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Performance reviews suck. (But they don't have to.)

June 6, 2024
Most people don't enjoy performance reviews, but when handled correctly, they can be a valuable tool to develop employees and increase practice success.

You want your practice staffed with high-performing employees who are great at their jobs and committed to seeing your practice succeed. Obviously. You also want high-performers to stick around.

So why would you cut corners when conducting performance reviews?

The fact is, 87% of dental team members want better performance reviews,1 which means only 13% of practice owners are providing feedback that’s actually valuable. Everyone else is just wasting time and talent.

When you factor in the never-ending staffing shortage and retention crisis, you can’t really afford to slack off on performance management.

Why performance reviews matter

Just thinking about performance reviews is enough to give most people heart palpitations. They’re supposed to be motivators, but if you’re doing them wrong, they’re judgmental one-offs that are full of bad surprises. Take this approach, and you can expect your employees to be on their very best behavior in the weeks leading up to performance reviews … while frantically sending their résumés to your competitors.

Too often, performance reviews are mishandled, leading to de-creased productivity and low employee satisfaction. Research shows that 30% of performance reviews actually resulted in worse employee performance.1

That’s not too surprising when more than half of all bosses don’t think performance reviews are an effective use of time.1 We can say with certainty that those who consider reviews a waste of time are doing it wrong.

Better performance reviews can save you

We’re all feeling the health-care staffing shortage. The ADA found that staffing shortages have reduced dental practice capacity by 10%.2 That means that even if you wanted to take on more patients, you might not have the staff to cover it. Dental Economics found that 23% of employee/associate dentists changed jobs last year and turnover for dental assistants could hit 30%.3

You don’t have to be an economist to realize that’s an unsustainable way to run a practice.

As much as we’d like to blame it all on the fallout of a certain pandemic, staffing and retention is a complex beast. And contrary to popular belief, employee satisfaction and retention isn’t something you can just throw money at and expect it to get better. Fatter paychecks definitely don’t hurt retention rates, but what top talent really loves—and deserves—is quality management and professional development.

It might sound like corporate bologna, but the truth is that good performance review practices cultivate a positive work environment where employees can grow.

You can build a stronger team

Talent acquisition can get you pretty far, but what happens after you’ve hired the best? Your top talent didn’t come all this way just to be mismanaged.

Performance reviews measure your employees’ progress so they can see how far they’ve come and how far they have yet to go to meet their goals. Recognition is shockingly effective at improving employee engagement. Celebrating wins can range from acknowledging major milestones to a figurative pat on the back for always being a team player. People want to be seen. These positive callouts reinforce a good team dynamic and make people care about achieving their best.

It’d be nice if your team consisted of nothing but rockstars, but unfortunately, there will always be some stinkers who drop the ball. In this case, don’t treat performance reviews as threats, but as opportunities to communicate and figure out what’s going wrong. If something is going poorly, bring it to light before it becomes a serious issue.

Documentation is everything

Getting the good and the bad written down is key for developing your employees, but it’s also essential for keeping your practice out of the courtroom.

The HR for Health 2023 State of HR Report found that dental practices faced over 700 employee claims or disputes, most of which were filed in the last three years. These claims ran the gamut from wage disputes to wrongful termination, yet 69% felt their practices were either fully or mostly compliant.4

For obvious reasons, claims put a huge strain on operations since your HR and other staff have to deal with them. Combine the direct costs of disputes and lawsuits with the opportunity costs, and you start to see a serious impact on your ability to attract and retain the talent you want.

4 essential elements of meaningful performance reviews

Performance reviews can be downright petrifying even in the best situations. Instead of jump-scaring your staff, you need to reframe reviews as an opportunity to mark progress. These should be checkpoint conversations, not gotcha moments.

1. Set up relevant goalposts and establish evaluation criteria. When setting up your performance measurements, be consistent but leave a little wiggle room for assessing specific roles. The performance criteria for your dental hygienist isn’t going to look the same as that of your receptionist, but it should all be relevant to your practice. Keep it specific and measurable so you can actually document progress (or lack thereof) and identify the next goals.

2. Provide thorough, constructive feedback. Assum-ing you’ve already covered the “what” with your employees, this is the moment to tackle the “how.” This is a lot easier when you treat the evaluation as a conversation that keeps your employees motivated and focused on success—both for them and your practice. Boil it down to work quality, productivity (measured both objectively and subjectively), and progress toward professional development.

3. Set fresh goals. Your performance review shouldn’t be a nitpicking session, nor should it be nothing but praise. Everyone has room for improvement, and here’s where you can strategize goals. Discuss and document your employee’s aspirations and how you plan to get them there. Use the tried-and-true SMART goal-setting technique for specific, measurable, achievable, relevant, and time-bound results.

4. Keep the conversation going. If you’re not regularly checking in with your staff on what they’re doing, how they’re feeling, and where they are on their paths, performance reviews are going to suck. That’s how these become bureaucratic tick-box exercises that everyone despises. While no one can promise formal performance reviews will ever be fun, they can be valuable and strategic.

Put a little more effort into ongoing performance management, even when it’s not review season. The more time you spend on having real conversations that actually matter, the less time you’ll have to spend babysitting, correcting poor performance, and onboarding new hires that will inevitably replace employees who feel unsupported. 

Editor's note: This article appeared in the June 2024 print edition of Dental Economics magazine. Dentists in North America are eligible for a complimentary print subscription. Sign up here.


  1. Boartfield R, Twigg, T. The end of the annual performance review. Dental Economics. August 15, 2022. https://www.dentaleconomics.com/16389512/
  2. Dental workforce shortages: Data to navigate today’s labor market. ADA Health Policy Institute in collaboration with American Dental Assistants Association, American Dental Hygienists’ Association, Dental Assisting National Board, and IgniteDA. October 2022. https://www.ada.org/-/media/project/adaorganization/ada/ada-org/files/resources/research/hpi/dental_workforce_shortages_labor_market.pdf
  3. Lanthier T. The 2023 Dental Salary Report: Results are in! Dental Economics. January 12, 2023. https://www.dentaleconomics.com/14286760/
  4. 2023 State of HR Report. HR for Health. https://5014795.fs1.hubspotusercontent-na1.net/hubfs/5014795/HRfH_InsightsandTrends_2023_updated%20230815.pdf
About the Author

Ali Oromchian, JD, LLM

Ali Oromchian, JD, LLM, is a world-renowned employment attorney and one of the nation’s leading authorities on medical and dental practice law. He owns two companies dedicated to bringing legal expertise to medical and dental practices: Dental & Medical Counsel, PC, and HR for Health. His devotion to compliance and health care is one of a kind.

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