The Role Of Top Shelf Employees In Dental Practice Management

Top revenue producing dental practice on rock bottom employee wages? That’s unlikely.

This is a post about a common blind spot or rationalization related to employee wages that many practice owners fall prey to, and what it can cost you.  Read on and evaluate the beliefs you hold about employee wages. 


You believe it’s hard to find good employees. 

You frequently lose staff members and go through the process of interviewing again, hiring again, retraining and interrupting your work flow again.  You can never build a great team this way.

You always search for the cheapest hire or the new grad with no experience who you can “start low and raise later”, but when you fail to give them a strong leader in the practice who can coach and train them on your strong systems and methods, they fail too. Do you even have strong systems and methods?

I love Seth Godin and when I read his post on the search for extraordinary people willing to take ordinary jobs, it got me thinking about a few dentists I know who want to grow their practice but don’t invest in building a team and office that can attract extraordinary people.

Deep down, you know you can’t build something great on bottom dollar employees.  But the trap is that knowing something and doing something are two different things. You may know that hiring an experienced hygienist with strong patient communication skills is going to increase the amount of restorative bookings coming out of her OP.  But do you do it?  Or do you get in your own way by repeatedly hiring one “cheap” inexperienced hygienist after another.

Inexperienced hygienists can be a great addition to your practice, but first you need strong team morale, clear cut and unified admin and hygiene systems and a decent orientation program before you bring a newbie on board.

Your “payroll savings” could be costing you big hygiene and restorative revenue.

And this insidious effect of cheap employees isn’t just applicable to the flooded dental hygiene market – it applies to assistants and administrators too.

Let’s do the math.

I was helping a neglected child practice who was stuck in the red, even after 5 years, had dismal production numbers, over 40% downtime, and who kept hiring the cheapest hygienists and administrators they could find.  The owner paid a decent wage for the dental assistant because his thinking was that he would drive the practice forward and then hire better people in admin and hygiene later – when he had more success and more budget.  But, it doesn’t work like that.  

Every team member is a point of interaction for your patient, and each interaction contributes to an overall positive, flat or negative experience. You won’t win raving fans and referrals from flat or negative experiences. And if you have cheap, untrained employees, no solid systems, and poor cross team communication, you are most likely delivering flat or negative patient experiences.  Your stellar dentistry skills can not overcome these problems. You need great employees applying proven methods to create great experiences.

Cheap Pay Math

  • Cheap hygienists for $25/hour x 30 hours/week = $750
  • Great hygienists with strong verbal skills for $45/hour x 30 hours per week = $1350
  • Savings = $600

So you might say EXACTLY ZOE! Why would I pay $45/hour when I can get almost 2 hygienists for the price of one and fill more ops.  The answer is because you won’t fill more ops. Simply having a hygienist available doesn’t fill ops, and you already know that.

What are you losing? Let’s say you hire just the one cheap hygienist and pocket the “savings”.  She doesn’t have the skills and you don’t have the systems to create stellar patient experiences.  So your practice delivers a flat experience. Your new patient goes home after her appointment and never talks about it to anyone. No endorsement, no referral. Ever.  But you saved $600 right?  Ok, maybe. But what did you lose?

If you had delivered a positive patient experience, and she referred even a single close friend of hers, the initial COE and hygiene appointment alone covers ~80% of the $600 “savings”.  And that doesn’t even count any additional resto work she may need, the Invisalign she may want next year, her fiance’s appointments the year after that and so on.  The lifetime value of a single patient is thousands of dollars. But you’re trying to build a practice with a cheap hygienist and by “saving” $600.

And if you tell me there is no way you will ever get, or have ever gotten at least 1 referral per week, then you have bigger problems and we need to talk.

If nothing else, I hope this post helped you examine your beliefs about cheap pay, saving on payroll costs, and how it might be hurting you.  If a girl could dream, I would dream that this post also triggered a moment of clarity where you could see the bigger picture for a moment, and see that all the processes in your offices should be orchestrated to create stellar patient experiences, and how investing in better systems, processes and employees will help you today and for the long run.   Begin with the end in mind.

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