What we talked about
Leslie Espinola has spent more than 35 years in the dental industry, though that was never the plan. She studied forensic science and wanted to join the FBI, then took a job in her father’s dental practice while she figured out her life, and never left. Today she is a Dental Executive Coach, Fractional COO, and founder of High Peak Dental Advisors, helping practices grow through better leadership, healthier culture, and smarter operations.
Show notes
Leslie Espinola studied forensic science and wanted to join the FBI, then took a job in her father’s dental practice while she figured out her life, and never left. More than 35 years later she is a Dental Executive Coach and Fractional COO who travels to client offices three and a half weeks a month, helping practices grow through leadership, culture, and operations rather than another marketing push.
What we covered
- What a Fractional COO actually does for a dental practice, why she travels to client offices three and a half weeks a month, and the leap of faith she took last year to start her own company, High Peak Dental Advisors, after a career inside large organizations.
- The difference between a manager and a leader, and the trap office managers fall into when they get promoted but stay stuck in the day-to-day instead of stepping up to lead.
- Why good leadership is always about people, how a healthy culture prevents turnover, and the operational truths most practice owners miss.
- Why so many owners stay disconnected from their numbers, and the sobering reality that a large share of dental offices are stolen from by a team member.
- A clear-eyed case for AI in dentistry, where it removes unproductive work so teams can stay patient-facing, and why she has not seen it take a single job in the industry.
- The win she is most proud of: an office manager who was weeks from being let go and, after one hard conversation and six months of mentoring, became one of the best leaders Leslie has ever worked with.
About Leslie
Leslie Espinola is a Dental Executive Coach, Fractional COO, and Founder of High Peak Dental Advisors, with more than 35 years in the dental industry. She is also a coach at the Dentist Entrepreneur Organization, helping practices grow through better leadership, healthier culture, and smarter operations.
- LinkedIn: https://www.linkedin.com/in/leslieespinola/
- Website: https://deodentalgroup.com
Episode 154 of the PreVetted Podcast.
Full transcript
Federico Ramallo (00:00) Welcome back to the pre-Vered podcast where we spotlight extraordinary people and remarkable talent reshaping our world. Today I am joined by Leslie Espinola. She’s a dental executive coach, fractional COO and founder of High Peak Dental Advisors. She has over 30 years of experience in dental practice operations. She has led multiple multi-specialty organizations.
through growth, transformation, and she’s been doing roles as general dentistry, orthodontics, pediatrics, and specialty care. She’s currently also serving as a fractional COO and executive coach at the DEO, the Dentist Entrepreneur Organization. Leslie is known for building data-driven, people-centered operational models that improve profitability while keeping clinical excellence front and center.
Lastly, welcome to the show.
Leslie Espinola (00:59) Thank you, Frederico. I need to take you with me everywhere I go. I need that introduction for everywhere.
Federico Ramallo (01:05) I can be your official introductory, you know.
Leslie Espinola (01:07) Thank you,
Anita.
Federico Ramallo (01:10) It’s a I mean, for me, doing the introductions, it’s both a privilege and a gift for the guest because we’re building stuff, we’re doing stuff and we don’t realize all the things that we do. So I love when I see when I I do the intro and I see the guests, you know, all with amazement, right? Because that’s me, you know. So that’s that’s my gift. Right.
Leslie Espinola (01:38) Well, thank you for that gift. And you said 30 plus years. And I’m like, wow, I just don’t feel that old. But hey, I guess I am. 30 plus years in the industry.
Federico Ramallo (01:48) Right.
Yeah, and they fly by so quickly,
Leslie Espinola (01:57) They do. Sometimes they do.
Federico Ramallo (01:59) Yeah, I am going a little bit of side track, but so when we’re kids, right, the reason we feel times pass slower, right, because when you are a 10 year old, one year is 10 % of your life, right? But the older we get, the smaller that percentage becomes. And that’s why we feel that time passes faster.
Leslie Espinola (02:25) Makes all the sense. Sure does. mean, time is flying by for me now. I remember I used to wait forever. I would start wishing for Christmas by June. And here it is. I just finished Christmas and I feel like it’s right around the corner again. And it will be before we know it.
Federico Ramallo (02:28) You
Hahaha
So you started as a dental assistant and worked your way up to running large organization. How did that happen?
Leslie Espinola (02:54) Well, great story. I was in college and I went to school to be a forensic scientist and I wanted to go into the FBI and that was my goal. My dad was a dentist, just retired last year and when I graduated he said, why don’t you come into the office and work for me while you’re trying to figure out your life?
And so I agreed and never left. I worked for him and his practice for 15 years. Never did go into the FBI. I’ve never done anything with forensic science. However, I have thoroughly enjoyed being in the dental industry and have loved every minute of it. And I’m glad that I made the choice that I made because it led me to where I am now. And I love doing what I’m doing now.
Federico Ramallo (03:44) That’s amazing. mean, that reminds me of how I met my wife. It was a summer flare. was a summer relationship. 11 years later, we’re still married.
Leslie Espinola (04:02) Hey, there’s summer fleas they’re meant to be.
Federico Ramallo (04:06) And we kind
of talk about it. It’s like, well, you know, this is going to be for, you know, for a few months because I was in Mexico for work, but, you know, I was coming back three months later, I was coming back, right? So, you know, and then I came back to Argentina. Yeah, but then I returned to Mexico and stayed. Yeah.
Leslie Espinola (04:25) Now,
nice. All right.
Federico Ramallo (04:28) So that was interesting. sometimes life is that funny, right? But I think it’s important that we seize those opportunities and we…
we try to take the best out of it, right?
Leslie Espinola (04:40) you
Yes, and he saw the opportunity as well. My father being my father, he saw that opportunity and he wanted me off his payroll anyway, or at least to get off his personal payroll and get into his business payroll and earn my way. And I, yeah, it just, was meant to be and, that is life. So, and I do often look back and say, man, I wonder where I’d be now if I had done that, but who knows, you know, it’s not what it was supposed to
Please.
Federico Ramallo (05:10) Right,
right. Isn’t that amazing? So what does a fractional COO actually do for a dental practice?
Leslie Espinola (05:12) Yeah, I was in it.
So when a dentist or owner, doctor needs something done and they don’t have senior leadership or they just don’t have quality leadership in their practice and they need to get things done, and it could be operational, it could be team development, it could be almost any systems in place.
They hire someone like me to come in and just do it. So the difference between coaching and being a fractional COO, I do both, coaching is talking them through how to get it done. Here’s what I’d like to see you do. Who is the person that’s going to help you get this done? I can give you all of the legwork. I can give you all of the ideas and recommendations, but you all are going to have to see it through. Well, a lot of doctors say, that sounds great.
and I love that, just come in and do it for me, right? So I don’t have to. So that’s a lot of the fractional work that I do. And I do a lot of that, a lot of it. I mean, I am on the road, I travel to offices three and a half weeks a month. So I’m in an airplane, you know, six to eight times a month, easily doing that type of work because they just don’t want to do it and they don’t…
maybe they don’t have somebody in the office who can see it through. And so I come in and I do that.
Federico Ramallo (06:46) Right, that’s interesting. It’s hard to find good leadership. And when you have a small operation, it’s harder because you don’t have a budget for a full time person. I’ve been on both sides where I hired somebody with more credentials for the position and less credential for the position.
you know, had good experiences, but you also had bad experiences where, you know, we end up paying too much money or we end up, you know, hiring somebody that is afraid to make the decisions, right?
Leslie Espinola (07:18) Right. And the thing about on-site leadership, and we call them, you know, practice managers or office managers or practice leaders, there is a true difference between a manager and a leader. But to understand that difference, you have to have the experience. And you have had to have had somebody
you know, mentor you on that. And so a lot of office managers, they’re hired, they were dental assistants or front desk administrators, and they did their jobs really well. And so then their doctor comes in and says, I want you to be my office manager. want to promote you. Well, what the new office manager doesn’t understand is that when you take that seat, you are should no longer be doing
the day-to-day tasks that go into what you were doing at the beginning of your career that made you good, right? You’re not personally dealing with the upset patient. You’re not sitting at the front desk and answering their phones, or you shouldn’t be anyway. And that’s so that you can do some more high-level oversight that grows and scales the practice.
And so that’s really the trap that happens when you’re on site office manager is that you can’t grow to that leadership level because you’re too busy ingrained in the trenches of it all. plus if you, you know, I’ve got, you know, to be exact, I’ve got 35 years of experience and there’s very few people who can say they’ve got that type of experience where they’ve been all over dental, know, specialty,
front, back, they’ve met all different people, worked with all different people, and sometimes that’s what it takes to train someone at that level. And who are going to get to do that? Right? Except, you know, you have someone like me come in and do that. So that’s why this position exists that I have right now.
Federico Ramallo (09:19) Right, right. it going from operation to management requires a whole complete different set of skills.
Leslie Espinola (09:27) It
does. And mindset shift. It’s a mindset shift. Yeah, you have to, know, being a leader is more about the people who perform the tasks and getting them to work at the top of their skill set to perform at an optimal level that grows the practice. And if you don’t know how to
Federico Ramallo (09:32) Right.
Leslie Espinola (09:52) leverage that or if you don’t know how to work with the team to get that then that’s when turnover happens. That’s when you know management is about authority and the title where leadership is about the people and the trust. So that’s why there you know that’s why there’s turnover in offices and and and managers just can’t take that next step up for leadership role.
Federico Ramallo (10:20) Right, and also what I’ve seen happen is that when you have a head that is a technician, I mean, as a doctor, it’s a specialization, technical specialization, right?
That means you are obsessed on the details. There’s so many nuances, but it’s all about that level of perfection. So when you try to apply that same ethos into managing people, it doesn’t work that way. I experienced that myself and it took my while to learn.
the skills of managing people, right? Or I’m in that process of learning more, right? Because it’s a whole different thing, right?
Leslie Espinola (10:59) Right.
it is. you know perfection is the enemy of execution. So we can’t we can’t want to be perfect at everything we do. We just need to move forward for the execution of it all and do the best that we can do. Perfection will set you back a couple of steps.
Federico Ramallo (11:24) Yes, when I started this podcast, I talked to myself to accept imperfection, right? Because otherwise I would not have launched the first episode. And then the second one is better, right? But.
Leslie Espinola (11:33) Right.
That’s exactly right.
Federico Ramallo (11:43) There were a of things that I didn’t like this, I didn’t like that, the audio, so many little details. Now I look at them and I realize how bad they are compared to the new ones. But I needed that process to learn. And the guests were great, great people. But still, there were so many things I needed to learn how to do better.
Leslie Espinola (12:00) us.
absolutely.
Federico Ramallo (12:13) So, so yeah, I am embracing imperfection as much as possible.
Leslie Espinola (12:14) Right.
I think we all need to do that. How often do we look in the mirror and want to see perfection on the other side of that mirror and it just doesn’t exist and it drives people insane sometimes.
Federico Ramallo (12:32) Yes, yes.
And the other thing is, if you don’t look back at what you were doing before and you see, this is bad or whatever, then you haven’t improved, because it means that you reach a plateau.
Leslie Espinola (12:44) That’s That’s right. That’s right. And there’s always room to grow. I there’s always somebody out there that can teach you more, something different, something better. And so we always have to look for those people that…
Federico Ramallo (12:47) So, you know.
Leslie Espinola (13:00) No more than us or no different stuff than us. We’re constantly learning. No matter what we do or what we know or how long we’ve been in an industry or sport or anything, there’s always someone out there that can teach us more.
Federico Ramallo (13:20) Right, yeah, completely agree. And having coaches that can help you and guide you, it’s so important. And I always think about why would a coach find coaches? And it’s a way to give back because they learn from somebody else and now they want to give back.
Leslie Espinola (13:44) That’s right. That’s right. That’s right. And you know, we have, we have coaching meetings at the DEO three times a week where all of us coaches get together and I get into these meetings and I think, wow, I must be the dumbest person in the room because they are so smart and I can’t compete where I don’t compare. But.
Federico Ramallo (14:02) Ha
Leslie Espinola (14:08) You know, and but there are certain things where, I speak up and they go, that’s, that’s, that was good. We didn’t think about that or that was right on. but I learned so much from my colleagues that I would have never thought of. And then I can take those to my clients and my members and the teams I work with. And it’s just always so important to be able to collaborate with people in that way. And I learn from the teams that I.
work with too. You know I learn something new every day from them who I’m trying to coach. I learn from them as well. It makes me a better person and a better coach.
Federico Ramallo (14:46) Right, right. And the other thing that you’re talking about, that reminds me to being able to put my ego aside. You know, I’m the one with the big ideas and blah, blah, blah, right? I think it’s natural we all have a little bit of that. Being able to humbly, be more humble and open to other people’s ideas and then, you know, engage on that. I think that’s amazing.
Leslie Espinola (15:16) We’re never the smartest one in the room. We don’t, shouldn’t be.
Federico Ramallo (15:20) Right, right. So where did you start High Peak Dental Advisors?
Leslie Espinola (15:25) I started High Peak Dental Advisors when I came to work for the Dentist Entrepreneur Organization because we are independent and so we start our own companies and we, you and I started High Peak because not only do I want to coach the DEO, but I want to do other things as well. I love speaking.
I love going to conferences and talking about leadership, dentistry, onboarding, team retention, all of those great things about dentistry that we need to know. I love speaking on that. And so I do that through high-peak dental advisors. I also want to be there for others who maybe want different lines of services that they need, maybe a revenue cycle management service. I’ll do that through my company.
at High Peak Dental Advisors. But that’s why I started. So I started it, you know, last year basically.
Federico Ramallo (16:26) Right.
That’s very interesting. I think that the human aspect of medicine practice is something that is invisible and has such a big impact on the organization and the quality of the service.
Leslie Espinola (16:41) Right. And I’ve always worked for large organizations, always, until recently. And it’s very different for me, and I love that I have had the opportunity to take this path.
to standing at the fork of the road a year ago and saying, all right, I’ve got this opportunity. Am I scared? do I, you know, I am scared. Do I take a leap of faith or do I go to what I know and stay with these big organizations where I am collaborating with a large team of people, where, I have support on the other side when I need it, where I’m making friends, I’m going into the offices.
Do I continue to do that or do I take a leap of faith in and believe in what I can do myself? So I took that leap of faith and it was the best thing I’ve ever done for my career and for myself and for my family and for the people that I serve at this point at this stage in my career because I’m giving so much more of myself than I ever did before.
Federico Ramallo (17:46) I think that the challenge in bigger organizations is that you feel a piece of the machine, right? And you’re limited to the box, right? This is your role, right? And then when you go to smaller organizations, there is no box, right? I mean, there might be the title, right? But basically you have a lot of freedom to do.
Leslie Espinola (17:57) That’s right.
Federico Ramallo (18:10) you know, different things, right? And you can see the impact of your work more directly, right?
Leslie Espinola (18:15) That’s right.
You know the the DEO organization is so supportive of us as coaches. I mean they back us 120 % if that’s even possible. What they provide for us is is so valuable to what we do. And so I give DEO and its leaders all the credit to this and I am just following and I and I often call my leaders at the DEO and ask for their
coaching for me, right? So I need some coaching from you and what’s my next move and this is a little scary. What are you going to, how are you going to coach me through this? And I do and I get that coaching and so I give DEO all the credit in the world to where I am in making this decision.
Federico Ramallo (19:05) Right.
So tell us a little bit more about the O. You you’ve been talking a little bit, but can you expand about what is your role and how they’re supporting the industry?
Leslie Espinola (19:20) Sure, so DEO is a, and I’m gonna try and get this right, it is a coaching platform where there are 40 of us coaches. We’re all experts in something different. There’s several of us and members or doctors.
DSOs will join DEO for the resources and the coaching that’s available to them so that they can scale to the next level. And those are the services we provide a couple of times a year or even four times a year. We do conferences like we’re getting ready to have the end of this week and they are focused on operations or revenue. We have a very specific
you
meeting twice a year on treatment coordination and case acceptance from an expert coach in that arena. And we all collaborate very closely. So when we’re meeting with our clients and our members, if we need to pull in an expert coach, we do. So that’s what it provides for the members who join DEO. It’s just this, it’s this platform of collaboration and other dentists who are going through the same thing that someone else is going to.
And then we have them at all different levels. have those $800,000 a year annual revenue practices, one location, all the way up to multi-location, you know, $20 million and more.
revenue streams and larger DSOs who are, know, a hundred million dollar in revenue stream with hundreds of locations and even though CEOs sometimes are part-time coaches at DEO. So it’s just this great resource for all levels of dentists that are out there who want more out what they’re doing.
Federico Ramallo (21:05) interesting.
Right. That’s amazing. And it becomes a self-selected group of people that are open to improve, right? They’re looking to improve, right?
Leslie Espinola (21:23) They’re
looking to improve and you know a lot of dentists are chair side, no they’re entrepreneurs. Every dentist that’s opened up their own practice is an entrepreneur.
But they get stuck chair side as a chair side entrepreneur instead of thinking at the CEO level at an executive level of I need to step back from the chair and allow my practice to make money for me. And what I need to have is high level oversight as an executive of my practice and pouring themselves into mentorship of their associates. And and that’s what a lot of the doctors want. They want to scale.
but they want to step outside of the chair to do it and they need to.
Federico Ramallo (22:07) When you say a chair, you mean that if they’re not there, the company’s not building, right?
Leslie Espinola (22:13) If they’re not there, the company’s not producing and that’s what we try and grow them out of. Right? So we don’t need owners, entrepreneurs to stay chair side all the time. If they want to do dentistry, that is their decision. Right? If they want to go in a couple of days a week and perform chair side dentistry because they love it, then we encourage that.
But most of them want to step out and be at that executive level, make more money, come up with an exit plan that works for them, scale to a DSO level, hire multiple teams. I mean, they all have different goals. And so we’re there to help them reach those goals.
Federico Ramallo (22:58) Right, right, because if everything depends on them, they can grow as far as their hands can go.
Leslie Espinola (23:05) That’s right. right. That’s right. The teams to able to operate without them in the practice all the time.
Federico Ramallo (23:08) And.
Right.
Right, otherwise they have a job. They don’t have a company.
Leslie Espinola (23:17) That’s right. That’s right. And it’s weighing them down and it’s tying their ankles.
Federico Ramallo (23:24) Right. So what does good leadership look like in a dental practice?
Leslie Espinola (23:31) People focused. Leadership is always people focused. A leader focuses on the people performing the tasks and grows and develops other leaders. That is what I find that all great running dental practices have in common, is good leadership.
And it is a person at some point in their career decided that they were going to stop being a passenger and they were going to start being a driver in the practice and lead the people that perform those tasks instead of directing the tasks like they are the only ones that know what work. So I just think good leadership is 100 % about the people.
Because that prevents turnover. It creates a great culture, which is number one. It creates a happy place where people want to be instead of getting that gut feeling on a Sunday night that, man, I got to get up and go to work on Monday. That’s not what you want.
Federico Ramallo (24:20) Right.
Leslie Espinola (24:38) It creates a steady influx of new patients because of the way they’re made to feel when they walk in the practice. Because patients don’t know if they’re getting good or bad dentistry. They only know the way they’re made to feel when they’re there. And that’s what good leadership creates and develops.
Federico Ramallo (24:58) Right. And, you know, patients can feel in the air the vibe, right? And that’s what they experience the most, right?
Leslie Espinola (25:05) That’s right.
That’s exactly right. And that’s what keeps them coming back. in my father’s practice, again, I was there for 15 years. We had less than 1 % turnover in those 15 years.
because
of our culture, because of the way that my father was not only with us as a team, but with his patients as well. People loved him. Even though he did great dentistry, and I’m not speaking to that because he’s my father, he did great dentistry, but the patients didn’t know the difference because they never went anywhere else to know the difference between good dentistry and bad dentistry. They stuck with us. And then all of the employees, we only added to our team.
So when I started with him, we were three operatories and there were only five of us in the practice. When I left 15 years later, we had 22 operatories, two surgical suites. We had eight hygienists. We had all specialty except for pedo. And we were a very thriving dental practice and we all knew our roles and responsibilities and we were very successful.
And our case acceptance was really, really high.
Federico Ramallo (26:25) That’s amazing. And is that model, your experience and that model that you are trying to implement with your, you know, what you advise, right?
Leslie Espinola (26:36) That’s
exactly right, because I lived it. I saw it. I worked through all the transitions we had when we grew and scaled that practice.
Federico Ramallo (26:39) Right.
Leslie Espinola (26:46) And you know, it’s not only about building out the practice and adding on to the practice. We went through three of those after I started. So we built out three times and that’s that’s hard enough as it is. But I’m going to date myself and tell you that when I started, you know, the practice management systems, electronic records was not available at the time. We were still using paper charts and and peg boards for financials. And we were
X-rays. I so I aged myself quite a bit there, but so all of those changes that have happened that continue to change today because AI has now come in and is really taking over and AI is amazing in this industry. And so watching all these changes and learning myself because when I left clinical, I left before AI was taking over. I left
Federico Ramallo (27:19) you
Leslie Espinola (27:44) when just the PMS systems were coming out and we were utilizing those quite a bit and we were taking digital x-rays then. Implants had really just hit the market and now AI is doing everything. They are helping with diagnosing for a young dentist coming right out of school. It is helping with notes and compliance. It’s just, it’s helping with writing
policies and manuals to scale your practice with systems and it’s incredible what it’s doing now.
Federico Ramallo (28:18) Yeah, I completely agree. I think it’s incredible. And I think that the limitations of the founder of the practice and the dynamic of the people becomes so much more important today because the AI productivity boost, you know, if those core issues are not solved,
then you cannot leverage the AI productivity boost.
Leslie Espinola (28:47) That’s right. That’s right. People have to be willing to change. That’s the great thing about operations is that operations is all about change. And that’s what I thrive in is change. A lot of people, it’s natural instinct to not like change. So.
So with AI coming on board, the way that I work with teams is that, you know, you may not be ready for change. And I know it’s hard. However, change is coming regardless of whether you want it or not. And you’re either stepping onto that bus and riding along with us, or you have to step off and go, go on because this is moving forward regardless. But the great thing about the AI with the teams is that AI is coming in and doing
those things that is so unproductive for the teams to have to do and which allows them now to be more patient-facing and customer oriented and focused which again is the cornerstone of success. It’s new patients, case acceptance and collections, right? So that’s the cornerstone of success.
Federico Ramallo (29:56) Right.
Leslie Espinola (29:58) And now it allows the teams to be more focused on that portion of it instead of calling insurance companies and trying to get breakdowns, know, trying to enter all the information into a system. You know, you might miss some phone calls, so why not have a little bit of that outsourced if necessary so you’re not missing a phone call during the day or even after hours. Utilize those systems and appreciate them for what they are.
Federico Ramallo (30:26) Right, right, right the wave rather than fight it. Yeah.
Leslie Espinola (30:30) Yeah, don’t fight it because
what’s going to happen and this is in all transparency and what I’m seeing lately is you have a seasoned person in the office. I call us seasoned because we’re older. You get ingrained in your ways and you do everything manually and they’re the hardest ones to get to change. And I often have to have those conversations of
You really need to jump on board. Otherwise, there’s not a place for you anymore. And I hate having to have those conversations. But they are being had more often than not. When you have an office manager or financial coordinator who’s been with the practice for 30 years or longer, and
Federico Ramallo (31:13) Right.
Leslie Espinola (31:23) They just keep doing things the same way and I come in because I’m all about AI and I find things. It’s my job to find things and I find areas where maybe success is not happening and I have to have that conversation with the owners and that person and they’re tough. But I’m finding that most of them will work really hard to jump on board. You know. And those few that don’t.
They just don’t and it’s unfortunate, but that’s where we are with it.
Federico Ramallo (31:56) Yeah, I don’t think AI is taking jobs. mean, they’re part of the revolution. Any revolution, there are some jobs getting lost by that. But I think that the jobs are getting transformed, right? And somebody that knows how to leverage AI is going to be able to take jobs of people that don’t.
Leslie Espinola (32:16) Right. And I have not seen any AI take any jobs out of the dental industry. You know, it enhances this industry and everybody’s jobs transform into something else. They are necessary. People are still very necessary in this industry. And I will I do not see that changing in this industry.
Federico Ramallo (32:24) Right.
Right, right. That’s very interesting that in dentistry you haven’t seen any job taken by AI. I think that’s a very important point.
Leslie Espinola (32:49) It is. It is. I haven’t and I don’t see it happening anytime soon.
Federico Ramallo (32:56) Right.
What other things do you see, you know, practice owners don’t know about running a healthy operation?
Leslie Espinola (33:07) Well, a lot of practice owners don’t understand their numbers. And that is the number one thing that they need to know in order to scale and be successful. A lot of them are disconnected from the administrative operations of their practice. All they want to do is demonstrate. And unfortunately, that’s when
you run into a practice that will never grow. So I always tell my owner doctors that you have to understand your numbers because if you don’t understand your numbers, how are you going to expect your team to move the needle? Right?
And how are you going to know what’s working and what’s not working? So if you’re not getting your end of day every day, then that opens you up to fraud, right? It opens you up to being stolen from. And it’s unfortunate that 70 % of all dental offices are stolen from and by a team member.
Federico Ramallo (34:10) wow.
Leslie Espinola (34:12) And so if you’re not on top of that, then this could happen to you. The other thing is you need to sit down with your leadership at least once a week and ask, how are things going? Where are we in the scheme of things? How are we doing with our numbers?
and be a part of that. And it could be just opposite. If the doctor does know the numbers, they need to be having that conversation with their leadership, right? Making sure they understand it. They need to be working in tandem and as a team. And so I think that’s probably the one thing that I find with a lot of people that I work with is that they’re just disconnected.
from the financial side and the administrative side of their practices, and they’re just sticking to the clinical.
Federico Ramallo (35:05) Right, right. They are still with the individual contributor chip mindset.
Leslie Espinola (35:11) That’s right. That’s right.
Federico Ramallo (35:13) The other thing I’ve seen happening is that they, know, I’ve seen this happening with leaders, probably applies for practice owners as well, when you have an organization, you know, there’s so many things happening at the same time. So when you’re doing, you’re not managing and, you know, you could have a negative net value by doing that, right?
and not realizing it because you feel you’re doing something,
Leslie Espinola (35:39) Mm-hmm, that’s right. And a lot of the times when they are so focused on one side of their practice, the clinical side, they tend to micromanage that clinical side of the practice. Instead of allowing their teams to perform at the top of their training and the top of their skill level,
They want to do everything, which slows them down. And they do that because they’re not involved in the front half of their business. So they just feel like the more they’re doing on the back half, the clinical side, then the more involved they are. But it’s really hurting the practice because you hire people to do a job for you. And you’re paying them to do a job for you. So let them do it.
Let them work so you can get up and move to the next thing.
and you get up and move to the next thing and the next thing. Or spend time in front of your desk or with your office leader learning more about the front side of your practice and where you can improve, where you can grow, how you can scale the team, where is the team, right? So you can’t afford turnover in this industry anymore because the candidate poll anymore in dentistry is very shallow.
And it’s really difficult to find quality employees. And we run into that every day, every state. It doesn’t matter. So you really want to be involved in the culture of your office and make sure that people are happy and that they know their roles and responsibilities and you allow them to take on those roles and responsibilities.
Federico Ramallo (37:22) Right, right. Delegation is a key part of running a business, And,
Leslie Espinola (37:27) Ownership. Yeah.
It’s ownership for what they do. If you have an action item that has no ownership, that’s like a to-do list that nobody’s going to do. So let people have ownership.
Federico Ramallo (37:38) Right.
Right, right, and that’s the context where you find a lot of people living, right? Living the practice, well, the organization, right?
Leslie Espinola (37:54) the organization. They are looking for a better culture. They’re looking for more money. They’re looking for more benefits.
And I’m not saying that in order to have a great team, you need to pay a lot of money or offer these extraordinary benefits and six weeks off a year, that’s not what it’s about. When you have a great culture, people will not leave you because you never know what’s across the street. And most, you know,
Most offices that have a poor culture will lose people very quickly within the first 90 days of starting. And so you have to get that. That’s one of the first things you have to get in line if you’re going to be successful is creating a really great culture for your team. And then they will be able to you and they will live through the difficult times with you and they will come out on top.
in the end with you.
Federico Ramallo (38:54) I was going to add something to that, but that’s amazing. I mean, what I was going to say is that when you micromanage people, you deprive them of purpose. Right. And that creates a condition for them to live.
Leslie Espinola (38:58) Please add.
Why not?
That’s right. I mean, you’re 100 % right.
Federico Ramallo (39:19) Yeah.
And I mean, it’s easy to say it. It’s harder to do it. So, you know, I also want to acknowledge that for the practice owners, right?
Leslie Espinola (39:30) Sure, sure.
And that’s what, you know, for me, that’s probably the easiest part. And it’s, and that’s weird to say. I just think for me, building a great culture and building, developing good leaders is the easy part.
It is implementing the systems. is getting the doctor to either give up some of the things he’s trying to control or be more involved in the things he doesn’t want to be in is the difficult part for me.
Federico Ramallo (40:01) Right,
right, yeah. The implementation, you know, and that’s why I find very interesting that you’re running your advisory practice because this is the hardest thing to do. You you can give the advice, but then, you know, the implementation part is challenging. Convincing the practice owner to…
Leslie Espinola (40:19) Is the right, right.
Federico Ramallo (40:24) to do those changes because that’s why we were talking about ego. It’s so close to their ego. It’s so close to their id, who they are.
Leslie Espinola (40:36) Right,
right. It is. It is. So yeah, that’s why we exist. But a lot of times, I can tell them all day long on a virtual meeting, but it’s the follow through where it fails.
Federico Ramallo (40:49) Right? Right, right. And I think that the impact of you being there, you know, flying and being with them makes a huge difference, right?
Leslie Espinola (40:59) it does and airplanes and hotels are my my home yeah so I do enjoy it I do very much enjoy it and the perks of it all you know I work very hard but I do like to vacation pretty hard as well when I do take them so there is a give-and-take
Federico Ramallo (41:05) Hahaha!
Right, right, yeah. Work hard, party hard, right? Yeah.
Leslie Espinola (41:27) That’s right. That’s right. Or just, you know, lay
on the beach. You know, I mean, that to me is a nice, nice vacation.
Federico Ramallo (41:32) Ha
Right,
right. So what is a win you’re most proud of from your career?
Leslie Espinola (41:41) Hmm. I’ve had several of them, but I think probably my biggest win and it happened just it’s happened within the last two years. I was working with an orthodontist and he had an office manager that he had for many, many years. And you know, the office managers who are set in their ways, who are managers and not leaders. His turnover was pretty high.
And he called me one day and he said, I need you to come into my office. I need you to meet with my office manager and I’m not going to say her name. I need you to meet with my office manager and I think we need to let her go.
And I said, well, that’s a shame. I mean, it really is after all these years. And she’s like a family member to you and your wife. And he said, I’m just not getting out of her what I need. So if you can come in and do something about it, Otherwise, we need to let her go. said, OK. So I went in, and I had one of those really difficult conversations that
is hard. It’s hard to hear. It’s hard to give, but it’s literally where growth lives, right? That’s, mean, these difficult conversations is where growth lives. And I was concerned that it was going to set her back, put her off or leave or worry she’s going to need to find another position. But instead that conversation went really well. And I told her before the conversation was over, said,
anytime you come across something that you’re unsure of or you want to talk just give me a call text me call me i will always make myself available to you and within six months of having that conversation with her and working with her she became one of the greatest leaders i have ever worked with in my career she turned the office around she built a culture like none other i’ve ever seen
And
the doctor was so impressed with her. I mean, he has elevated her to a level of decision making of you handle the team. I trust you with my practice. I’m going to step back and you continue doing what you’re doing. And she has elevated. And I am so proud of that because I feel like I had a hand in that because she was this close to being terminated because she didn’t know how to
be a good leader and had never had a mentor to work with her. And you know at you know she’s she’s in her upper 50s as well and she just never had that and instead and he gave me the opportunity to do that with her before he terminated her and I think that is probably one of the biggest wins I’ve had in my career that has made me feel the best about myself and about what was accomplished through it.
Federico Ramallo (44:38) That’s amazing because you literally changed her life.
Leslie Espinola (44:39) Thank
Maybe, I mean, I like to think that.
I could talk about leadership all day. Leadership to me is one of the most important things and I think her being open to working with me and having those conversations, she developed herself. She just needed somebody to give her the information and to give her the space and the feedback she needed to be able to do that. And I had that person, you know, when I left my dad’s practice,
As a clinical assistant for 15 years and started on the path that I’m on today. I had that person who who invested in me and who believed in me and who mentored me and who is now a great friend to me and every time I talk about leadership I see her face in the back of my head, you know and and I am so thankful because I look back on her after 20 years and I think that she’s the reason
are part of the reasons why I’m doing what I do today. Why I can sit here and have these conversations. Why I’m on podcasts. Why I get on stage and talk about this stuff is partly because of her. And so I want to be that person to other people. And I feel like my greatest win to date is that I became that person for this other person. Hopefully she looks back on me today and she says, she’s what I needed to build my career.
career. So that makes me feel really good.
Federico Ramallo (46:15) That’s amazing. think that the yeah, there is a an agency that they, you know, that people have to make those decisions, right? Whether they listen to you or not, right? But I think that your role becomes a catalyst, right? A catalyst in chemistry is an element that makes the chemical process happen or accelerate it, but does not participate in it. Right.
So, you know, but but it’s this idea of, know, the we are we are part of that transformation. Right. By by matching, guiding, you know, just giving the right feedback, the right time. Right. But at the end of the day, is there accomplishments? Right. But, you know, our participation helped to make it happen. And, you know.
I think it’s worthwhile to mention both, that it’s their decision, but also your contribution.
Leslie Espinola (47:08) Yeah.
That’s right. I’m much more effective working with people than I am with systems. Definitely. And they say that personalities don’t scale and that systems scale, but I don’t necessarily agree with that. I think personalities can scale. think personalities can grow. I think they can develop.
And then that’s what leads you when you’ve got the right personality and you can develop that personality that then you can pass that on to the people that work for you. And then you implement systems because now the people are more
and tuned. You know, the culture is so good, they’re like, yeah, let’s bring it on. Let’s bring it on and let’s do it. And if it doesn’t work, then we can go backwards and we can, you know, we can stop doing it and try something different. But when you’ve got a great culture because of great leadership, you can bring on anything and scale that way.
Federico Ramallo (48:17) That’s amazing. Leslie, we’re running out of time. I truly appreciated you being here today. Any final remarks, any final advice before we wrap it up?
Leslie Espinola (48:21) Thank
Well, I would just say, know, again, going back to that leadership, you know, look for someone who can mentor, who you can learn from, continue to grow. know, growth is lifelong. It doesn’t ever stop. And I’m continuing to grow every day. And I hope I become better and better every day that I wake up. And I want that for everyone else as well. And let’s just make this world a nicer and kinder place.
Federico Ramallo (48:55) Amazing. Leslie, thank you very much for joining us today.
Leslie Espinola (48:58) Thank you,
Frederico. I appreciate it. Nice to be here.