Joe DeLoss: Here you are hiring somebody for, call it, $14 or $15 an hour for an entry-level position. That person has spent 90 minutes on a bus to show up to work. They’re worried about their rent payment next month, and the benefit you offer them is a 401(k) that you might be able to tap into when they’re, you know, in their 60s. It’s not a relevant benefit.
Erika Grotto: Healthcare lessons from unconventional sources, today on HFMA’s Voices in Healthcare Finance podcast. Hello, and welcome to the podcast. I’m your host, Erika Grotto. On today’s episode, our president and CEO, Joe Fifer, is interviewing the first of two speakers from our upcoming Revenue Cycle Conference. Joe DeLoss is a social entrepreneur and restauranteur who will be talking about what the healthcare industry can learn from other industries. His approach is so interesting, and I think there’s a lot here for our audience. So without further ado, here are Joe and Joe.
Joe Fifer: My guest today is a unique addition to our podcast. Joe DeLoss is a social entrepreneur whose latest venture, Hot Chicken Takeover, is taking over the Midwest with fried chicken plus a community spirit. We’ll get into that in a few minutes. Currently, Joe is the owner of six Hot Chicken Takeover locations in Ohio, but he actually began his career in the finance world as an investment bank analyst. His passion for entrepreneurship and community impact then guided him to create an unconventional workforce and HR strategy, and those are the kinds of things we’re going to get into in a few minutes here. He’s actually going to be a keynote speaker at HFMA’s upcoming Revenue Cycle Conference, and I’m just really excited to talk with him today about what the healthcare industry can learn from what he’s doing in a different industry. So welcome to the podcast, Joe.
DeLoss: Thank you so much, Joe. I’m really excited to talk.
Fifer: Yeah, and I will not forget your name today, I promise.
DeLoss: Me either. That’s helpful.
Fifer: Yeah, there we go. So for listeners who might not be familiar with you and what your work is, or maybe even wondering why we’re talking about fried chicken on a healthcare podcast, could you just give us a little background and talk about some of the unique things you do in your business?
DeLoss: Yeah, of course. Thanks for having me, and yeah, it is a little unconventional to have a fried chicken entrepreneur on a healthcare podcast, but I promise, there are connection points. And so, you know, for—really, forest from the trees to just introduce myself a little bit more, more than anything I’m an entrepreneur that has been just, from a really young age, deeply interested in imagining ways to do business and imagining ways to engage customers and employees in different ways. And that passion for entrepreneurship, for me, was also paralleled with a passion for community service and impact through much of my life. And somewhere along the way, I had a great mentor that told me there’s a name for this called “social entrepreneurship” or “social enterprise.” And I became kind of a student of the discipline, and the combination of those two passions of mine are really what led me to this current adventure I’m on, which is that in 2014, I started a fried chicken business called Hot Chicken Takeover in my living room with my wife, and taste testing with friends. It was a heck of an adventure. But that business has grown really substantially since, and so we have six locations right now in the Midwest, in Columbus, Ohio and Cleveland, Ohio and we’re kicking off some rapid expansion. But ultimately, we’re serving a delicious kind of fried chicken, hospitality-forward environment alongside of engaging a really unique workforce. And so we talk about what we do as a fair chance employer, which means we’re willing to give a fair chance to all of those that apply for our jobs. The majority of men and women that have joined our team have been affected by a lot of adversity in their life, ranging from incarceration to addiction to homelessness to being a survivor of human trafficking. And, you know, it’s with kind of a lens toward supportive and transformational work practices that we’re able to empower our team for ultimately a lot of personal success, but alongside a lot of professional success. And so hopefully by way of introduction, when you think about this broader labor crisis, there’s broader opportunity in the workforce to engage people differently and support people differently. We’re doing that in our own little lane of the fast casual food industry.
Fifer: It just sounds so fascinating, and I had a couple of questions in mind before we entered in here. Of course, about 10 more popped into my head as you were describing that. Just first of all, let me congratulate you on that combination of entrepreneurship and social good. It’s the old saying of, if more of us did that, wouldn’t it be a better place to live. So thank you.
DeLoss: Thank you.
Fifer: So one of the things I’m thinking about here is that healthcare and the restaurant industry, one of the things they have in common—especially right now, you just alluded to it—is staff burnout. We’ve heard stories in both industries about overworked staff dealing with customers (or in our case patients) who are stressed. I’ve heard these stories firsthand through frontline workers about how stressful it is through this pandemic. I mean, it was already a stressful environment and the pandemic made it extraordinarily worse. And of course, the economics in the employment world today are very odd. So again, lots of similarities, large rates of turnover. We’re talking about workers whose pay isn’t very high. You can go on and on about some of the similarities. So what are some of the ways you’ve addressed these issues that we’re all dealing with in order to keep your staff working for you and feeling good about coming into work every day?
DeLoss: Yeah, really informed and aligned question, Joe. When I think about those comparisons, there’s a lot of novelty about our story and the Hot Chicken Takeover story because of who we hire. But the more important question is, of course, how. And I think “how” is where we start to see a lot more parallels with the work we do together. If we kind of take away the novelty of who, what we’re talking about are a lot of entry-level job that are ripe with high turnover, burnout, you know, you name it. Highly competitive wage rates right now. A lot of downward pressure. And the reality is, especially when you think about an entry-level employee or the candidates for those types of jobs, they’re generally people out in our community that have been up against some adversity, whether it’s professional education opportunities, whether it’s food security, housing security, you name it. It’s that instability, that personal instability that ultimately becomes professional instability. And so when you think about people citing turnover because of attendance, because of transportation, childcare issues, etc., those are all symptoms of the instability out in our community kind of in my mind. And so as an employer, our orientation is, how do we make investments in somebody’s personal stability and professionally reap the benefit from that? And so there are a lot of mechanisms we can talk about, ultimately, that are ways that we do that. But really, at a high level, our orientation is just to meet our team where they’re at and to think about those employee benefits and support systems in ways that are more relevant to somebody that’s trying to build a foundation for their life and some upward trajectory in their career. And when you can deliver on that as an employer, you’re going to buy yourself a lot of loyalty, a lot investment. And you know, so just so people know that there’s proof in the pudding that we sell, in our industry, we’re looking at turnover rates anywhere from 120-150% a year. It’s just generally accepted that that’s what you do in our industry. Our turnover rates on an annual basis are around 40%. And so, depending on the statistic you pick, our business practice has yielded, usually, a 3X return over industry on turnover rates. And when you think about continuity of service to ultimately our fried chicken guest or ultimately your patient, continuity of service, of guest experience, starts going through the roof when you have that kind of tenure of team member that are able to foster relationships with people in a different way.
Fifer: You know, actually I wrote down the word “loyalty” as you were describing what you’re doing and then my thought was, well, “loyalty” can be a dangerous word. Because if you demand loyalty, it’s really not loyalty, but if you enhance that environment where you welcome loyalty and then you reap those benefits, that’s really the difference. And that’s where, again, the loyalty word can be a little dangerous, but I love what you’re doing, and you stole the word with what what I was going to follow up on.
So let’s shift a little bit away from the employer and employee relationship side to maybe the customer side. In our case, we start talking about our revenue cycle, and that’s another, in a way, a common area with the restaurant industry: that’s customer service. And honestly, I think we as an industry—and I’ve said this publicly many times, I don’t shy away from it—I still think we have a long way to go, and that’s why I’m so interested in learning from you. We always want patients to have an excellent clinical experience, but the revenue cycle folks are oftentimes the front door, they’re the first experience but also the last point of contact in terms of subsequent billing and all those kinds of things. And a bad customer experience can ruin a good clinical experience, just like a bad customer experience could ruin a good piece of fried chicken. So in your experience, how can workers who feel satisfied, they feel loyal like you talked about and valued, how can they contribute to a better experience for the people that they’re serving, turning it outward to the customer?
DeLoss: I think there are a lot of parallels here for what we’re talking about. Ultimately, we are serving a different product to our end user than you are in so many ways. But we have seen that the type of investment we make in our team members automatically converts to an investment in our guest. And the hospitality that our team delivers is really a representation, in my mind, of the hospitality we have delivered to them. And so, you know, the reality is, you’re in a complicated industry with a complicated process and a lot of patients who are up against a learning curve to understand the system that you play in and your members play in day in and day out. And so I think as we’ve seen that investment in our team members translate to an investment in our guests, the way that really plays out are, you start to see people that start forming trust with us as a brand, and that has nothing to do with our, you know, this kind of mission that has some novelty prescribed to it. But it’s really about building a series of encounters with somebody that are consistent, that from person to person, from restaurant to restaurant, from experience to experience, that are commensurate with similar feelings of, oh, I’m starting to trust that I get the same thing every time I come here. And it can be delivered from different people. And I think that continuity goes a long way. And I have to imagine, particularly in your instance where you’re likely encountering some patients that are in times of stress, associated with their intervention with you, whatever that might be, if you and your teams can start standing up as trusted resources that are delivering hospitality in a way that feels secure and stable and not combative, that goes a long way. It sounds like, you know, to your own credit, you’ve been carrying that torch for awhile of, there’s an opportunity here to differentiate our level of service. And we’ve definitely seen that play out in our environment because similarly, the bar for quality in service in the food industry, especially right now, is categorically low. And we’ve, you know, we have a lot of KPIs associated with the way we deliver on guest service and satisfaction to ensure that our teams are out there on the front line, yeah, really waving that flag every day they can.
Fifer: It’s interesting. You know, we went to brunch yesterday with some, actually my brother-in-law and his wife, and our waitress, she was awesome. I mean, the food was great. We went to the place for the food, but she joked with us, we had a lot of laughs at the time. We ended the time. She learned that our family members were from out of time, so she rattled off—she said, oh, have you eaten here and have you eaten there—she rattled off three or four restaurants that she recommended. And I have to tell you, we were walking to the car and my brother-in-law and his wife, they both said, hey, we should find out when she’s working and we’ll go back there when she’s working. I mean, it was a good example—the food was the food. It’s the same as we’ve always eaten at this restaurant. But they wanted to go back to see her, and that’s a good example of that customer experience that goes beyond just the product that you’re buying. And I think the same thing does apply to healthcare, you’re right. Almost all patients are there in times of incredible stress and what they’re looking for is for someone to hold their hand and walk them through—figuratively of course—walk them through the revenue cycle process. I think there’s terrific similarities there, even though the service itself is very, very different.
You’ve mentioned investment in staff several times, and I know that you have a unique environment with hiring people with their own difficult circumstances, but you also offer some unique benefits geared toward meeting some of those unique challenges that they face. But some of these are challenges that we all face, like flexible schedules and counseling and other kinds of things. And in this tight employment market, we have to—I think—we have to keep thinking about these things that add to culture to create an environment where people want to work. So as you think about, again, the similarities, are there lessons here for the healthcare industry from what you’ve done that you think might apply?
DeLoss: Yeah. You know, I think there’s a couple kind of milestones I’d share in regards to that, and I’ll save the conversation on those benefits as well. So if I think about the four pillars of Hot Chicken Takeover and the culture we’ve fostered, one of those is about really delivering a set of clear expectations and pathways for team members, especially when you’re looking at an entry-level workforce. There aren’t many people in that candidate pool that could really point to any positive work experience they’ve had in life. Oftentimes, you know they’ll talk about, ah, my manager didn’t tell me what to do to get promoted, or I didn’t get training and development, I had this run-in—you can think of the list that leads to turnover. And so, we take a really objective, clear approach to preparing people for their advancement. And we put that in their hands as a roadmap, which is to say that, your opportunity to grow here is really up to you, and this is what it looks like. And so the objectivity there is really empowering, and it also takes pressure off your managers, frankly. And so I think that’s kind of a pillar of supportive employment that can make a big difference and start to develop an experience that is different than what folks are used to. The second is, not only can you just tell people what you expect of them, but you’ve got to give them really frequent feedback. And so, you know, most people—and you could ask this question about yourself and your members—most people are giving annual performance reviews, if anything, to team members in terms of performance feedback. When you’re looking at turnover that’s upwards of 100% a year, they’re not even going to make it to their first performance review, so what are you doing? And you’re definitely not doing many performance reviews. And so what we do is, we take a 90-day snapshot of performance and are giving people feedback every 90 days, both based on their job performance but also their performance as a member of the team, based on our company values. And so that makes a big difference. The third thing to share is really around benefits, and we talked about this, I kind of indicated this earlier in the conversation, but benefits have to be hyper-relevant an aligned to where somebody’s at in their life. And so here you are hiring somebody for, call it, $14 or $15 an hour for an entry-level position. That person has spent 90 minutes on a bus to show up to work. They’re worried about their rent payment next month, and the benefit you offer them is a 401(k) that you might be able to tap into when they’re, you know, in their 60s. It’s not a relevant benefit. It’s not relevant to where somebody’s at because they’re not at a point in their life where they’re in a position to have the privilege of doing long-term planning. And so in lieu of—we do have 401(k)s, but we also have short-term match savings programs, and so if you’re investing in education or a healthcare expense or a child expense or a transportation expense, we will match a certain amount of money, one to one, every year that you invest in that. Which also means that we get to be part of a lot of first apartments, first cars, other things like that that go a long way. And so those benefits, that idea of relevant benefits is something that you can apply on a broader level too and so we have financial literacy programs, professional development and advancement programs, but you have to take off your hat of being used to providing benefits to a whole bunch of white collar or white jacket type positions and think about what’s more relevant to the folks you’re hiring. Paid time off. Parental leave. A lot of meaningful opportunities like that. And so all of those things for us wrap up in this last bucket, what we just talk about is, we talk about having a dish tank culture. And so regardless of who you are on our team, whether you’re an externally hired COO or a new crew member who just joined one of our restaurants, you’re going to start by doing a week’s worth of dishes in our restaurant. And I still—all of our office staff still takes dish shifts every three months and get out there. It’s an opportunity to try to foster an environment that demonstrates that every position on this floor has value, and I think in particular, in the healthcare environment, where you have a very hierarchical—whether it’s through education or position or compensation—how do you start demonstrating the dignity of every job in a meaningful way? We try to do that in a very simple way through a very simple position, which is doing dishes. But that also means that there are a couple days a year where I’m paying a COO a C-level executive salary to get his arms wet in a dish tank.
Fifer: I love it.
DeLoss: But the cultural implications of that are pretty tremendous.
Fifer: I love that idea. I did a fair amount of—and I wish I’d have done more—but I did a fair amount of shadowing and rounding with our nursing executive, or I went into the OR or radiology and just various departments, and gosh, I always learned a ton. I didn’t actually—you know, some of those positions, you wouldn’t want me to be in nursing, technically, like washing dishes. But if you’re right there with the nurses, you’re asking them sincerely what’s it like and they’re taking you into patient rooms and have patient conversations, it was a tremendous learning environment for me, but it also sent this huge message to the nursing staff or to the rad techs or the OR team that I cared about what was going on. So as a finance person, maybe that’s a good corollary for our members, is—and I used to joke with our chief nursing executive—again, this is another, I used this metaphor earlier about patients, but I’d ask her, I need you to hold my hand as we walk through these patient units, because I felt like a fish out of water. But she just made it easy for me by introducing me, explaining things, and didn’t make me feel like a dummy when I was totally out of my element. So maybe that’s the healthcare corollary to some of this.
DeLoss: Yeah, it sounds like part of the value is just asking and dignifying the dialogue because it’s really empowering to say, “You have something to teach me” and not just “I am here to descend upon you policies and provisions.” So I think the parallel is really just about holding space to have a productive dialogue and learn from one another and foster some trust.
Fifer: The word I throw to add onto that is “sincerity.” It’s not one where you’re checking the box just saying, “Hey, I’m here because I’m cool and trying to mingle with the minions.” No, this is a sincere interest about what happens on the front line, and I think that’s a really powerful thing. And it’s getting harder and harder I think for people to do those kinds of things because life gets busy and busier in the professional world, but you’ve just demonstrated how important it is, and I love the corollary to healthcare.
Well gosh, this has been awesome. I really appreciate you spending time with me today. I’ve learned a little bit in this conversation, which is great. I’ll learn more at the Revenue Cycle Conference. Look forward to you presenting there, and thank you for spending time with me today here, Joe.
DeLoss: Yeah, thank you so much, Joe. I’m excited to continue our dialogue here soon.
Grotto: Voices in Healthcare Finance is produced by the Healthcare Financial Management Association and written and hosted by me, Erika Grotto. Sound editing is by Linda Chandler. Brad Dennison is our director of content strategy. Our president and CEO is Joe Fifer. Please sign up for our Revenue Cycle Conference in New Orleans. You can hear more from Joe DeLoss as well as some other great speakers. You can register by going to hfma.org and clicking on Education and Events. And if you have any questions or comments for me or any other member of our podcast team, let us know. You can reach us at firstname.lastname@example.org.