The two sides of dental staff compensation: Staff vs. Doctor

Staff compensation is one of the most important issues to a dental team, however, dentists often disregard it, much to the frustration of the dental team. For a subject that is so often dismissed, many staff salaries are what cause the practice overhead to skyrocket. Keeping the topic of compensation taboo within a practice creates confusion, anger, and alienation, and often leads to high staff turnover.

The office that is comfortable discussing such a weighty issue – putting it out on the table, so to speak – will ultimately have a friendlier and more trusting work environment. Let’s review the most prevalent concerns and misconceptions often overheard by dental teams:

The Dentist’s Position – “The biggest obstacle facing my practice today is attracting and hiring good staff.”
The Staff Position – “I wouldn’t recommend dentistry as a career to my friends or family because the benefits are nonexistent. I’m career-minded, yet I feel that there is no real benefit in staying with dentistry.”

Good employees are not found; they’re created. Dentists must determine if their work environment is conducive to creating self-directed and confident employees. It is the dentist’s responsibility to hire, train, trust, and praise employees for a healthy work environment to be cultivated. A confident, respected, and knowledgeable staff person will the sing praises of the profession. When this happens dentistry will obtain a favorable image capable of attracting young and energetic employees.

The Dentist’s Position – “Work ethics seem so much lower while salary and benefits are in greater demand.”
The Staff Position –“I work hard, come in early, work through my lunch, and often stay late. I feel this dedication is worth far more than the small raise I just received.”

Work ethics have changed a lot less than most people think. Yes, today’s workers seem to expect more benefits and better compensation, but in my experience it’s not the expectations, it’s the frankness. Workers are much more open than they were 20 years ago. This openness has made it appear that younger workers want immediate gratification and that they’re more interested in their paycheck than their performance. The day of the silent “Yes sir, yes ma’am, I’ll appreciate whatever you feel I’m worth” mentality is as dated as the polyester uniform!

The Dentist’s Position –“My staff salary percentage should be between 20% and 24%, but it is close to 30%. Now it’s time for evaluations and salary reviews.”
The Staff Position –“Our evaluations have been postponed for over six months. I know the doctor hates to tell us we’re doing a good job because 30 days later it’s our merit review and time to discuss salaries one-on-one.”

Employee Performance Reviews are essential to keep communication open and the employees in a progressive rather than regressive mode. An evaluation should be done verbally at the end of each week during the 30- to 60-day trial period. This should be a five- to 10-minute exchange of, “Your models this week look much better” or, “I really appreciate the extra attention and concern you expressed toward Mrs. Conner yesterday” or, “As your employer, I see great potential in your ability to communicate our periodontal protocol to recare patients.” Encouragement is the key to new employees moving forward.

It is also important to remember that evaluations at three, six, and 12 months do not mean an automatic increase in salary. Offering increases at different tiers of learning is a fair way to award raises, not just across the board.

The Dentist’s Position – “I know my staff members are dedicated and deserve raises, yet my accountant tells me I’m 5% to 10% above the norms. What am I to do?”
The Staff Position – “If our doctor quit listening to his accountant he would realize we are his greatest asset, not his biggest liability!”

If staff salaries are too high, it’s a strong indication that the practice is grossly under-producing. The quick, easy, and wrong way to reduce staff salaries is to reduce the number of staff. Many dental practices are understaffed by one to two employees, which ultimately overloads the entire team. This tactic is nothing but a Band-Aid on a wound that will never heal.

Hygienists who are properly trained will earn up to three to four times their salaries for the practice in increased production. Staff persons such as assistants or business employees on average earn up to seven times their salary. My clients who have a high percentage of salaries often hire additional staff under my recommendation and increase the practice production by $10,000 to $20,000. Ultimately, their once too-high salary percentage falls into the norm of 20% to 24% of collections. (This excludes all doctor and on-site laboratory salaries, taxes, and benefits. Taxes and benefits are separate line items on the Profit and Loss Statement.)

The Dentist’s Position –“I’ve lost several key employees over the past year to other businesses simply because I can’t compete with big business compensation structures.”
The Staff Position –“Two of our staff members left their careers in dentistry for improved compensation. I’d leave too, but I truly love my job, coworkers, and boss. He works very hard and wishes he could improve our benefits. I know when the practice improves our benefits and salaries will too.”

Dentists often feel they cannot compete with outside big business. The fact of the matter is, the practice has the potential to be a “big” business. Staff turnover is costing far more money annually than an attractive benefit package. While newer practices cannot offer the same benefits packages as well established practices, there must be a plan created for future growth that sounds attractive to the employees.

I recommend having each staff member write down the benefits they already enjoy, i.e., vacation, paid holidays, continuing education trips, birthday luncheons, holiday parties, and more. Then ask them to make a “dream list” of benefits they would like to see in the practice. The dentist should meet with his or her accountant or practice administrator to estimate the costs involved in each of the benefits requested. Once this is finished, create a graduating plan of increased benefits and let the team know. “We are currently averaging $62,000 per month in collections. Once we average $70,000+ for three consecutive months, health care benefits will be included.” Or, “When we average $75,000 per month, a 401K Plan will become a reality.”

Sometimes the “dream” sheet of team benefits may sound trivial to the employer, but it’s important to remember that if it’s brought to the table, it’s worthy of consideration.

Staff turnover and staff shortages will remain a serious problem in dentistry until recognition and respect prevail. Dentists cannot praise or compensate staff members who are poorly trained in clinical, business, and communication skills. On the other hand, team members will not stay in a practice with low levels of appreciation and inadequate benefits. The remedy to this situation is improved team and practice systems development, which are available through many consulting firms and dental training centers.

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