Offshore Dental Practice Team Members: A Solution or a Folly?

Gary Takacs: Welcome to another episode of The Thriving Dentist Show. I'm Gary Takacs, the Thriving Dentist Show podcast founder and co-host. We have a great episode for you today. The title of today's episode is Offshore Dental Practice Team Members, A Solution or a Folly? Hmm. This is a topic that we have not covered on the Thriving Dentist Show, and there is more and more evolution of having offshore support for dental practices, and we thought it might be useful to talk about this and put it on the radar screen a little bit. 

But before we get into today's episode, the next announcement I have is we have a top clinical tip from Doctor Jacob Dent. And this tip is fascinating. The 8 senses every dentist should know for better patient care. Again, the 8 senses every dentist should know for better patient care. By the way, you'll hear it audially if you're listening to the podcast audially, but Doctor Dent was kind enough to produce a video as well. And so there'll be a link in the show notes if you want to watch this. The clinical tip in video format. You can certainly listen to it in the audio, but you'll get even more out of it if you go to the video. Just go to the show notes and you can click on that, and you'll be able to watch it in video format. No further ado, here's Dr. Jacob Dent, the eight senses every dentist should know for better patient care.

Dr. Jacob Dent: Have you ever had a patient come into your office with special needs, whether that's an intellectual or developmental disability, or maybe just they're neurodivergent or neurosensitive, and you really felt uncomfortable or really weren't sure about the best way to treat this patient on your first visit? Because for many of these patients, dental anxiety or just compliance becomes a big challenge. So one of the keys that I find in my practice is desensitization tends to be the best practice when it comes to first visits and subsequential visits just to get our patients comfortable with coming to see us. Now, is there anything that you're going to do twice a year for 30 minutes that's going to make a bit of difference in their overall oral health or systemic health? Absolutely not. But one of the pearls that I try to give to all of my classes and to my associates is the best way to approach this patient population. I ask the right questions. We do a great job of asking our health history questions, but we do a very poor job of asking sensory questions, ways that we can improve their experience, but also help understand some of the challenges that they are facing that are really sensory related. 

For a lot of us, we know about the 5 external senses, but there's 3 internal senses that we also violate every time that a patient comes into our office, and those are proprioception, vestibular, and interoceptive. And when you look at all 8 senses that each person has, and we realize that a lot of our patients have dental anxiety, not just our patients. Patients that have disabilities or special needs, we realize that this could be applied to all of our patients. So here's my pearl for dealing with patients with either an intellectual or developmental disability or neurodivergent or neurosensitive: have them come in, especially if it's a child or someone that requires a caregiver, have them show you what it looks like at home. And when I say that, ask the parent or caregiver to be the dentist, meaning give them the toothbrush, put on some gloves, and let them demonstrate what it looks like at home, because I've always found the role of a new person and a new environment is a bad result. 

And if you have someone that can demonstrate the proper technique, the proper efficiency of how to brush at home in your office, your success as a hygienist or dentist will only go up. So first thing, let the parent or caregiver be the dentist first. But the second thing is in that first visit, make sure that you acknowledge the sensory issues and the struggles that the family is dealing with at home, because they're going to be your biggest advocates. They're going to be the ones who's doing the work day in and day out. And if you can do a collaborative care approach that allows them to have the tools and have the knowledge on how to do things properly, you will be amazed at the success of your dental visits twice a year. And remember, prevention will always outlast restoration. Thank you.

Naren Arulrajah: Hello, everyone. Welcome back to the Thriving Dentist podcast. This is Naren, your co-host. And I wanna take a second to thank Doctor Dent for that awesome clinical tip and for doing the video for us. Thank you, Doctor Jacob Dent. I really appreciate you. And if anyone has any questions, go to the website and send it in, and we would make sure that Doctor Dent gets it. Now, let's jump into today's recording, and it's all about offshore dental practice team members. Is it a solution or a folly? Is it something you should do or not do? Offshore dental practice team members. 

And my take on this, Gary, is the world has changed a lot. So if you had asked me the same question five years ago, I would have given you a different answer than the answer I'm going to give you today. Of course, you have a lot of experience because you work with practices. Some of them use it, some of them are successful. You have tons of experience, the good, the bad, the ugly, and I have some experience because I run a global team spread across 6 different countries, US, Canada, and other parts of the world. So I do have some experience with this idea of people who are not coming to the same office. So hopefully between our two brains, we'll have a wonderful conversation today.

Gary Takacs: Well, Naren, it's interesting because even just a few years ago, say pre-COVID. Pre-COVID, if someone said to me, offshore dental teams, what do you think of that? My first reaction would have been, offshore could be very useful in certain professions, in certain industries, it could be very, very useful. Look at customer service. Customer service is 100% outsourced. Every national company. Sends their customer service offshore, every single one of them, every one of them, 100%. And very mixed results. Some of it is quite pathetic, absolutely pathetic. And in other cases it's actually done very well. But I would have said, no, that's something that isn't going to apply to dentistry, because dentistry is a service, professional service that's delivered in person. Yeah, there are robots that place implants today, Naren, do you know about that?

Naren Arulrajah: There are, what did you say?

Gary Takacs: There are robots that place implants.

Naren Arulrajah: Oh, I didn't know that.

Gary Takacs: Oh yeah. Oh yeah, it's not necessarily new. But it's been, the robots placing implants. But I don't think dentists need to worry about being outsourced by robots doing the industry. However, we thought it was a topic that, this is more of a conversation. We're sharing some experiences and thoughts around it, and it's certainly something that is more possible today than it ever was before. And part of that was, when COVID hit in the spring of 2020, everybody was working remotely after that for a while. And so now, actually businesses have more experience with that, and part of that experience has maybe led to the experience that we had post-COVID, along with some technology that makes it more plausible, has made it something to take a look at. And that's really the purpose of this podcast interview, to, hey, let's talk about it and see if there might be a fit.

Naren Arulrajah: Yeah, absolutely. I love one of your favorite answers. It depends. It's an answer that fits many questions. Hey, should I add an associate? It depends. Should I buy my building? It depends.

Gary Takacs: Generally, the answer is absolutely, but if the building is priced at 5x fair market value, no, so. If it has some kind of problem that's going to cost you lots of money, then no. But certainly that answer, that generic "it depends" answer, fits very well. Offshore dental team members, solution or folly, it depends, could be either one. Let's unpack this.

Naren Arulrajah: Let's jump in, Gary. So, I'm gonna jump right in, and I'm gonna start by talking about your personal experience. I know you work with dozens of practices, and you know their businesses intimately. You work with the owners, you work with the team. Of course, you and your team support them, and your objective is to help them achieve their dreams, whatever their goals are, but more importantly, make this year better than last, and every year is the best year yet. So in that context, Gary, what has been your experience when it comes to offshore team members that your practices are using, and of course, how do you see it today versus, let's say, pre-AI, pre-3 years ago?

Gary Takacs: Let me answer the question very, very specifically.

Gary Takacs: I do have direct personal experience with an offshore team member supporting my own practice. And this happened in 2018, so pre-COVID. In 2018, we had the opportunity to do a test, and to test the concept of having a remote offshore team member that worked 40 hours a week. Covering our hours, spoke English, spoke impeccable English, supporting our practice, and it was a test, and I chose to participate in that test because I was intrigued, intrigued about how this could be done. And we had a team member, one dedicated team member working 40 hours a week, and I have to tell you, Naren, in every task we gave her, she exceeded. Exceeded our expectations many times over. And we started out, she was not trained, she was trained in business. She had college experience. I don't believe she was a college graduate, but had college experience. She's very articulate, very well trained, but no experience in dentistry. That was the ground rules going in, we'd have to train her. Well, that's what I do. So I trained her, and we started giving her tasks that had low risk, and these are the kind of tasks, there, every office has tasks that need to be done, that our team members never get around to doing because they're so overwhelmed with everything else. Does that make sense, Naren?

Naren Arulrajah: Yes.

Gary Takacs: For example, following up on unscheduled treatment plans. Every practice has a very large number of dollars in unscheduled treatment plans. And it's one of those systems that our team members typically put a low priority on. But sometimes that priority becomes a higher priority, because we need to work on filling the schedule. But there's many, many tasks that we would hand off to our remote team member. With proper training, everything she did, she did really well. Naren, we wanted to get to the point, I had a vision for this. And my vision was, I wanted to get to a point where she could answer our phones. We have a VoIP, a Voice over Internet Protocol phone system, so we literally flip a switch, and she can answer the phones. Remember, she's working our hours.

Gary Takacs: And the reason I wanted to solve that, Naren, this will be near and dear to your heart. Because we learned that we were experiencing a higher volume of missed calls during business hours because they were going to our voice message. I've developed a standard for that. Today, in 2026, we're recording this podcast episode, the goal is to have 10% or lower missed calls that come in during business hours, 10% or lower. And 5% or less is ideal. But at the time, we were up close to 30%. And I wanted to get to a point, I'm embarrassed to tell you that, but that was the reality, that's just the raw data. And those are people calling in. Now, in 2018, a person might have been more likely to leave a voice message. The message would say, we're currently taking care of other patients, kindly leave us a voice message and we'll return your call. Now, maybe in 2018, the number of people that would leave a voice message. Was something. I believe in 2026 that number is 0. No one's gonna leave a voice message in 2026. They're just gonna go to the next office in their search. So I wanted to solve a problem with a remote team member. I trained her. My daughter, who happens to be the office manager, also trained her. The other team members that are on the phones also trained her, and we got to the point where she could answer the phones. 

And we would flip the switch, so it solved the problem for us. And by the way, we knew it was working when new patients would come in, and her, it was a stage name. Her stage name was Victoria, that wasn't her actual name, but she went by Victoria. And new patients would come in. And it's, oh, can I meet Victoria? And we would say, well, actually, she works remotely. And they would say, oh my gosh, she was so sweet. Tell her Carol said hello. And we would say, you know what, we're gonna send a message later today to Victoria and let her know you asked about her. Please do, let her know she was fabulous. Yeah, that was not a one-off experience. That was something that happened routinely with new patients.

Gary Takacs: So that experiment worked extremely well in my experience, and the team loved it because they could push things downhill. To our remote team members. Some things that they either didn't wanna do, didn't do well, or it was just stacking up, they had no time to do it. And this is more relevant today than ever, Naren, because since COVID, we've experienced wage inflation. In dentistry, unlike any other time period in our history. Now, wage inflation has always been part of the game, wages go up. But in the post-COVID era, they have gone up at a higher percentage than ever in history. And in fact, it's led experts to revisit what is the appropriate percentage that we should be paying collectively to our team. That number has gone up according to the American Academy of Dental Accounting Firms. That's gone up, it's gone up. 

And so, what's the highest category here, and I'll put you on the spot, as a category. What's the highest expense category for any dental practice owner? Our wages, yeah, staff compensation, and so that's out of hand now. And so if there's certain tasks that can be done remotely, allowing our team members to focus on the things that can't be done remotely, such as interacting with our patients. Guess what could happen? That could be a good combination of things.

Gary Takacs: So, my own experience in that test, it was a year-long test, massively exceeded my expectations. Now, since then, in my coaching work, we've had many, many of our coaching clients utilize offshore support. Guesstimate now, Naren, but in our coaching work, I would guesstimate that somewhere around 1/3 of our clients. A third of our coaching clients are using some remote offshore support in some way or another. About 1/3 of our clients are. So it's not the majority. But it is being used, and I get to see the data, and I get to see that it's very good. The results are very good. And let's also add another element to this, Naren. We're in a hiring situation today that's unlike any other time period we've had in history. And that is that there are more job postings in dentistry, jobs available, than people applying for those jobs. Now, that's not just hygienists, but that's dental assistants, hygiene, administrative team members, office managers. There's more openings to fill than people filling it. Do you recognize that, Naren? Would you say that's true?

Naren Arulrajah: Yes, Gary. Absolutely, Gary. I do notice that for sure.

Gary Takacs: So now, there's jobs being listed. They're not even getting applications, let alone someone that they feel might be a good fit for the practice. So, you put all those variables together, and I am all in favor of domestic team members. Absolutely. I'm all in favor of that. I don't wanna take any jobs away from domestic team members. However, what if you can't find them? What if the task that they do, none of your team wanna do? Yeah, we can find team members that would love to do that, and do it at a fraction of the cost. It's something that I would invite an open-minded approach. Does that accurately describe your sentiment? My sentiment is, the idea of an offshore team member or team members in dentistry deserves an open-minded approach today. Would you agree with that?

Naren Arulrajah: I think so, Gary, with a few nuances, and I know you're gonna ask me some questions. Do you want me to save my thoughts for now, or do you want me,

Gary Takacs: we'll get into this in the nuances, and I appreciate your nuanced answer because I believe that that's what will allow any of our listeners to consider whether this might be useful or not. So let me start. Let me flip roles here, and I'll ask you some questions. Are you OK with that?

Naren Arulrajah: Yes, Gary

Gary Takacs: I'm gonna get real specific with my next question. What roles, you work with hundreds of dental offices. What roles do you think can be effectively transferred for offshore support for dental offices? Name some tasks and roles.

Naren Arulrajah: Great question, Gary. And I wanna address your question around how would I feel about your answer and what are the nuances. And I'm gonna mix the two, right? So, at the end of the day, if you take a dental office, there are things that you need somebody at the office to do. You are taking care of a patient, you need an assistant to help you as you go through and take care of the patient. You need a hygienist in the office to, again, work with the patient because they have to see the patient and work on the patient. And there are some tasks, technically, I'm talking about if you really, really strip it down to the base level. The person doing the work doesn't have to be at the office, right? For example, answering the phone, you already used that as an example. Technically, they could be anywhere and answer the phone as long as they have a good internet connection, as long as they're trained well, as long as somebody's monitoring them. All of those elements are there, it can be done.

Gary Takacs: I'd add one more thing, as long as it's cyber secure.

Naren Arulrajah: Exactly. Cybersecurity is very, very, very important, especially in healthcare, especially in healthcare. You don't want your data just going and getting sold. Let's say you have some patient data and somebody in Indonesia, I'm just picking Indonesia, I don't know why, is now selling your patients' information on the black market for 10 bucks, their credit card information, their name, their social security number, because some thief in Russia wants to use that information and do some nasty stuff with it.

Gary Takacs: It's happened. This isn't some sci-fi fantasy. It's happened. It happened in dentistry. It happened last year with a massive hack into one of the clearinghouses that they're still unraveling now a year and a half later.

Naren Arulrajah: Absolutely, Gary. I think that's a great point. So coming back to what I was saying, any task where the person doing the task doesn't have to physically sit in your office could be given to offshore. Now, if you had asked me this question literally 4 years ago, before we all heard of ChatGPT and AI, I would have said, yeah, great idea, because A, you have a staffing shortage, you can't find the people, especially people who are qualified, who can be trained, and this might be cheaper, and maybe there's some companies that train people to do certain roles in dentistry, and you can work with them to get it done. But I do think if I were to just look at my crystal glass into the future, I do think eventually AI agents. Will do some of these tasks. Is it all of them, by when? I cannot say that. 

For example, one of the tasks is dealing with the mess called insurance, right? Verifying, is it covered, is it not covered, sending the paperwork, then rejecting it, going back and redoing it, appealing it, all that stuff a human has to do. And as a dental practice, you are a specialist in dentistry. You have 20 years of training, extra training, you've worked on thousands of patients, so you know what you're doing. But the same question about, do you know how to deal with that particular insurance company in 2026? There is somebody who has done that for so many years, and he or she knows how to do that, right? So, I do think the challenge that practices face is how do I find someone who has that knowledge, specific domain knowledge, in my local community, and that gets trickier and trickier. So, if there are companies that specialize in that function, as an example, and can do it for you at a high quality at a low cost, you might be like, I don't want the headache, and I'm saving some money, let me go do it, right? With this, quote unquote, done-for-you offshore service.

Gary Takacs: Well, the insurance challenge, that is a perfect example: eligibility. Benefits verification, claim submission, claims follow-up. Every dentist listening to this knows that if they have a person in their office that's doing all that, eligibility, benefits verification, claims submission, claims follow-up, that person spends a heck of a lot of time on hold with the insurance company, that's part of the game. And do you want someone on hold at $28 an hour or a fraction of that offshore? That's a great example of a task that I think can be effectively handled offshore. And to be fair, there are onshore solutions to that. And I'll name one here, eAssist. Many of our doctors have experience with eAssist. The only problem I have with eAssist, Naren, what do you think the only problem I have with eAssist is?

Naren Arulrajah: Expensive, very expensive.

Gary Takacs: Very expensive. They do it well. I'll give them credit. It's a shine company now. They do it very, shine bought eAssist. They do it very well, but it's very expensive. But that's an example of something. And by the way, they're doing tasks where you're already getting a big haircut because of being a PPO provider, you're getting paid a fraction of your regular fee and then paying a mint to do all that process as well. You're getting squeezed on both ends there.

Gary Takacs: What would be some other examples of some tasks that could be done? I'll name some too, but what do you think are some other tasks that could,

Naren Arulrajah: for example, let's say you have a lot of patients who are not coming regularly to your practice, so you may want to do recall, right? Of course you can do reactivation. You could do texts and automation, but sometimes you need to leave a voicemail, that personal touch. So I think, as long as you can get people trained and you're monitoring them, you could technically go ahead and hire this company. And there are two types of. Companies where they sell you a person or a body, and they manage the body and they put them in an office and whatnot, then they might do a little bit of training, but you really have to keep an eye on it. Almost like an employee you have, right? You have to train them and manage them and stuff, and now you have to do it remotely.

Gary Takacs: Yeah, I say beware, beware of any company that says, oh, our remote team is plug and play. Yeah, that doesn't work. They may be very well trained on the task. They may be very well trained on your practice management software. That's another point. Today, if you have Dentrix, Eaglesoft, Open Dental, if you have Curve, if you have the majors, they know all that, so they don't have to train on the practice management software, but to say that anyone's plug and play. I believe is a gross overstatement. That team member, if it's one, that team member needs to learn your practice and understand the style and nuance of your practice to support it in a way that is seamless. This can be a seamless experience, Naren. That would be the goal. When patients would come in and ask to meet Victoria, that was seamless.

Naren Arulrajah: Yes, because they didn't know that she was remote.

Gary Takacs: By the way, if anyone would have asked, I would have shared it with them. I'd have said she actually works remotely. It happened to be offshore, and if they asked me where, I would have shared with them where, but it's kind of a complicated conversation. Nobody ever asked that. But there are things that can be done. What are some things you do that you transfer offshore?

Naren Arulrajah: Yes, Gary. So, in my experience, Gary, I run my team, going back to pre-COVID, work from home, and it happened because I just hated getting up in the morning, getting dressed, going to the office. And also it happened because I found you can get better talent in certain countries at a lower cost. So, for the same money, I can get double the value or triple the value for certain roles. So, I ended up building a team, and today, a lot of companies work from home, tech companies and so forth, after COVID, but at that time, it was very novel and new and interesting. Where people work from home, but they all got a salary. They all got vacation. They all, there were communities in different locations, so they would get together and meet up and do things. 

And I treated them like regular employees. I didn't really treat them like a resource that, I only have one of them. There are 300 people all over the world. They all work together, they all knew each other, they all had relationships with each other. So, I treated them like employees, and focused them on different areas. So one person or one team focuses on this part of what we do and somebody else does that part, and they got good at it, and they had managers and support and training and all that stuff.

Gary Takacs: So of course, post-COVID era, most companies have experience with remote workers, whether it be domestically or offshore. That's something that isn't like science fiction anymore.

Naren Arulrajah: Yes, because COVID forced everyone and they're like, yeah, it works.

Naren Arulrajah: Yeah, for sure, we're benefiting by that. So, Gary, let me go to question number 3 for you. Can you provide some very specific examples in your client offices when an offshore dental team member has been valuable? I know you gave me one example. Any other examples?

Gary Takacs: Well, let me go through a few. I'll just rattle some off really quickly. What we used to call collections in the practice, Naren, now has a much more sophisticated title. It's called revenue cycle management. That means collections. Everything related to payment in the practice, again, eligibility, benefits verification, claims submission, claims follow-up, all of that could be handled very, very, very proficiently and very well. 

Another example would be, you mentioned, following up on unscheduled treatment plans, following up on reactivating people that are past due in hygiene. Sending correspondence, the follow-up correspondence to patients, the things that have been developed and systematized in the practice, all of that. There's been some marketing support that can be done with offshore team members, for example, posting on social media. Again, they're not originating that themselves, they're the ones that are doing the posting work of it. So social media postings, that can be done very well by remote team members, and telephone support. Doctor, if you don't know what percent of the calls you're missing during your business hours. Then you might be in for a rude awakening, as I was when I learned that in my own practice. Doctor, we don't have a problem. We always answer the phone, Naren. Does the hair on the back of your neck stand up when a doctor says, no, we always answer the phone?

Naren Arulrajah: It happens at midnight. It's OK. It goes to voicemail.

Gary Takacs: But if you don't have data on that, you don't know.

Naren Arulrajah: I think most doctors don't have data.

Gary Takacs: They don't have data. You can get that data. You can get it from your marketing company. You can get it from your telephone company. Either way. It doesn't matter. It's just hard data. And when I discovered that ours was over 30%, I had absolute denial around it. No way. And then they showed me the data. It's like, oh my gosh. And this was from 7 to 4. Those were hours, 7 a.m. to 4 p.m., not midnight, not midnight. So phone support would be fantastic as well. Those are just a few of the examples that could be done. But anything that falls mostly in the admin area of the practice, anything on your project list that isn't getting done, could be a candidate for this, right? That falls in the admin area, for sure.

Naren Arulrajah: Thank you, Gary. Let me ask you another question I have for you. Can you define some of the potential financial benefits when the right offshore team supports a dental office?

Gary Takacs: You mentioned it earlier, Naren. It's not a secret. Wage scale for industrial nations is higher than areas of the country that don't have a lot of industrialization. So, wages in the US. Your wages are outrageous, Naren, in Canada, as you figure out how to tax everything, so your wages are just obscene in the country of Canada, but we could go to Western Europe, very high wages, UK, France. Scandinavian countries is very high, but there's underdeveloped areas of the world that have a lower wage structure. One of the things I was concerned about, Naren, as a humanitarian, when I was given this opportunity to test the idea, and I'll share the country. I won't share the name of the company, but I'll share the country. The country was Zimbabwe. 

And one of the things that I appreciate about Zimbabwe is it's an English-speaking country. Now they speak the Queen's English. It sounds like the Queen of England, but they speak English. But I wanted to make sure that these remote team members weren't working in a mud hut somewhere. I didn't want to support that. And we discovered that with the wages they were paid, they were able to provide an upper middle class lifestyle. They could own their home, they could own their car, their kids could go to private school, they lived in safe neighborhoods. It's hard for us when we look at the hourly rate, we look at that, and we say, how in the world could anyone live with that, but their expenses are a lot different. Does that make sense, Naren?

Naren Arulrajah: Yes.

Gary Takacs: And there's entire countries, entire regions of the world where that's accurate. And it's supporting quality of life more globally.

Naren Arulrajah: For sure.

Gary Takacs: But some of the financial benefits to the practice is lowering that wage overhead, especially if you're a PPO practice, because you are not controlling your fees. If you're out of network, you've got much more control over being able to give raises. As a practice owner, I know this may sound contrarian, but I wanna pay my team members as much as I can. As much as I can, within realistic boundaries. Because then I can attract and keep the best team members. And you can do that if you're out of network, cause you can set your fees. 

Now, again, do you have an unlimited ability to set your fees? No. Some of it is bound by market conditions. But when you're out of network, you have an opportunity to raise your fees to support the wage. Frankly, demands that are available today, that are required today. So I see some very definite financial benefits, because the highest line item expense is wages, is staff compensation, and if we could bring that, if you're in an urban area or either coast, it's 30% or less is our goal, and that's 30% of your collections, if you're not on either coast or a major inland city. Major inland cities, Chicago, Saint Louis, Denver, then in those areas, it's 30%. If you're in any other part of the country, your goal is 28% or less, because the wages are lower if you're not in a major urban area. So there are very definite advantages there.

Gary Takacs: Naren, I wanna ask you the last question. You have a lot of experience on this. You run an offshore team, you run a remote team. What do owners get wrong about managing people remotely?

Naren Arulrajah: Great question, Gary. I think the number one thing they get wrong is they think somehow these people come with a button, you press the button and everything goes smoothly.

Gary Takacs: Plug and play.

Naren Arulrajah: Yeah, that doesn't happen, right? Of course, companies like eAssist specialize in one thing, and maybe it's somewhat plug and play, but a lot of times, this person you're hiring that's part of another company sitting somewhere else, you still have to manage them, you still have to work with them and make them part of your team. So, in my experience, Gary, I treat them like any employee, whether it's in office or off office. We are very, very strict in the hiring process. Literally for every 100 resumes we look at, we hire one person. We go through several interviews. 

We could go through several assignments, depending on the role, they have to do different assignments, and only after they pass those assignments, they go through a round of 3 to 4 interviews. So you are really, really tough on hiring people. I look at the core behaviors, some people call it values, that make our best people our best people. What are those? Do these new people we're going to hire have those behaviors? And once all that is done, then you onboard them, again, training, 2, 3, 4 weeks, depending on their role, then some kind of an onboarding phase, 3 months, where they're being actively coached, mentored, monitored, helped, having that infrastructure. I love your quote, Gary, hire slow and fire fast, let go of people quickly. If it's not a good fit, you will notice it pretty quickly, and just trust your gut and let go, and create a team that's empowered to do that. And of course, nurturing the people, like in anything else, people could be great today and not so great tomorrow, so bonus plans, reviews.

Gary Takacs: An important element here of success with remote or offshore would be if you've got buttoned-down systems, you've got buttoned-down processes and systems. We have 24 in our coaching, 24 systems, and our clients that are using remote or offshore team members can. With those systems as the guide, as the guardrails, they have a lot of success with these team members implementing these systems, not necessarily all 24, but many of those, when you have systems. If you're flying by the seat of your pants, now imagine how it is flying by the seat of your pants if you have a remote worker that's 5,000 miles away. That isn't gonna go well. So this is a good reason to really get buttoned down with systems in your practice, because many of the times, these remote team members are able to make advancements in these systems the office was never able to do before. 

There's another element here that's a little bit murky, and it's kind of dark, Naren, and that is ethics and work, work ethic. I hate to say it, Naren, but there's a lot of people that really don't wanna work, domestic, don't wanna work here in the United States. They don't wanna work. I don't wanna sound like a grumpy old man, but they don't wanna work, and one of the things that I found. With my own personal experience with remote or offshore workers and also with our clients, and this was said very clearly by a client of mine. So he hired his first, as a larger office, multiple doctors, he hired a second one. And he says, fantastic. And he said, I'm filling positions that were going begging. No one was applying. But he said, you know what I like most about my two, they're dedicated workers, they're not floaters, they're dedicated people. He said they want the job. They want the job. And I think if you're listening to this, we've all experienced interviewing candidates now where. They're really not that motivated to work. Motivation plays a role.

Gary Takacs: And I wanna, as we come to the finish line here, a couple of comments. First of all, if marketing is one of the areas in your practice that you'd like to improve and you'd like to attract more quality new patients, I'd strongly recommend that you. Reach out to Ekwa, schedule a marketing strategy meeting, if that's something that you feel like is on your radar screen. Now, what's the URL, the best URL for them to do that?

Naren Arulrajah: It's ekwa.com/td . ekwa.com/td .

Gary Takacs: Yeah, Thriving Dentist. And if you'd like help with coaching, maybe help sorting this out and seeing whether remote might be a useful strategy for you. Yeah, schedule a coaching strategy meeting with me. Go to thrivingdentist.com/csm . 

Going back, offshore dental team members, is it a solution or a folly? It depends. It depends. I've got considerable experience with this. I'll be happy to share that with you and maybe sort this out for you. But do make sure to come back to the systems thing before you hire anyone. Whether it be in person, offshore, remote, make sure that the systems that they're stepping into are buttoned down, so that you can provide those guardrails to support a team member in your practice. Well, Naren, this has been a fun discussion. Admittedly, it's a controversial discussion. I'm OK dealing with controversial topics, but it's something that might be worth considering, and frankly, it's something that we found useful. 

I will tell you, Naren, our listeners may know that I do a lot of team meetings. We do those by Zoom, so we do it remotely, and very often remote team members are brought into our team meetings. And it's amazing to see how they flourish in the right environment. And I'm seeing them on the Zoom, they're remote, and I'm seeing them in that meeting, and they're asking questions, they're asking details, they're coming prepared. I'll challenge them and I'll say, hey, we're gonna have a meeting in 2 weeks, here's the report that I'd like you to come, and I want you to talk to me in detail about that report. And they are ready to go. And it can be very rewarding. 

Now, I'm not saying that's a universal experience, but it can be very cool. So, dental offshore support team member, is it a solution or folly? It depends. Well, guys, Naren and I will simply thank you for the privilege of your time today. And I hope this has been useful. But let us know. Send us a message, send us an email, let us know if you found this useful. And on that note, thanks for the privilege of your time, and Naren and I look forward to connecting with you on the next Thriving Dentist Show.