Last year I had the pleasure of emceeing Maeva Dental Advisor’s Inaugural DSO Accelerator and Management Meeting and I had the opportunity to interact with multipractice owners from around the country. I asked the dentists, owners, and managers in the room to list the problems that were keeping them awake at night. Their number one answer was recruitment and retention of dentists, one of the biggest headaches dentists face.
I’ve heard that the average employee dentist lasts about 18 months in a position, though I imagine it would be difficult to get hard data on this. But let’s say the average stay in a position is two or three years; that’s still a problem. Patients want continuity of care. What if you saw a new physician or dentist every other time you went in for a checkup? Wouldn’t that shake your confidence?
So, let’s figure out why dentists leave and see if we can turn that around. I’ve spoken with countless dentists from private practice and DSO backgrounds, and I’ve compiled their concerns into the following categories.
Practice profile
A dentist who wants to work slowly on large cases is going to face challenges in a high-volume, bread-and-butter practice. A practice that depends on income from placing implants may run into trouble forcing an uninterested dentist into surgical training. It’s like fitting a square peg into a round hole, as the saying goes. During the hiring process, you should have a clear idea of the procedure mix that will be required to keep your operations running. Now, ask candidates open-ended questions about what kinds of dentistry they want to do and compare the two. If you first tell interviewees that you need them to do molar endodontics, then what do you think they’re going to say? Take the time to get to know them as clinical dentists and don’t ask closed-ended questions.
Practice location
I consider this a subset of “practice profile,” but it seems to be such a common issue that it deserves its own category. Some places are just tough for associate placement. Rural settings, for example, often face more of a challenge attracting recent grads than picturesque suburbs with popular school districts. Be wary of offering large signing bonuses and increasing compensation; this may attract dentists, but it won’t necessarily retain them. Instead, refine your recruitment search for dentists who want to work in this location in the first place. I realize that’s not easy to do, but isn’t it better to spend money finding a great long-term employee than to keep throwing money at short-term ones?
Culture
Sometimes a personality is just not a good fit for the culture you’ve created. If you have a positive and productive culture, then weeding out the bad apples is a good thing. But the other possibility is that your culture may not be as healthy as you think. A robust exit interview process with soon-to-be-former associates should reveal whether there are other team members who are quietly ruining your culture and chasing away great dentists.
Work/life balance
While many group practices and DSOs tout that their model allows for a better work/life balance, it turns out that may not always hold up in the long run. Private practice owners have to take on more administrative tasks than associates, but they also often have more flexibility when it comes to taking time off. Look to remove red tape and make it easier for dentists to take the time they need to avoid burnout. Sure, your practice may take a financial hit now and then, but I’d rather retain a great associate.
Desire for ownership
Many dentists went to dental school with the vision of owning their own neighborhood practice. They dreamed of charting their own course. Those dentists may not last long as associates, whether they work for a group practice or a traditional solo practice. If you find that dentists are leaving because they’re entrepreneurial, consider finding ways to give them more control of their location. It doesn’t just have to be equity! What about granting an associate more say in marketing, material selection, technology investments, and the like?
Staffing a dental office is hard work. We need a mixture of people and personalities, some of whom need to be licensed and/or certified. Turnover is a major headache for every dental practice in the country, but the added challenge for group practices and DSOs is that they have to hire dentists as well as the rest of the dental team. Maintaining consistency in your dentist workforce is critical, not just for your own sanity, but also for your patient outcomes and satisfaction.
Chris Salierno, DDS, is the chief editor of Dental Economics and the editorial director of the Principles of Practice Management and Group Practice and DSO Digest e-newsletters. He is also a contributing author for DentistryIQ and Perio-Implant Advisory. He lectures and writes about practice management and clinical dentistry. Additional content is available on his blog for dentists at thecuriousdentist.com. Dr. Salierno maintains a private general practice in Melville, New York. You may contact him by e-mail at [email protected].
