Podcast Episode 37 | Taking Risks and Reaping the Reward

Heather & Scott (MD) Paviol

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The Prosperous Doc® podcast by Spaugh Dameron Tenny highlights real-life stories from doctors and dentist to encourage and inspire listeners through discussions of professional successes and failures in addition to personal stories and financial wellness advice.

Shane Tenny, CFP® is our podcast host and Partner at SDT. He has lectured numerous times for hospitals and physician groups and, most importantly, helped hundreds of clients develop strategies to navigate through turbulent times toward their financial goals.

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Scott Paviol: 00:00 The higher you go up, the less people will tell you when you make a mistake. And I say, please, I want you guys to tell me when I mess up. The hardest thing is to get someone to tell you the real thing.

Intro: 00:13 From Spaugh Dameron Tenny it's the Prosperous Doc podcast. Real stories, real inspiration, real growth. A show for doctors who are ready to improve their overall wellness in every aspect of life. Now here's your host, Shane Tenny.

Shane Tenny: 00:32 All right. Welcome back. I am Shane Tenny. Glad to have you with us on this episode of the Prosperous Doc podcast. When we think about 2020 and the year that is behind us, there are a lot of words that I know come to mind. Unprecedented is probably the one I heard the most. Bizarro, stressful, crazy, a lot of other words that I won't say out loud here on the show. And we know, you know, that physicians dentists in particular found themselves in the epicenter of both the healthcare crisis of the COVID pandemic, and the financial upheaval of the economy, practice shutdowns, uncertainty over incomes and even your own healthcare. But we also know that there were a lot of bright spots during the storm. And today we're going to highlight one of those.

It's a scenario that I think some of you might listen to and say, "Well, that sounds lucky." But I would draw on one of the best definitions I've heard for luck, and that is when preparedness meets opportunity. So today I'm talking with the dynamic duo, husband/wife duo of Heather and Scott Paviol. Scott is a dermatologist, owner of Paviol Dermatology in Charlotte, North Carolina. Heather is an interior designer with a special affinity for healthcare spaces. And they both have a real passion for leadership, vision, culture, coaching. The last 12 months have brought some tremendous professional change and opportunity for their dermatology practice, but it's also opened up tremendous personal opportunity and challenge for their marriage, for working together, for building something new. We're going to cover the facts of their story in the first half of the show and the feelings of the story in the second half of the show, Scott and Heather, thanks so much for being with us today.

Heather Paviol: 02:22 Thank you so much for having us.

Scott Paviol: 02:23 What an intro. Thank you, Shane.

Heather Paviol: 02:23 Yeah.

Shane Tenny: 02:24 Well, we got to lay down our A game for you guys.

Scott Paviol: 02:26 Yeah.

Shane Tenny: 02:27 So 2020 was a big year for you. I know when we were talking over the last couple of months, I couldn't believe how it unfolded for you guys. Before I ask you to unpack the story though, what's the word that comes to mind as you think on last year and what it meant to you guys?

Scott Paviol: 02:43 For me, honestly, I would say God or universe. Whatever's accessible to you. For me, it was just a complete opening of possibilities that I had thought about, and Heather and I had talked about numerous times about better situations for us. And it just all came together and yeah. So just very much so in line with that.

Shane Tenny: 02:43 All right. So-

Heather Paviol: 03:07 I would say silver linings, or oddly satisfying.

Shane Tenny: 03:13 Both of which are two words, just to be clear.

Heather Paviol: 03:14 Yeah.

Scott Paviol: 03:14 Don't put Heather in a box.

Heather Paviol: 03:17 No boxes for me.

Scott Paviol: 03:18 Refuses to be in a box.

Shane Tenny: 03:19 All right. So we'll pivot off silver linings. What happened? Take us back to maybe the beginning of COVID and just where you were professionally, Scott. Mentally, emotionally, that sort of thing.

Scott Paviol: 03:29 Yeah. So Heather and I moved in together after I finished residency at University of Michigan. We were in a long distance relationship my entire residency, got married out of residency, and then joined a practice that was already successful at the lake in Mooresville, where I started as a fresh dermatologist. A young dermatologist. And worked really hard over the next six years and built the practice a lot with conversations with Heather and a lot that, I call it, my midlife crisis occurred during that time where kind of did all the things that I wanted to do. Paid off loans, built a practice, brought on a PA, built incrementally from patient base and a monetary standpoint year after year after year. Then boom, COVID happened. In the middle of that, I got a letter in the mail while I sat at my desk at Mooresville. It was an independent dermatologist's retiring two minutes from our house in Charlotte. And prior to that, I was commuting about an hour and a half a day. And that was kind of the spark that everything flowed from.

Shane Tenny: 04:36 And out of curiosity, I realize I don't even know from our prep conversation, had he sent the letter out to any and all dermatologists in the area? Was this a huge [crosstalk 00:04:44].

Scott Paviol: 04:48 Oh yeah. I'll get a little more seasoning to that. So I had earlier in the year, both had a conversation with Heather about maybe finding a place or starting a new place closer to home, and also prayed to have something. So I said, I don't know how, but I need some space created where that can happen. And I kind of gave up the control over it. And yeah. So this Dr. Shubach sent a letter to all the local dermatologists. I hadn't really heard of him. And the letter said, "I'm retiring in the middle of a COVID pandemic." He's an older doctor. He's 77. And he was trying to sell his equipment. So my front desk brought this letter to me, and I Googled him just because I actually thought we might need equipment at our office. And I realized it was two minutes from our house, and actually across the street from one of my best friends who's a [inaudible 00:05:43]. So I literally called Heather that day, and she's like, "You need to call him like right now."

Shane Tenny: 05:49 Wait. Did you call him, or did you call, Heather?

Heather Paviol: 05:52 I said, "If you don't have time to call, I will gladly call." But he was like, "No, no, no, I got it. I'll do it on lunch break."

Scott Paviol: 05:58 She made the subsequent call to Sweet B's position as we go down the road and got the neighboring suite that we're going to expand into.

Shane Tenny: 06:07 Okay. So stay with the story there. So you said ... I'm just struck because I don't want to miss the opportunity, which is we all have to remember where we were in March of 2020, which was it was DEFCON four on CNN. Nobody understood what COVID was, how contagious it was, and everybody in any sort of touchy practice, whether it's down in the mouth like a dentist or a dermatologist, was imminently facing their requirement to shut down. And you got a letter-

Heather Paviol: 06:35 [crosstalk 00:06:35] losing their office for a week on and off, because he had a partner at Mooresville, one position would be in the office and the other would take off. It was a very awkward time. No one knew what was going on, and they were still able to be open, but he had limited the number of patients he was able to see at that time. But before COVID broke out to where it was really affecting everybody, I would say, he just casually had said, "I would like to be in any space by August." And I was like, "Nobody starts a brand new business, number one, in eight months. And number two, in the middle of a pandemic."

Scott Paviol: 07:08 You got visibly upset with me.

Heather Paviol: 07:13 I was like, that doesn't actually make any sense right now, but okay. And then a few weeks later he received the ... He just screen shotted the letter. He took a picture of it and texted me. And I was like, "This is not serious." I literally couldn't believe it. So then he calls them.

Scott Paviol: 07:28 It all sounds great now, but we were coming off easily our best year at Mooresville. easily. I wasn't even accepting new patients. We were doing planning for a cosmic expansion downstairs with construction, adding several staff, and now looking at, "Okay, yeah, sure commute. But whoa, total restart."

Heather Paviol: 07:49 And he was already limiting the people that he was seeing at Mooresville.

Scott Paviol: 07:54 Yeah. Couldn't even accept new patients. So I called Dr. Shubach and he answered and I said, "What are you doing with your patients?" And he said, "I'm about one day away from sending a letter to them with three dermatologists who I recommend. I love my patients dearly. I've had this practice for 44 years." And I said, "Well, would you consider not sending that letter for a week, and maybe see if we can make this happen? And so I joked and I say he sent the letter out and he didn't think anyone would be dumb enough to take over the practice in the middle of a pandemic.

Shane Tenny: 08:25 And he found you. Yeah. So over the course of that next ... I'm struck by the fact that that is the exact sort of thing that would have been so easy had you all not been clear about your own goals and desires and wishes to say, "There's no way we can do this. There's too much uncertainty, there's too much fear. We were just crushing it up here. I'd rather drive an hour and have a practice that's thriving than take over." But instead, because you'd been clear about your own thinking and goals, when this letter came across it was like, "Yeah, this is exactly what I had been saying."

Scott Paviol: 08:59 I'll give Heather 100% credit on this, in that I probably wouldn't have ... I am much more risk averse, and she had prepared me and felt very strongly and supported me for many years to put me in that position where I felt comfortable doing that. Because it meant ... We had just moved into a new house, I'd put my heart and soul into the current practice, and I'm very attached to the staff there, and very proud of what I did, and I've always wanted to leave places better than when I started. I believe that I did that. So that was very calming for me. But yeah, it was a little bit both amazing and terrifying, and maybe not the smartest thing to do. And we had to make significant sacrifices because of that as well.

Shane Tenny: 09:40 And so over ... I think pretty quickly you came to the realization, "Okay, he wants to sell, we would like to buy, let's do this." And then I think you ended up doing a site tour and realizing having some epiphanies with a little bit of, Heather, your skill and vision and perspective. Yeah?

Heather Paviol: 09:57 Yeah. I don't think I realized how bold of a move that was until you just laid it all out there. Yeah. We had talked about things in years leading up to that, and we were just both in a prepared place, like you were saying. But when we visited the site, it literally was built in 1985, and they had paper records and I don't mean just a few. 14,000 of them. And there was one room just for deceased patients-

Scott Paviol: 10:24 Charts, not the bodies.

Heather Paviol: 10:28 Yes. And I immediately was like, "We need to acquire the next side of this building, because you're going to burst at the seams here." And I made a whole map plan of a whole bunch of moves that we can make over the next few years. And I just have had a vision for him, and for the things that we've discussed in terms of how we could ... He is so adamant on changing healthcare, and he will do a wonderful job with that. And I have the touch of like, "How can we actually do this?" And humanized experience within the facility itself, and the ways that you go about it. And so it just seemed like a great opportunity and space just to see what we could do within still yet another framework. We can't just bulldoze the building and start over. We're still working within constraints, which I think empowers creativity, ultimately.

Scott Paviol: 11:15 Yeah, so that was the other thing ... It was about ... My office that I shared with Dr. Simon was 5,000 square feet and a plan to expand another 3000.

Heather Paviol: 11:15 Downstairs.

Scott Paviol: 11:27 Yeah. And then this office was 1500 square feet.

Heather Paviol: 11:30 And he was so excited about it. He was like, "This is perfect. I don't need anything else. This is how I see it." And I was just standing there watching him and I was like, "He has no idea what's going on here." But it was fun.

Scott Paviol: 11:43 Meaning she immediately knew that we needed more space at some point. But I was just like, "This is a sign, I'm fired up." And she had a little more situational awareness from a property standpoint. I kind of knew the people, and she knew the space and the business flow more.

Heather Paviol: 12:03 He's actually never even spoken to the physician that sold us the left side. The part B.

Scott Paviol: 12:07 True story-

Shane Tenny: 12:08 You're referring just to help explain it for everyone. You ended up realizing, "We need more space," and I think Scott, you said, "Oh, okay." And then Heather you basically just cold called the other suite owner, kind of the adjacent space.

Heather Paviol: 12:21 Yeah. He actually took my call on a 10 mile bike ride, and he just took my call and he's like, "Yeah, what's up?" We had a few conversations and I just let him share what was going on at that facility. And then-

Scott Paviol: 12:35 He's a doctor.

Heather Paviol: 12:36 He is a physician. He owns multiple practices. And this is a pediatrician's office. And they had felt COVID more seriously in terms of volume. Finally he said, "I would be interested in selling at some point, and I gave it a few days and I called him back and I was like, "What about now? Is this a good time?" And he was wonderful. He was very easy to work with, and it was a really good transition. The physicians there and the staff there were able to move to another location, and then we acquired the bright yellow left side of this facility.

Scott Paviol: 13:06 And I'll add a little flavor to that. So my group, Piedmont Healthcare, doesn't deal in real estate at all. So they just buy leases to wherever spaces you occupy. And they're one of the reasons that I could move so quickly, because they are responsible for IT, and that's again, I was on the phone a bajillion times over this week, basically, of deciding, seeing if Piedmont was comfortable to commute to Charlotte. And anyway, so we had to purchase the building, which I need you to call my financial planners to figure out that's a smart move.

So I negotiated with Dr. Shubach for that to be able to get the space, because he wanted to sell. And then she negotiated separately without that doc even talking to me, she got a much better rate because we were like, "We need to close on the left side before they find out I paid for the right side," which was too much. And then so she got a way better deal on the left side, and we closed at the same time with two different owners. So they never found out who paid for what.

Shane Tenny: 14:08 It is a great story, as I have reflected on it. It was kind of thinking about our session today, that's why opened with, I think, a great quote, which in some ways it sounds lucky, and there's an element of things in life with your timing, but it's being prepared when the opportunity presents. And I'd punctuate your point, Heather, which is just ask. What's there to lose by just asking whether they'll be willing to sell, or whether they'll sell for this price, or whether they'll be ... If you don't ask, you don't know.

Talk a little bit about, I guess, just the early challenges, because we're laughing about it now a year in reverse or a year past, but there were challenges. Moving, setting up shop after you've come off your best year, you've got staff, you've got a 14,000 patient records, a whole room for deceased records. Was there a, "Oh darn," moment?

Scott Paviol: 14:56 Oh. I don't know, you could speak first maybe on that. I probably had five, "Oh darn," moments.

Heather Paviol: 15:02 Well, I immediately felt bad for the staff that had to scan all of those 14,000 documents.

Scott Paviol: 15:08 Yeah, about three weeks of scanning.

Heather Paviol: 15:10 It took them three weeks. But early on, while the humidity and the office is extremely high, the HVAC was questionable, there were multiple physical elements of the building that were interesting. There was a leak within the first month, and I was like, "Wow, this is so fun."

Scott Paviol: 15:26 Cut down a couple trees under the cover of darkness to avoid the HOA.

Heather Paviol: 15:33 Oh great. And I don't know, I think that it was ... We just went in and I think there was a moment for both of us where we were like, "Wow, we just bit off a huge chunk of something that we weren't really anticipating." And it's funny to hear people tell me about their 2020, because they're like, "It was so ... I read all these books and I watched all these movies, and it was so restful." And I was like, "Rest." So we don't do that very well, apparently. We just buckled down and got the office ready to open as quickly as possible, and we wanted it to be welcoming, and I don't know. What was another thing [inaudible 00:16:04]?

Scott Paviol: 16:06 I really wanted to be intentional about ... I really felt like it was a very unique opportunity to have staff buy-in from the beginning, and my talk to them was, "You've got a chance to be a part of a new practice DNA that has existing patients, but you guys are scrubbing some of the walls, scanning the charts, I'm willing to involve ... My wife is involved in this, and it's kind of like a startup mixed with an established practice with Piedmont." So it was a really nice blend of things. But yeah, I think the thing that always gave us confidence, at least me confidence, is I know that we have skills. And if you do right by people, I know if I'm in the room and I'm doing right by the patient, you can't lose that. So that's how I ground myself when things get scary. Or I remember how good Heather is that design, and I just know how talented my team is. And that's very grounding for me because, yeah, you can get caught up in your head on a lot of big stuff.

Heather Paviol: 17:05 It was this weird sensation of rush, rush, rush, rush, rush, purchased the building, him working with Piedmont, all these inner working things that there was a lot going on that I don't think that everybody really knows, because everybody was doing their jobs, actually. Everybody was doing their role in playing it to the best that they could and communicating that process. But it was a lot of hurry, hurry, hurry and then pump the brakes immediately in certain situations. So one of the big things that's still ... I would say it's a challenge, is to merge a tenured staff with younger staff that knows the way that he works.

Scott Paviol: 17:42 Yeah. Tenured meaning we retained Dr. Shubach's staff, who were a staff of two. One, our office manager Pam, who's has been there for 31 years, and Becky, the front desk flash MA who's been there for 13. And then I brought my squad, who I was familiar with, I knew were exceptional, from my previous practice. So you got a lot of emotional stuff there, honestly. I was both aware and unaware of you put your foot in your mouth sometimes, or you miss opportunities.

Heather Paviol: 18:12 It's been a cool challenge to see just, because they know him inside and out, but then me being around and present and involved allows other people to share stuff with me. And so it's just a cool dynamic to see. And also not to avoid ... Pam, the office manager shared, she was like, "It felt like everyone was just coming in and taking all this stuff out that had been there for 31 years." And that kind of broke my heart a little bit, and I wish there was more awareness around it. And I apologize for that. And so it's just cool to see everybody merge, and that is still a work in progress, and will continue to be. But it's also exciting too, because everyone's learning each other.

Shane Tenny: 18:49 Yeah. It's an opportunity. I want to talk a little bit about that and your involvement, Heather, and just the culture that you're building right after this break.

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So Heather, right before the break you were talking about just merging and assimilating the staff and just you being there. So your professional training is interior design. How much are you at the practice, or were you? Was that daily work for awhile? Are you still there a bit? Because I know you've developed a relationship with all of the team.

Heather Paviol: 20:50 Yeah. So I guess leadership development and organizational performance has always been like something I'm very, very interested in, and especially in health care, for different reasons. But I actually had an office at the NC Music Factory that was a co-working space that's no longer there. And working at home, obviously, is frustrating sometimes. So actually the side that we bought, the yellow pediatrician side, I made a section of that my office. And I try to be very mindful of if they're coming in and out of there. But I think that it was interesting because I never felt like I could be involved before, especially because he's a part of Piedmont. And I think other people make ... There's assumptions and stigmas and social structures that are in place where people are like, "Husbands and wives shouldn't be working together." So I actually had the office manager and one of his staff members that he brought from Warrensville, and they were like, "You need to insert yourself more." And it was really because they love that I'm there. They love that I have their back and I'm a part of them. And it does feel like I'm a part of them. I don't [inaudible 00:21:51].

Scott Paviol: 21:51 Yeah, for sure. Right off the bat when I got us school, I was really not open to Heather really being a big part of the practice.

Heather Paviol: 22:03 But he needed all the business coaching on the side, for free. For free.

Scott Paviol: 22:07 Yeah, I owe her a lot, truthfully. But over time, and especially with this, it's been really awesome. I just completely have wanted to for a long time. And now I'm graced, her being part of the practice also. Because she makes me better, she knows stuff that I don't know, times a 1000. I don't even want to imagine what the office would look like if Heather wasn't doing the design. I can only imagine, and it's just been really great, and I think people see more of me also with Heather being there more often. And she just ... I don't want to just give credit to the south, because it's not just because you're from the south. She's so warm, she brings the staff coffee, she's always so thoughtful, writes little notes to the staff. And she's just the most thoughtful person in the world and makes me more thoughtful because of it.

So it's really nice to, again, break away from some of that dogma of separate home and work and whatnot.

Shane Tenny: 23:03 Right. So it doesn't work for everybody, but for you all, in general you've been able to ... It's worked, it's been beneficial.

Heather Paviol: 23:11 I'm more strategic, visionary, design, business oriented, and like the operations and how that goes and organizational performance type stuff, and truly leadership. And then he's the deliverer. We have conversations and I'm like, "Go do it," and then he'll go do it. And then the buy-in is insane. And I know that if that came from me, even if it were a separate group of people, it probably wouldn't be that way because I don't have that finesse that he has. So we just know our roles.

Scott Paviol: 23:38 Yeah.

Shane Tenny: 23:42 I think it's a great point to not only be able to identify your uniqueness, but also then be able to appreciate it and operate within it. Now with that said, I don't think it'd be disingenuous to present that it's always roses all the time. Where do you butt heads? What are the things that have driven you crazy or where you end up getting stressed or frustrated?

Scott Paviol: 24:00 Let me preface that by saying when this happened, both of us were like, "We need support in multiple facets." So we got marriage, counselor, I have a therapist. There's a lot of stuff, it's high stress and lot of things happening all at once. And so did feel the need to do that. But go ahead on where we butt heads.

Heather Paviol: 24:21 Everywhere. No, I think that ... I do too have a therapist on my as well. I think that it's us being able to ... One of the best things I've ever heard is that it's assertive style speaking. Our therapist told us that. And having that as sort of self speaking really helps, but we were butting heads-

Shane Tenny: 24:37 What are you saying there? [crosstalk 00:24:38].

Heather Paviol: 24:37 Assertive style communication.

Shane Tenny: 24:40 Assertive self, gotcha.

Heather Paviol: 24:42 Yeah. Assertive style communication. That has been very useful, so we're not taking anything personal when we're sharing and you're just allowed to share it. Now we've been through a lot of things to get there. But we butt heads on boundaries, conflict, and the ability to deal with conflict and how to be aware of conflict and how to communicate that conflict. And I think that until you have those boundaries and you're able to face some of those things, your personal life and your work life can really just overlap. And so a lot of it was originally arguing about him bringing home work stuff, and then just spewing it everywhere. And then our life constantly became everything about his work. And for me, I lost myself a bit. I'm usually not that type of book person, but I was, and I'm a very independent person and I'm very opinionated, and I found myself just mopping up the mess that he would bring home, essentially. And also innately wanting to help, and having expertise in that area I wanted to share. And he wasn't welcoming that very much at first. And it took a long time for us to get to a place where we were able to be able to do that. But I would definitely say conflict, communication, and boundaries.

Shane Tenny: 25:55 Talk a little bit about the marriage counseling, because I know that's so valuable. And I'll personally vouch for it as well. 22 years in a marriage, and I spent a lot of time in a counselor's office. I know a lot of people see it as the stop of last resort or a desperate move or something like that. Scott, it sounds like you almost saw the tidal wave coming, and took in counseling as a preventative measure a bit. [crosstalk 00:26:17]

Scott Paviol: 26:16 Well, [crosstalk 00:26:19] and again, five years ago I wouldn't have told anybody that we were in marriage counseling. But now I try to tell people because I've seen that it helps and it gives you that ... Part of it's that we also went through a coaching program, and we're both like ... We know that if you work the process, it helps. And so we've been open to that. It's just something to work on and gets you better. I don't know.

Heather Paviol: 26:43 Two things that popped in my head just now when he was saying that is I had a coaching program. And one thing that that afforded us was the ability to speak the same language that was outside of what we were conditioned to know before we'd gotten married.

Shane Tenny: 26:59 Give me an example.

Heather Paviol: 27:00 I married the doctor. Now I'm the doctor's wife that drinks Starbucks then goes to Pure Bars. And then I'm supposed to do all the work at home and take care of this stuff, and yet I'm also supposed to be doing whatever that is that my job is at the time. Because that's how your things are interpreted. And his was, "I'm the male figure. I make all the money, you do all the stuff at home." And that was just a weird thing.

So when we went through the coaching program, we were able to speak the same language. For example, like, "Come from your essence." That's something that we learned in coaching. And that means, when you come into a room, how are you interpreted by other people? And essentially that's your essence. And we were able to see each other's essence, and speak that word essence in different scenarios, it really just allowed us access to one another. And during the coaching program, my coach actually told me, Alice, she said, "Ride the horse in the direction that it's going." And I think that's really important. Choose the same horse, just ride the horse in the direction that it's going, instead of trying to retrain the horse.

Shane Tenny: 27:00 Is Scott the horse?

Heather Paviol: 28:03 No, there's just a horse in the practice.

Scott Paviol: 28:06 I'd say it's more like ... Because it's really bigger than the practice, what we like to talk about. A lot of it is the practice is almost the playground that we bring our thoughts on healthcare together, both from a design and a patient experience and a culture standpoint. I think we'll do things in addition to Paviol Dermatology's walls, but also is a platform where we can show people how medicine can be, and really rewrite the healthcare experience. Even at a smaller practice that can be translatable.

Heather Paviol: 28:46 And working together as has been a while. I'm not employed by Piedmont, but my work is really to support his vision and our vision. And I think when you tell people that you're in therapy, they kind of go, "Whoa, what is that?" That's one thing. And the other one is like, "Oh, you do a lot of work with your husband?" That's another thing. So I think that having on a therapy, ultimately the other thing I wanted to say, is that it taught us to value one another without it being a metric that most people think. Like, how much money he makes, or how many tasks or chores are done, and just really see what each person is bringing that is in service of our relationship and what we want to create.

Shane Tenny: 29:28 And because you have close physical proximity, Heather, with essentially using part of the space that's in the office and being there, your relationship together, and you're inner working dynamic, that's very visible to the staff. And Scott, you were talking about just how much warmth and care you bring, Heather. That's almost setting the tone for the culture that we want to have with you. And then ultimately with the patients.

Scott Paviol: 29:28 Yeah.

Shane Tenny: 29:54 I'm kind of struck by what you are acknowledging, which is we're trying to set a new way and a new tone, both for your squad that you brought with you, for the team that you inherited, and trying to set that new tone. And it is also a real that there can be tension, there can be division, there can be hurt feelings between the old way and the new way. I know you guys are both real keyed into leadership and culture and things like that, so what things have you done intentionally, or been aware of that you've done to try to bring everyone together and centralize the culture and the focus?

Scott Paviol: 30:27 For me personally, a couple tangible things. I really like getting people to do things that nobody's good at. So I think cleaning the office, getting all that set up, doing things that nobody has turf over is really helpful as far as team building. And then Heather had a great concept that I brought to the staff, again one of these walk in meetings that we do, and she gives me a great idea, and then I bring it to the staff. But like the concept unlearning and recreating from there.

So I had a conversation with the staff last week and said, okay, stuff at the fan. Everybody brought all their stuff from the old office, stuff from Dr. Shubach's office, we've got a couple of new hires from other offices. And so now we need to acknowledge that there are ways that we're used to doing things, and now we have to come together and create a new way that we're going to do something, now that we've got a little traction, how can we create our new way? That's actually Paviol Dermatology.

Heather Paviol: 31:27 Reassimilate

Scott Paviol: 31:27 Give up some of the stuff that we don't want to bring with us.

Heather Paviol: 31:30 And how are we going to bring in people that we add to the team? And they're bringing more people. That's been really cool to mandate.

Scott Paviol: 31:41 And then just I was very poor at speaking the elephant in the room, or calling out conflict in the office. And I'm still not great, but I really do believe, and I know it works, and I'm still not great at it, but having the difficult conversation before it becomes a bigger deal. So calling out the stuff, it's usually if you trust the person that you have respect for. You can talk about pretty much anything if they know that you generally have they're best interest in mind. And I try to do that with everybody, including ... Heather does it with me, I do with her, just have the conversation. You have a deeper relationship that way, and people trust that you're not withholding stuff. And that was a mistake I made a lot earlier in my career. I just wanted to be the nice one.

Shane Tenny: 32:18 Yeah. I remember from a coaching program as in years ago, the mantra was, "If you think it or feel it, say it gently."

Scott Paviol: 32:30 Yes. [crosstalk 00:32:31].

Shane Tenny: 32:31 The key part, but if you're thinking it or feeling it, you got to say it, you got to acknowledge what this is, gently.

Heather Paviol: 32:38 It's fascinating to see. I was in a meeting with Pam and Scott, and she was able to share stuff with me, and I immediately looked back at her and was like, "Remember what you shared with me?" And she said, "Yeah." And I was like, "You need to share that with him. That is the relationship that you two should operate." And the same with him and her.

One of my favorite things that Scott does with his staff, and I'm so proud of, because I think it's something that we really believe in, and it's offering a space where people can make mistakes without being penalized, or just scolding, or it's very easy to respond in a weird awkward or frustrating way, especially when your numbers aren't where they want to be as a new practice. And you knew where they were, and despite the pandemic, they need to be here because we have to pay all these people. It's very easy to respond in a certain way. And I think that he does a fantastic job of allowing them to feel like they can fail and/or fail, and supporting them in that process. That's one of my favorite things that we do.

Scott Paviol: 33:41 Well man, I'll give you a good story. This happened this week. I'll give Daniella a shout out today. So every meeting we have a bandaid award where someone says, "I have this mistake," and I try to do that to normalize that everybody makes mistakes. And then when we talk about did we need to change anything, or was it just human nature? Do we need to change the process? So Daniella sent in a little bit wrong prescription, and ultimately our staff member found out, told Daniella. Daniella then called the patient, admitted her mistake, and made it right by her. And I listened to her make the phone call and she did an exceptional job. She owned the whole thing, and the patient ultimately had a stronger relationship with us because of it, because we owned it.

I said, "Daniella, how'd that phone call make you feel?" She said, "I'm sweating terribly right now. I feel awful." I said, "Don't forget that feeling. Okay. Let it sink in. You've got to remember that. But you also remember that nobody died, and that you're okay. Think about it for five minutes and then we've got to go forward, and you're okay." Don't say things like, "I'm a loser. I suck." That's not productive. You got to say, "I made a mistake. I owned it. I had the conversation, and now we're going forward."

Heather Paviol: 34:50 I think it's really powerful too, because there is this thing that permeates in certain physicians offices, where everybody wants to make the physician happier. Their job is to make his life easier, more efficient, and ultimately happy. And so it's really cool for him to give them that space.

Shane Tenny: 35:07 I so think so, just from a leadership standpoint too, to humanize. We all put our pants on one leg at a time. Scott, I love the idea, and I might steal it, the band-aid award. Which is, we do make mistakes and it's okay, and we're going to fix it. And then culturally, I'm setting the tone that this is an okay space, which breeds ultimately the trust. When you build that culture, then the party that benefits the most is not just all of you. It's the patient.

Scott Paviol: 35:34 I'd rather we found out about the mistakes when they're small, instead of people hiding them until you have a bigger mistake.

Heather Paviol: 35:40 And ultimately it allows him to be on the same playing field with them, because he makes mistakes too. Everybody makes mistakes. So it builds integrity and trust within the whole network, which awesome.

Scott Paviol: 35:51 I'm going to say one more mistake thing, because I think it's really important that I realize that the higher you go up, the less people will tell you when you make a mistake. And I say, "Please, I want you guys to telling me when I mess up." The hardest thing is to get someone to tell you the real thing. So I really respect. I want my staff to be like, "Hey, that wasn't cool." Or, "Hey, you messed up there." Please. I love that. I'm totally down with that, because otherwise you get a bunch of, yes people around you, and you're not getting any better.

Heather Paviol: 36:15 That's probably why our relationship works together.

Scott Paviol: 36:18 Yeah, she calls me out.

Shane Tenny: 36:20 Heather's generally willing to help point out.

Heather Paviol: 36:22 I'm like, "Here it comes gently. Are you ready?"

Shane Tenny: 36:24 Or just, "Here it comes."

Scott Paviol: 36:27 I make mistakes all the time.

Shane Tenny: 36:29 Well, I'm so grateful for your time. I think the story of 2020 in the Paviol household as a captivating one. And I'm struck, maybe to just put a bow on it, I'm struck with the evolution of what you all are creating with your skill set and your vision. Because there's so much a medicine that's drilled in and it's clinical. It's clinical. I get 10, 12, 14 years of clinical, clinical, clinical, and there is more to patient care than clinical. And Heather, it brings in your vision for space and beauty and color. And how does it feel? And so I'm building a little PowerPoint in my mind here. I got clinical, I got the space and the look and the feel, I got the culture. How is this patient treated? And in some ways, all of that is as important as the clinical care, I think. And so I think it's just a tremendous Testament to who you both are, what you're building together, and the impact you're going to make on your patients in your community. So congratulations to you.

Scott Paviol: 37:27 We want to follow up 2022, and see if we're still feeling good.

Shane Tenny: 37:36 Excellent. We'll do the Paviol Dermatology recap in a year. See how it's still going. So thanks for being with us today.

Scott Paviol: 37:36 Thank Shane.

Heather Paviol: 37:36 Thank you so much.

Scott Paviol: 37:44 It's a real pleasure

Shane Tenny: 37:45 Yep. Thank you for joining us for this episode of the Prosperous Doc Podcast. We do release new episodes every other Monday, so check them out. Subscribe. We'd welcome your reviews, and I love getting emails from you if you're listening and you have a colleague, or a story to tell, or a topic you'd like us to tackle, you can email me directly. Shane@whitecoatwell.com Thanks. We'll see you back here next time.

Outro: 38:12 This episode of the Prosperous Doc podcast is over, but you're not alone on your journey. Spaugh Dameron Tenny has been helping physicians and dentists prosper through financial planning for over 60 years. To connect with us, visit SDTplanning.com today, and take your financial wellness to new levels. Join us on the next episode of the Prosperous Doc podcast.