Find a chair, and go to work!

April 1, 2000
The question that is being asked, though, is: Who wants to work in a dental office? If you don`t want to be playing a continual game of employee musical chairs, learn how to hang on to the good ones!

The question that is being asked, though, is: Who wants to work in a dental office? If you don`t want to be playing a continual game of employee musical chairs, learn how to hang on to the good ones!

Ira S. Wolfe, DMD

Doctors seem surprised to find themselves scrambling to fill vacant positions. It won`t be long before dental recruiters are "headhunting" your employees and lurking outside the dental office, much the same way as they do in other businesses.

According to a survey by the Saratoga Institute, the time to fill job openings is up from 10 days in 1996 to 51 days in 1999! The record unemployment - coupled with job expansion and a need to stay nimble and competitive - means it is as important for dental practices to retain their best, most highly-skilled workers as it is to retain their best patients.

However, many businesses - including dental practices - are diverting so much attention and resources from their own core businesses trying to find people to work, they find profitability strained and capital for expansion evaporating in lost productivity and hiring costs. These shortages will translate into billions of dollars of lost output over the next five years. To make matters worse, motivational levels in many practices are at an all-time low.

Is this a temporary problem, fueled by a robust economy? According to our research, we don`t think so.

Here`s why:

(1) The percentage of the U.S. population holding jobs increased to over 67 percent during 1999. The under-14 age group, largely unemployable and unskilled, accounts for nearly 20 percent of the unemployed. Unemployable disabled make up another 14 percent. Give or take a few percentage points, that is all the people there is, folks.

(2) The rate of women entering the work force is flattening out and will drop over the next 10 years. Much of the demand for labor has been filled by women and by corporate downsizings. Downsizings will continue, but they will slow. At the same time, the growth rate of females entering the workforce is predicted to decrease from 1.8 percent to 1.4 percent by the year 2015. Most women who want to work are employed.

(3) According to the U.S. Labor Department, there will be approximately 145 million jobs by 2005 and only a 148-million-person workforce. That three million difference means that many companies are going to have to acquire workers form other sources ... and one of those sources is going to be dentistry!

Simply put, the supply of jobs available has surpassed the supply of employable people. With the number of skilled and service positions available now and the new jobs being created daily, the number of people willing and qualified to fill them has stretched our human capacity to its limits.

Smart business owners and managers are rethinking the impact that too many jobs and not enough employees will have on the way they do business in the next decade. Thriving businesses understand that recruiting, training, and retaining employees is no longer an administrative function, but a competitive strategy.

What will this mean for doctors? Preparing your practice to recruit and retain employees will require very different strategies and an acute understanding of different cultures, needs, and priorities. Not only will new job candidates look very different in the next 50 years, but the scarcity of entry-level employees in today`s market translates into a scarcity of qualified people to manage and supervise entry-level employees in the future.

Technology has also increased the pace and complexity of practice. The role of a chairside assistant has evolved well beyond hiring a high school girl to mix cements, pass instruments, and clean up rooms. Doctors who want to keep pace with efficiency, quality, and profitability will need to hire and train employees who can keep pace and handle the complexity.

What`s a doctor to do?

1. Recognize good people when you see them. In a recent issue of the Harvard Business Review, only 16 percent of senior managers were confident that they could identify the differences between their high performers and low performers. As a result, managers really don`t know good people when they apply for jobs (or why good people leave).

The first step in finding good people is knowing why your good employees perform up to your expectations. Why do their behavioral styles blend so well in your workplace, what motivates them to do well, what values do they share with you, what expertise do they possess, and how much potential do they have to grow.

2. Create the "irresistible practice," a desirable culture that attracts the best patients and employees. The challenge for thriving practices will be to market their businesses to prospective employees as the best place to work, just as other types of businesses market to customers as the best place to buy.

3. Never introduce poorly motivated employees into a workplace of competent, skilled people. It can be devastating! How do you feel when you are surrounded by people who are less motivated than you are? How motivated are you when you are surrounded by people who slow you down and interfere with your results? The choices are clear.

Mixing productive employees with underperforming "warm bodies" only demoralizes the workforce and feeds turnover. If you begin to hang around complaining, negative people, you will just become a more negative, bitter complainer.

Select employees who fit your culture, share your values, and have a positive attitude. Hiring "warm bodies" just to fill open positions is a very shortsighted solution.

4. Your most valuable asset is your people. How much would your business be worth without the people working in it? Microsoft now is the richest company in the world and its biggest capital asset is knowledge and information. Who creates, controls, and dispenses the information? People! Business owners are now including human resources as an asset on their financial statements, not as an expense or liability. Invest in your people.

5. Current employees are your highest probability prospects for growth. The return on investment in training the right people can be as high as 10 times greater than investing in capital improvements.

6. One of the most efficacious things a doctor can do is match people with jobs that play to their skills, behavioral style, motivations, and values. Making a good job match requires doctors to possess rich and detailed information about their employees. Pre-employment and professional development assessments are not only cost effective, valid, and legal, but they also are a prerequisite for protecting your human assets and your bottom line.

7. Finally - but possibly one of the biggest strategic challenges - is to offer competitive salaries and benefits. Lack of benefits and minimal wage increases are age-old complaints of dental employees. Competitive employee benefits have been the exception, not the rule. Unfortunately, many dental practices are offering wage and benefit packages that barely compete with even entry-level, fast-food jobs in today`s market.

Another overlooked consideration is that many employees are more focused on their weekly wage than their hourly wage. Sure, everyone wants bragging rights about making $10, $12, $14, or more an hour. But, most doctors don`t employ their workers for a full 40 hours per week, nor do they pay employees when they are not working. That means dentistry is no longer competitive for employees dependent on a consistent weekly wage.

How does focusing on hourly wages adversely impact the employee? You agree to pay $12 per hour for a chairside assistant or administrative employee. Your average workweek is 36 hours and you see patients the equivalent of 48 weeks per year. The employee`s weekly salary is $432 and the annual salary is $20,736.

But, based on a 40-hour work week and 50 weeks per position, with two weeks` paid vacation, the annual salary for this $12-per-hour employee in another business is $24,000, excluding an additional $864 for vacation pay. The difference in being an employee for $12 per hour in a dental practice and in another business is over $4,000, excluding benefits. The wages in this dental practice, in real full-time employment wages, are the equivalent of less than $10.80 per hour.

For an employee looking for a less-than-full-time equivalent position, dental practices are great places to work! For an employee trying to pay bills, dentistry still is a great place to work, but it just is not keeping pace with the demands of employees nor competing employers.

Dentists must begin to think of wage and benefit compensation in terms of what employees need - what they need to live on, not what the dentist pays per hour - if they are to attract and retain employees prepared to drive the practice of the 21st century.

Hiring and selecting employees the way "we`ve always done it" will threaten to derail many successful practices. Managers who continue to make hiring and retention decisions based on prior successes will typically limit their growth and underutilize their capacity in the future. The ultimate choice - you can keep drilling for "people wells," knowing the people supply is low, or create a workplace that attracts the best candidates is like water flowing downhill.

For more information about this article, contact the author at (800) 803-4303. A biography of the author appears on page 12.

Visit Success Performance Solutions online at

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