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.

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.

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.