Dilemmas in dental hiring

As most dentists know, hiring employees can be challenging. This article focuses on three particularly tricky issues:

1. Replacing an employee who is still working at the practice

2. Preventing current employees from sabotaging new employees

3. Managing new employees who demand a higher salary than your current team

Let's explore effective strategies for discreet hiring, retaining valuable talent, and navigating the complexities of pay rates to ensure that your practice remains both fully staffed and successful.

Hiring on the down low

It's hard enough to fill positions, but what do you do when you want to replace someone who's still working at your practice?

We recommend that if you have an employee with an intractable job fit issue, consider being up front by simply letting them go. While this may leave your team short-staffed, it's better to address the issue than risk further damage to team morale or patient relationships. But if you can't do that, there are ways to hire discreetly.

Communication is key

Prevent hurt feelings and job security speculation by adopting a proactive hiring philosophy with your team. Explain that, as a business owner, you continually collect résumés, talk to potential applicants, and occasionally post positions to develop a pipeline of potential employees in case the practice grows or someone suddenly leaves. If employees are aware this is normal, it won't seem obvious when you're looking to fill a specific position.

Confidential job ads

If you must hire discreetly, many job boards offer the option to post a "confidential" job listing. They'll hide your practice's name and address and instead use your zip code to target applicants near you. This allows you to post a job ad without raising suspicion and prevents overzealous applicants from contacting the office.

The downside of confidential job posts is that they receive about 30% fewer applicants than those posted with the company's name. Candidates usually want to know where they're applying and may fear that the job poster is hiding something by concealing the name of the practice.

Alternative interviewing

Since you can't interview in-office, consider inviting candidates after hours or conducting phone or video interviews. You can even meet at a coffee shop. Instead of a working interview, do an assessment test to evaluate their skills. If you want the candidate to meet the team or engage in a traditional working interview, offer the employee you plan to replace a paid day off for the candidate's trial.

Reassuring your team

Obviously, let the affected employee go before the new applicant starts and address the concerns of the rest of your team. They might start to worry you'll replace them as well, especially since you hired someone without their knowledge. Consider pulling them into a quick meeting to explain why your decision was made and how you feel this new employee will be a better fit for the team as a whole. Stay calm and address any questions and concerns your employees may have.

Preventing sabotage

Many dental offices are continually hiring because their office manager or specific employees are either running the practice inefficiently or scaring off employees. In one instance, a dentist wanted to replace three toxic employees, so he spent months finding the right candidates. However, once he hired them, he simply added them to his team without replacing the original employees. The "old" employees made life so uncomfortable for the new hires that they quit within the month. Not only did this dentist waste his time, money, and energy, but he also reinforced a destructive practice culture.

This is why resolving the cultural and leadership issues that have led to low retention is crucial before hiring someone else. If this is an ongoing situation, consider working with a consultant for support while changing your practice's dynamics.

Have a structured onboarding plan

Another reason offices are constantly failing with new hires is because they're thrown into the role without a life preserver. A structured onboarding plan consists of:

1. One-on-one meetings to review their job description and discuss your expectations

1. A training plan to upgrade their knowledge and skills

1. A review of your employee manual so the employee understands your benefits and guidelines.

2. Biweekly check-ins to evaluate their growth and respond to their questions

3. Fun get-togethers (with the doctor paying) for them to build a rapport with the rest of the team

To make this honeymoon period last as long as possible, ensure the employee's first day is special. Decorate the office with banners and flowers, gift them a coffee mug, and introduce them to patients with a compliment.

Handling pay discrepancies

It's not unusual to discover your employees make less than what job applicants are demanding-and apparently getting. You have three obvious options for dealing with this:

1. Hire the new employee at their requested salary and increase the compensation of everyone else in that department to match it

2. Hire the new employee at their requested salary without raising your team's compensation and hope they don't learn about it.

3. Insist on paying the employee the same compensation as your current employees and hope they accept the job as-is

From a hiring and retention standpoint, the first option is best. Increasing the compensation of your current employees to match your marketplace can prevent resentment and mass resignations.

But this option can generate financial and performance issues. Increasing your current team's compensation can inflate payroll costs to the point where they become unsustainable. Your team may also expect a compensation adjustment every time you hire someone new. Worse, this practice undermines a compensation system philosophy that raises are a reward for individual performance. If underperforming employees can get the same raise as everyone else, why would they ever improve? To mitigate this, unilaterally increase salaries if it's clear that your current employees are truly undercompensated compared to their peers.

The second and third options also have their issues. Inevitably, your team will learn that their colleague is making more than they are, which won't end well. The third option is the most fiscally responsible option, but it may prevent you from filling an opening quickly-or ever.

What should you do?

Ideally, your practice has a pay structure that links performance to compensation by defining the specific skills each employee needs to master in order to merit a pay increase. This means that both new and veteran employees are paid according to what they can do. New employees would have to demonstrate their mastery of these skills to justify their salary demands. Even if you don't have this kind of pay structure, you can have an honest conversation with the candidate to understand their perspective and negotiate a salary that matches your practice. Here are sample negotiation questions:

• How did you arrive at this salary level?

• Does this amount include the value of benefits?

• Our current employees with this job title make $XX when benefits are factored in. Given this information, would $XX be acceptable to you?

• As a business owner, I want you to be able to live comfortably in our community and also provide a salary that matches your skills and your contribution to my practice. Since your requested salary is higher than what my current team makes, what, specifically, will you do to justify this amount? How will you increase our production/ collection /efficiency so that the practice can afford you?

Closing thoughts

Navigating the complexities of hiring isn't easy. Your goal isn't just to fill a vacancy, but to enhance your practice's overall culture and efficiency. These strategies will help you streamline your hiring process and cultivate a workplace where both new and existing team members can thrive. To assist you, contact us and we'll send you a template for posting confidential job ads and/or the Dental Wage Planner to assess and plan your team's compensation.

Editor's note: This article originally appeared in DE Weekend, the newsletter that will elevate your Sunday mornings with practical and innovative practice management and clinical content from experts across the field. Subscribe here.