But that’s not fair! Dental leadership and bickering employees

“You let new employees get away with stuff you wouldn’t accept from us!” The dental assistants tell the dentist with intense indignation.  

“We produced over a million, I haven’t had a raise, and all I got at Christmas was a candle? It’s insulting!”  The hygienist grumbles in the staff room to a supportive audience.  

“How come she gets to stroll in late when we have to hustle?” The front desk team stage whispers to one another. 

Meanwhile, the dentist is barricaded in her office, irritated with the endless parade of complaining employees. Is this dentist being unfair? Are these employees immature and entitled? Well, yes. And also, no. 

The myth of fairness 

Most of us developed a belief in childhood that coupled identical with fair. For example, if your brother received more cookies than you, wouldn’t you complain to Mom that she’s being unfair? Even if he was 13 and you were seven, didn’t those extra cookies suggest Mom loves him more?  

Practice leaders (and parents) like to say, “I treat everyone the same so no one can complain.” Equal treatment sounds like impartial justice, but in a team and a family environment built on diverse roles, strengths, and needs, equal can actually translate into unfair. Shouldn’t an active 13-year-old get more food than a seven-year-old?   

Fairness isn’t about giving everyone the same thing, at the same time, in the same way. It's about giving everyone what they need to succeed.  But how do employees know if their dentist is aiming for fairness or if their leader is biased? This is the core question and it’s why well-intentioned dentists can get it wrong.  

The information gap 

Let’s be blunt about dentists’ communication preferences. Dentists bask in their personal happy place when engaged in clinical conversations. But many dentists approach employee conversations like the “brave” Monty Python knights who upon encountering a scary rabbit, shrieked, “Run away!” instead of standing their ground.   

Running away, avoiding, or procrastinating generally doesn’t work for patients, and it truly backfires for practice leaders. Let’s examine the scenarios we began with. What should the dentist do differently?   

Four techniques to establish a “fair” practice:  

Share your leadership philosophy.

Describe your personal values, aspirations, and challenges at a team meeting. Explain that your goal isn’t to treat every employee equally, but to treat everyone fairly in a way that honors that person’s needs, strengths, stressors, and situation. This transparency will help employees understand your future decisions.

If the dental assistants understood this philosophy up front, they might have been less resentful. The dentist could agree that she’s handling new employees differently because dental assistant training and the hiring environment haschanged, and she must adapt. She could acknowledge that this feels unfair. The conversation would have shifted from blame to a deeper understanding that leaders and employees must adjust to a changed landscape.

Develop a fair compensation system.

At the heart of most employee dissatisfaction is their perception that they aren’t being rewarded fairly. And sadly, most employees are correct.The way most dentists make compensation decisions isinherently unfair. Feeling overwhelmed, dentists employ an array of salary tactics to appease employees so they won’t leave. But placating employees isn’t a great compensation strategy, and it’s about as effective as covering gaping wounds with duct tape. You might hide the bleeding, but sooner or later you’ll have to manage an infection. In fact, things often explode around Christmas time when employees expect bonuses to simultaneously make up for any cash shortfall they experienced during the year and convey recognition and respect. That Christmas cash (which is actually a gift not a bonus) carries a heavy emotional load.

In our example, the hygienist felt insulted because:

1. She didn’t see the candle as an expression of appreciation
2. She believed she earned a bonus
3. She thinks high production equates to pure profit that mostly enriches the dentist who doesn’t want to share.

Her reaction is typical in practices that don’t have a compensation system that’s transparent, predictable, and based on objective criteria. We conflate money with respect, which is why compensation is emotional as well as financial. In practices with an effective compensation system, employees don’t need a Christmas bonus to feel well rewarded. Compensation is not a topic that dentists should avoid, which is why I’ve specialized in helping dentists with this system. 

Practice open book management.

Our hygienist was also upset because she made assumptions about production and profitability. This isn’t unusual because many dentists hesitate about sharing the practice’s financials. Look, the team doesn’t need to see your P & L, but they do need a basic understanding of how money flows through the practice. Without that context, a team will naturally assume that producing over a million means the dentist is living large while employees are cutting coupons. This misunderstanding is exacerbated in PPO practices. Unless you educate them, employees won’t realize that when a practice collects only 75% of what it produces, it’s possible that expenses will exceed collections and the practice simply can’t afford raises, bonuses, or swanky Christmas gifts.  

If you want a more engaged, mature, and motivated team, then treat employees more like business partners instead of children getting an allowance.  

Be consistent about results and elastic in your support.

Our third scenario, with the chronically late employee, represents a common quandary. How can we make an exception for one employee without giving everyone the same leeway?  

The way out of this dilemma is to follow what we’ll call the results principle. This principle means that you expect employees to achieve the same results but you’re flexible with how they go about it. The standards are the same, but the process can be negotiated.   

For example, your practice requires employees to arrive by a specific time so they can prepare for patients and participate in a huddle. If an otherwise conscientious employee has a legitimate barrier to arriving at that time, you maintain the goal by requiring this person to complete the preparatory tasks that would have otherwise been their colleagues’ responsibility in the morning. This negotiation allows the practice to get the same results but in an individualized way.  

The key is to be open about the basis for your decisions, especially if it can be perceived as getting “special treatment.” 

The leadership mindset shift 

In sum, don’t aim for sameness. Aim for results, accountability, and a cohesive team. When your team understands that fairness means supporting each person appropriately, you create a practice culture that builds trust, reduces drama, improves retention, encourages self-direction, and engenders personal responsibility for growth. 

If you’d like help training your team, shaping expectations, or building systems that support fair—not equal—management, I’d be happy to help. 

Editor's note: This article appeared in the March 2026 print edition of Dental Economics magazine. Dentists in North America are eligible for a complimentary print subscription. Sign up here.