The Big Quit: Dental industry staffing struggles during the pandemic and beyond

The Great Resignation, aka “The Big Quit,” is this generation's Achilles heel. Every industry is wrestling with retention, agonizing over attrition, and trying to tackle turnover.

By January 2022, the United States Bureau of Labor Statistics (USBOLS) reported that 4.3 million workers had quit their jobs.¹ This number is down from the historical record of 4.5 million reported last November, but it is still alarmingly high.² What is more concerning is that 41% of those employed, mostly in professional positions such as health care and dental, are actively looking for another job.^3,4 Chances are there is someone in your practice right now who is actively searching.

Dental practices are not immune to this situation. They are also faced with a bewildering conundrum. You might be surprised to learn that there is much more to this story.

The USBOLS also reported a notable influx of 390, 000 employees returning to the workforce, particularly in professional and business services, leisure and hospitality, and health care. They also reported that the unemployment rate was at 3.6%, near a 50-year low.⁵

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These statistics indicate that there is finally a light at the end of this tunnel. Unfortunately, job growth is still too low to begin to heal the labor shortage because there’s still a sharp decline in the labor force participation rate.

While the pandemic is primarily blamed for the labor shortage, it wasn’t the only reason. It caused a ripple effect of poorly thought-out decisions geared toward quick-fix solutions. The government poured $5 trillion dollars into the US economy. A staggering $700 billion was allocated toward unemployment, including weekly stipends of $600 in Federal Pandemic Unemployment during the peak of the pandemic.⁶ In North Carolina, this meant they received a maximum of $350 per week in North Carolina Unemployment Insurance (NCUI) plus $600 per week in Federal Pandemic Unemployment Compensation (FPUC) for a total of $950 per week and $3,800 per month.⁷ As a result, there has been a significant power shift from employers to employees. The reality is, a significant amount of the workforce financially benefited from the pandemic. They were suddenly in a position where they could choose when or whether they went back to work and where they would work.

Things are about to change

The primary reason change is coming is due to inflation, which is at 9.1% and climbing—the highest rate noted since 1891.⁸ It’s forcing consumers to pull back on spending, the economic growth rate is weakening, and everyone has a looming fear that we are doomed for a recession. This means they are concerned about their personal finances.

As inflation continues to rise, the government is frantically working to balance the economy by tightening the reins on the country’s tax and spending policies. That means the “free money” has ended.

Through this process, both federal and state governments are conducting wage audits and have uncovered just under $163 billion in improper unemployment income (UI) payments.⁹ This means that those who received illicit UI benefits must repay those monies, they’re barred from receiving UI benefits for a minimum of one year, and they’re required to serve time.

This is one circumstance where employees were financially benefitting from not working.

With the labor shortage, job seekers suddenly had the upper hand and could name their price. Feeling the pressure to keep their businesses open, employers paid their exorbitant demands.

Wages and salaries had increased 5.7% over the 12-month period ending in June 2022 and inflation has now increased to 9.1%.¹⁰ Employers simply cannot continue to increase wages under these circumstances. These, among other circumstances, will cause a shift in the labor market. Both employees and employers should be prepared.

If you’re looking for work, your window for asking for (and receiving) the stars and moon is quickly closing. For employers, there’s work to be done to attract and retain employees. Now is the perfect time to look at what may be going on.

When it comes to a dental practice, your team is your most important asset. They are essential contributors to a profitable and thriving practice. Their skillset accounts for 85% of a practice’s assets while employee efficiency, talent, and attitude determine its pace and growth.¹¹

The time, stress, and cost of hiring and training new employees are significant. Turnover can have a negative impact on your practice. It brings about multiple problems, including excessive costs, knowledge loss, and low productivity.

The cost of replacing an employee ranges anywhere from 16% to 213% of an employee’s salary.¹² U.S. organizations are estimated to pay up to $1 trillion in turnover expenses annually.¹³

You can adopt the strategies that drive employee retention by building a culture focused on communication, recognition, transparency, and relationships.

Workplace culture

Contrary to popular belief, compensation is not the number one reason that employees leave. Toxic company culture is ranked as the number one reason that they are leaving their jobs in record numbers.¹⁴

According to the Society for Human Resource Management (SHRM), 58% of employees quit a job due to a toxic workplace culture and the annual cost of culture-related turnover is $223 billion.¹⁵

Search social media posts for dentistry and the common thread for discord is that the environment is toxic. But what exactly does that mean? It includes incivility, lack of trust, lack of ethics, bullying, lack of appreciation, fault-finding, and workplace harassment. It can also include being overworked. Due to the labor shortage, employees are having to do their job and the job of another person. This means they are working additional hours, and it’s taking a toll on them mentally, physically, and emotionally.

Workplace favoritism is the unfair practice of treating one employee better than the others. Reward structures must be transparent so that employers and employees understand and comply. Without transparency, favoritism can begin to take root. The implications are far-reaching in their influence to promote a toxic work culture that destroys alignment, engagement, commitment, and integrity.

Bottom line, positive workplace culture is not just your best attraction strategy, it is also your most valuable retention strategy because it’s a driving factor in aligning and engaging your employees.

Compensation and benefits

Another reason employees leave is that they feel they are not fairly compensated. During the labor shortage, employers hired new employees with exorbitant salaries but failed to increase the salaries of their long-term team members. Unfortunately, word gets out fast.

Employers need to evaluate their options on how they can fairly compensate their team to level the field. It’s important to note that employers that provide fair compensation have a 56% lower rate of attrition.¹⁶ Therefore, a best practice for increasing employee retention is to ensure that you are compensating employees in line with industry standards, starting with baseline salary.

Competitive pay is more than just dollars in a paycheck, it also includes benefits that contribute to their total compensation—health-care coverage, life/disability insurance, paid time off (PTO), and retirement benefits. Making sure that your total compensation package is competitive will also increase your chances of retaining employees.

Employees often focus on their salary and don’t consider other benefits that play a huge role in their total compensation. Therefore, it’s important to provide employees with a “total compensation summary” at the end of each year.

Employee well-being

Employee well-being is quickly rising on the list of “must-have” from prospective employers. As a result of COVID-19, employers have a greater responsibility to safeguard the health of their employees. However, as the pandemic lingered, employers had to address another pain point—the effects of burnout and exhaustion. By the end of 2020, I experienced the onset of exhaustion and encroaching burnout and found myself navigating this alone due to the lack of available resources. I quickly discovered that there were and are still many employees silently struggling.

Sadly, only one in four employees feels strongly that their employer cares about their well-being, the lowest percentage in nearly a decade.¹⁷ Employers should view this as an urgent call to action to prioritize the health and well-being of their employees as they continue to battle retention, attrition, and hiring challenges. The bottom line is that people can’t be productive, present, and efficient if they aren’t well.

Strategic hiring

Investing in the right hires from the beginning is crucial. When hiring, it’s important to avoid misalignment in skills and role responsibilities by clearly defining your expectations for the position in your ad, and in telephone and in-person interviews. Be aware of mismatches in experience and culture during the interview process. Even though you may be desperate to fill a position, hiring the wrong person means a host of problems later.

In fact, 80% of turnover is due to bad hiring decisions.¹⁸ You don’t want to spend money on a new hire just for them to quit, or to have to let them go months later.

Employee onboarding

Effective onboarding is an integral part of retaining employees. In fact, 40% of employees who don’t receive adequate training leave their job within a year.¹⁹

Training and development are crucial to employee retention. Employees should never be placed into their respective role until they’ve received the required training and can demonstrate that they’re ready. If employees are not trained for their jobs, they may feel underprepared for their work or as if they are not performing well. If employees feel like they can’t do their job, they may pursue opportunities that offer comprehensive onboarding and on-the-job training.

Onboarding should be a six-month to year-long process that achieves multiple goals. Effective onboarding reinforces a positive workplace culture, sets clear expectations, clarifies policies and benefits, and integrates new hires into the company culture. It also connects new hires with existing team members and enables planning for their long-term future.

One-on-one meetings

One-on-one performance review meetings can help employees understand the definition of success in their roles and are a wonderful opportunity to find out what makes an employee tick and what they need to be their best selves. Outlining goals and performance can lead to a more positive work environment.

But meetings with your employees should not be limited to performance reviews. Leaders should create a channel for employees to give feedback and connect as well. This helps practices grow to support their employees and address their needs. Practice continuous listening, hold regular one-on-ones, and leverage employee surveys to safeguard employee turnover. This can be as simple as a 30-minute “walk and talk” which takes them out of the normal meeting mode and creates a more relaxed environment.

Opportunity for growth

A fantastic way to prevent turnover is by giving employees opportunities for growth and development. Research shows that only 38% of departing employees said they saw professional and career growth opportunities and those leaving noted this as one reason why.²⁰

Invest in time and resources to help employees succeed at their jobs while providing opportunities where they can level-up their knowledge and skills. By doing so, employees could progress into new roles within your practice instead of seeking opportunities elsewhere.

Communication, collaboration, and co-creation

These three items are essential for both attracting and retaining top-level talent. It is important to articulate your vision, align and engage your team, listen to questions, address concerns, provide feedback, and implement suggestions all of which are the cornerstone of leadership. The goal is to align and engage them by educating and updating on benchmarks and acknowledging that they are the key to practice growth and success.

Thirty-nine percent of employees do not feel that they are provided an opportunity to collaborate or co-create.²¹Employees who do not feel engaged or involved tend to disconnect. When they do, other opportunities become more attractive.

Employees want to feel like they play a role your success. When they are actively engaged, enthusiastic and inspired practices tend to see higher rates of productivity and a reduction in absenteeism and turnover. An estimated 75% of the reasons for employees quitting can be prevented.²² So you need to evaluate these key areas and make changes as needed.

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