Should you hire more staff?

Since 1985, I have had the pleasure of working with many dental practices. In that time, we have developed outstanding questionnaires for new clients, which a committee of consultants and I review prior to beginning work with each new client. These questionnaires provide tremendous insight into each practice`s strengths and weaknesses, so that we can take advantage of opportunities and implement the proper systems in the clients` offices to achieve preset goals.

Roger P. Levin, DDS, MBA

Since 1985, I have had the pleasure of working with many dental practices. In that time, we have developed outstanding questionnaires for new clients, which a committee of consultants and I review prior to beginning work with each new client. These questionnaires provide tremendous insight into each practice`s strengths and weaknesses, so that we can take advantage of opportunities and implement the proper systems in the clients` offices to achieve preset goals.

One interesting observation we have made in reviewing these questionnaires is that most practices have the appropriate number of staff members. In other words, they are neither understaffed or overstaffed, but have hit it exactly right. The reason many practices feel under- or overstaffed is because of their business systems, which do not fully maximize the number of staff members in each practice.

Do the math

How do you know if you have too few or too many staff members? One way is to use a flexible statistical model. For example:

- Front-Desk Staffing - The general practice formula for front-desk staff is approximately one individual for every $350,000-$400,000 of production. (We use production because work has to be done whether or not money is collected.)

- Dental Assistant Staffing - For each dental assistant, we typically find that we are looking at approximately $250,000 in revenue.

- Hygiene and Hygiene Assistant Staffing - Adding hygienists to a practice is a system we cover in our one-year consulting program. Practices complete the Hygiene Productivity Form so that we can assess their hygiene departments to determine the ideal number of days, types of services, and average annual production. Because of the degree of customization within hygiene, The Levin Group has found it virtually impossible to create a standard formula for this staffing issue.

Adding a hygiene/assistant position to the practice can be highly productive. However, determining whether or not you need one can be very confusing. Although the formula for a hygiene/assistant is one for every 1.2 hygienists, many offices are not designed or equipped for this additional staff member. We have found, however, that practices with a well-run hygiene/assistant schedule can increase hygiene production by as much as 100 percent!

Production and volume

If the previous formulas were all you needed to know to make staffing decisions, every practice would be perfectly staffed. However, you`ll notice that I used the word "flexible" in reference to flexible statistical model. The flexibility is imparted from another formula known as "average production per patient." Average production per patient reflects the average amount of dentistry produced during a single patient visit daily, weekly, monthly, quarterly, and annually. While this may seem difficult to calculate, it is fairly simple and can be handled by many software programs.

The number of staff needed by a practice is also proportional to the volume of that practice. This is where flexibility comes in. For example, a high-volume practice will have a lower average production per patient and, therefore, will need more staff members than a low-volume practice. More patients will be checking in and out. More patients will need to be scheduled. More sterilization will take place, etc.

A low- to medium-volume practice will have a higher average production per patient and will need fewer staff members. In fact, low-to-medium volume for dentists is the best model in dentistry for several reasons. One of these reasons is that the overhead structure is lower due partially to needing fewer staff when the average production per patient is higher. The average production per patient must be factored in when using the above model to make staffing decisions. Running a dental practice is not easy, but these formulas should help get you on your way to maximum productivity and profitability.

Roger P. Levin, DDS, MBA, president and CEO of The Levin Group and the Levin Advanced Learning Institute, provides worldwide leadership in dental management for general dentists and specialists. Contact The Levin Group at (410) 654-1234.

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