. I’ve interviewed candidates who haven’t thought about how what they’ve done before might be relevant. They’re not well prepared with answers. Candidates must do their homework and think about what they want a recruiter to know about them.

When both parties do that, it creates a better interview experience for everyone. And I will reiterate that employers must be aggressive with things like sign-on bonuses, and how and when they’re going to use incentives. A lot of people are receiving multiple offers, which is a nightmare for a hiring manager because now they’re competing.

A sign-on bonus is a good way to incentivize someone to stop looking, stop interviewing, and get a nice reward for joining the organization. But I recommend not paying it out until 6 months into the job because we’re seeing people stay for 90 days then take the money and run.

I’ve not seen a market like this in my experience. I haven’t seen anything this aggressive, particularly in healthcare, but it continues to be a market that is greatly affected by the pandemic.

DSOPro: Talk about the changing workforce dynamics, especially as they relate to the pandemic.

I’ve worked in financial services, insurance, marketing services, sales organizations, and IT organizations before. These are very aggressive, highly regulated markets that have already experienced a lot of change in terms of managing human capital and have made those adjustments. They continue to do so since the pandemic. 

Candidates today are picking up on inconsistencies during the interview process. They are well-connected in social media, and they read the Google reviews. They’re looking for work-life balance, top wages, and great benefits. They want flexibility—which includes not working 50-60 hours per week. They want an engaging culture where practices are investing in them. If they’re not hearing those things during the interview process, they will keep looking. And they don’t often have to look very far because the practice down the street probably just lost a dental assistant, doctor, or hygienist.

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We show practices how to tackle these people issues long term. We help create an experience for employees that stands out, whether it’s for a solo practice owner thinking of growing, or a DSO that has 40 or more offices. We show them how to focus on the cultural issues and build a practice that attracts the right people.

The impact of losing an employee in a solo practice that has five staff members is significant. If you lose a hygienist, your productivity and revenue take a hit. And the time it takes to find the right replacement worsens those problems. If you don’t know how to use some of the job boards out there, and are not experienced in recruiting or using that technology, you must learn these tactics or outsource the work to someone like us. 

DSOPro: What services does Maeva offer groups to help with team management?

HR is a very big beast. When it comes to HR, most people think about recruiting, but tied to that is job development, recruiting strategy, retention strategies, employee benefits and compensation, employee relations, and solving employee issues. Other pieces that fall under HR include developing talent and ensuring staff continues to learn and grow. Many people in the dental field don’t know how to do all of that and need to bring in an expert. 

We offer a unique service because we can project-out certain work. For example, if a client does not have an employee handbook, they will need guidelines for their employees that outline benefits, time off, and employee policies. That is a project we can put in place. 

We can provide a fractionalized approach, like help them hire a new manager for multiple locations. Or if they want to develop a front desk person into a manager, we have a manager development program we can tailor to the dental practice. We can teach them how to have a performance discussion, how to set goals with their teams, how to conduct a one-on-one or have a team training meeting, or how to handle a sexual harassment claim or a compensation discussion. We give them field work, like real applications, so they start to develop confidence in their ability to manage a team.

Most people hate HR. Nobody wants to have a confrontation or deal with conflict because they don’t know how. Or they fumble through it because they’ve had a bad experience and don’t want to repeat it. There are frameworks for having a difficult conversation. There is a way to navigate that conversation so that it’s positive, but you get your point across. If someone is eager to learn, we can teach them how to do that.

When you visit a practice where people are excited to work and feel appreciated, you want to work there. That’s why we require all our clients to conduct working interviews. Whether they are hiring for the front desk, a dental assistant or hygienist, or a doctor, they go in and shadow for half a day. We want them to feel what it’s like to be part of that practice because they are joining a culture.

And they pick things up right away. They may think, “This group works well together. There’s great energy. They’re very supportive. A patient was really upset and I saw how the group worked together to handle it.” We often hear things like that, and the experience is important because that’s what they’re buying into. We didn’t invent the concept, but it’s like “Try before you buy.” You might as well see what your life will be like working there 8 hours a day.

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I appreciate these stories and have learned from their experiences. It helps me understand the environment and makes me want to make it better for people working there. I don’t want somebody who is unhappy working on my mouth.

DSOPro: What do you see coming, where do you see things going and the best ways to get there?

We’ll continue to see a lot of M&A activity. It’s the best way to scale and grow. You can buy more with more locations, so from a procurement standpoint, it’s a smart thing to do.

I think the best way is to be open to the guidance and advice of people who want to help and are experienced in growing businesses. Take everything you can from them and learn. And when you’re ready to be on your own, you’ll be fine on your own.

I would never try building a business without having a good advisory team. It’s like building a house. You need the general contractors, carpenters, roofers, plumbers, and electricians. We have expertise in accounting, finance, bookkeeping, human resources, management, and all the steps of growing, acquiring, and building a practice from the ground floor up while hitting KPIs and performance metrics. We know how to grow safely and the right way.

We can see how this performance is going to predict future performance. Once you hit that stride—your retention is up, your turnover is down, your performance ratings are high, and your employees are saying great things about the practice—you’re on the right trajectory. Then, let’s buy another practice or open another location.

We’re a little bit like Sherpas. We start working with you on your foundation, then we’ll get you to the next level, and the level after that. At some point you won’t need us anymore and we’re fine with that.

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About Paula Fontana

Paula Fontana is COO/VP People & Culture at Maeva Dental Advisors. As the COO and HR Practice Lead, Paula ensures that clients receive the absolute best Maeva experience possible. This means that Maeva maintains an effective organizational framework, appropriate business and technology systems, and experienced talent to guarantee that clients can and will reach their desired goals. Finding the alignment between people, process, technology, and business goals is what Paula excels at. Proving that high-performing systems exist because the right people are in the right roles has been the cornerstone of her career. 

Before joining Maeva in 2018, Paula was the Head of Learning & Development for a XEROX Company and held senior leadership roles within Travelers Insurance and The Hartford Financial Services in Talent Acquisition and Client Relationship Management. She was the co-founder of Corporate Staffing Solutions, LLC, and the VP of Operations for Dunhill—both national employment agencies. In 2003, Paula was tapped to help launch another successful start-up, Executive Connections, LLC, a boutique executive search and consulting group. This combination of Fortune 500 and SMB business development experience has enabled Paula to leverage over 25 years of growth minded, people-centered leadership. 

Paula is an active member of Dress for Success, a global nonprofit organization that provides professional support and coaching services for women. She holds a BA in Communications from Central Connecticut State University and is a Certified Workforce Planner and Executive Coach. Paula lives in West Hartford, CT, with her family.

About Maeva Dental Advisors

Maeva Dental Advisors is a recognized and trusted industry leader providing dentists and dental practice owners who are interested in growing their practice or DSO with enhanced management advice, solutions based on best practices, and proven industry experience. Maeva Dental Advisors also powers dental practices who seek to grow without selling or merging their practice by delivering the power of strategic “DSO” business operations services.

We take professional and personal pride in putting our experience and expertise to work to help our dental practice clients grow and succeed. Through all stages of your practice growth, we offer a comprehensive selection of practice management and growth services and targeted business solutions designed to make your business soar.