Hiring quality employees is not unlike providing quality dentistry. It requires planning, use of the right tools, and a methodical process. Establishing well polished hiring procedures from day one will save new dentists a career of regrettable hiring decisions.

It all begins with a little thought. Take 15 minutes and consider what you want this person to do. Once you’ve done that, update or write a job description for the job tailored to attract the employee you need. Include the job title, job summary, and specific duties. This is a simple yet critical tool in the hiring process. It clarifies what skills the applicant must possess and explains what duties they would perform.

When advertising, include salary range, location, hours, and importance of the position in your wording. Promote the advantages of your practice, “new technology, flexible hours, friendly and progressive environment.” Advertise in a variety of media, including employment websites, etc.  And encourage applicants to email resumes to expedite the process.

When reviewing resumes, look for those that explain skills and detail work experience chronology. Don’t assume that experience translates into good employees. Keep an eye out for resume red flags, e.g. only listing years rather than specific employment dates such as 2009-2011.

When you’ve narrowed your list to the top five, pre-screen potential candidates by phone. You want to use the conversation to address your most pressing concerns immediately, such as gaps in work history, salary expectations, etc.

During the face-to-face interview, ask the applicant to specifically explain past responsibilities. Be sure to ask open-ended questions such as, “How would you describe your previous employer?” Test for the best. Take advantage of Internet testing tools that are now available to dentists. Such testing has been used in the business sector for years to help companies identify the better candidates for specific positions. And finally, check references.

Still looking for more resources on how to hire the best employee? Go Here Need help with new employee testing? Click Here

Are you getting the most out of your hygiene department? Many new dentists aren’t sure how to measure the effectiveness of their hygiene departments. Establishing performance measurements and identifying a few fundamental expectations can make a big difference.

Consider these:

• If the hygienist receives a guaranteed salary regardless of production the expectation must be that s/he produces three times her/his salary.
• In addition to a base salary, consider paying hygienists a commission for achieving additional production.
• Schedule the hygienist to produce at 3x her/his daily wage.
• Evaluate fees and determine if they are too low. Look at the procedures conducted in an hour to determine the production per hour costs. If the hygienist is paid $40 per hour and the cost for the prophy, not including the dentist’s exam, is $80, the hygienist is making 50 cents on the dollar.
• The hygiene salary should be less than 33% of her/his production, not including the doctor’s exam fee.
• Insist on periodontal assessment. One-third of hygiene production should be in interceptive periodontal therapy. Require the hygienist measure the total number of dollars produced in the 4,000 code and divide it by his/her total production. Report that once per month at the monthly meeting.
• Customize the time per patient based on patient need not on a standard one-hour allocation for each patient.
• Provide hygiene hours in the evening if patients are requesting late appointments.
• Evaluate the effectiveness of pre-scheduling. Practices using six month scheduling achieve only 76% patient retention and have a nearly 50% higher loss of patients than similar-sized practices that do not pre-appoint.

Establish expectations and performance measurements for hygiene and watch this department become a full contributor to your practice profits.

Still looking for pointers on effectively managing your Hygiene Department? Go Here

Your training may be excellent, your techniques may be superior, and your compassion may be unsurpassed. But if patients are rejecting treatment or not following up on your recommendations it’s critical you consider why that is happening.

Many new dentists struggle with treatment acceptance because they haven’t considered the barriers that many patients have to overcome to actually say “yes.”

Consider these suggestions to improve your treatment acceptance among patients in your growing practice.

• Present treatment plans to patients as if the person were a member of your family.
  

• Present the plan that you honestly feel the patient needs, not just what you think the patient can afford.
  

• Communicate to the patient clearly and in lay terms what this plan consists of.
  Many doctors talk way over the patient’s head.

• Put yourself in your patients’ shoes. If you went through the very same procedures in your own practice would you accept treatment or would you walk out?

• Consider using a trained treatment coordinator.

Professionally trained treatment coordinators are expected to achieve an 85% rate of treatment acceptance. This person is responsible for answering the many questions that patients have but often don’t want to bother the doctor with. Such as, “Why does the doctor think it needs to be done now? How much is the treatment going to cost me? Can I make payments? How many appointments am I going to need? Is the procedure going to be painful? What happens if I just wait a while?” and the list goes on.

The treatment coordinator also makes sure the patient is scheduled. If the patient doesn’t schedule that day, it is the treatment coordinator who follows up. They break down the barriers that prevent patients from pursuing recommended care. They offer reassurance and unlimited assistance to the patient in helping them fully understand the treatment, the need for it, and the benefits of pursuing it.

Over the last 12 months an entire year slipped by. For some the close of 2011 saw productivity and team cohesiveness stronger than ever. For others it was yet another year of more of the same. Inadequate systems that managed to shuffle through ‘11 will limp into ‘12. Productivity will continue to teeter between the “sorely lacking” and the “barely good enough” levels – not because the doctor isn’t working his/her hardest or individual team members aren’t committed to the cause. Rather it’s typically because the primary focus is on dealing with whatever problem has to be managed right now and not on addressing what caused that problem and what can be done to prevent it in the future.

Ironically, a mere 24 hours over the next year could transform a practice locked in a seemingly perpetual state of crisis management or lackluster success into one of superior efficiency and productivity. Monthly business meetings that are given just two hours of dedicated, uninterrupted doctor and staff time could be most cost-effective, production efficient step you’ll take to achieve your practice’s full potential in the coming year. The key: designate every member of the team a contributor. Here’s how:

1. Block off two hours each month over the next 12 months. These are the 24-hours that you commit to continuously improving your practice during the next year.
2. Develop an agenda with input from the entire team.
3. Include all areas that impact the profitability/success of the practice. For example: numbers of new patients, recall patients, collections, treatment acceptance, production, accounts receivables, unscheduled time units for doctor and hygiene, uncollected insurance revenues over 60 days, overhead, etc.
4. Distribute the agenda at least two days in advance of the meeting.
5. Assign each member of the team to report on the area for which they are responsible. For example, the scheduling coordinator reports on the monthly production as compared to the goal, the number of unscheduled time units for the doctor, and the doctor’s daily average production.
6. Encourage team members to come prepared to discuss topics on the agenda. For example, if the doctor has a higher number of unscheduled time units than desired, the team can discuss contacting patients with unscheduled treatment, encouraging hygiene patients with unscheduled treatment to move forward on recommended care, identifying patients with unused insurance benefits, etc.
7. Seek input from everyone by asking questions such as, “What is your reaction to that?” “As the patient, how would you react?” “What are the advantages of this approach? What are the potential disadvantages?”
8. Delegate responsibilities and establish deadlines for completing tasks identified during the staff meetings. For example, if hygiene cancellations are high and the group has developed a plan to reduce the cancellations the person responsible, probably the hygiene coordinator, needs to know she is accountable for implementing the changes and should be prepared to report on the effects of those changes at the next monthly meeting.
9. Share ideas during staff meetings for improving the work environment, the patient experience, and the efficiency of the practice.
10. Designate the amount of time you will spend discussing each issue and avoid getting bogged down on unrelated topics.
11. Discuss only what is on the agenda.
12. Hold staff meetings off-site in a conference room with a conference table. Many local libraries, community colleges, and other public facilities have public meeting rooms available for use.
13. Eliminate outside interruptions.
14. Seek consensus from the staff as to the best time to hold staff meetings; meetings scheduled outside normal work hours should be paid.
15. Hold meetings at least once per month, more frequently if you are implementing several changes.

Meetings are meant to be designated times in which you can focus all of your energy and team resources on addressing key management issues and problems that arise as a part of operating a small business. Run correctly, they are the most effective means to identify and solve problems, establish policies, share information, motivate each other, define areas of responsibility, and exchange ideas. Use them to your practice’s full advantage.

Shoot HIGH for 2012!

Sally

I am an associate dentist. I have been working with the Senior Associate for a little more than 2 years, and he is now wanting to make changes to our contract. Having no dentists in the family and few friends in the field who I would feel comfortable sharing this information with, who can I ask for advice regarding this associateship? I need a relatively unbiased opinion, and still being relatively new to the field, I don’t want to make a rash decision out of anger or emotion. If you could give me any resources to help me, regarding average percentages (of collections, production, etc) or average pay for someone in my position, or if I could consult with anyone on this site, I would greatly appreciate it. I am a regular reader of your magazine and truly appreciate all of the helpful advice you offer.

Thanks so much.

-Allison

________

Hi Allison,

Thank you for reading the magazine. I am going to refer you to Jason Wood, Attorney. Please call him.

Law Offices of Wood & Delgado

20 Pacifica, Suite 320

Irvine, CA 92618

(800) 499-1474 toll free

(949) 553-1474

You need legal advice to protect yourself. Jason specializes in dentists. Let me know if you have any trouble connecting with him. Also, most associate dentists are paid a % of collections with a range of 28% to 35%. 33% being the most common %. Hope this helps.

Best regards,

Sally

**This post has been added by a new contributor – Mary Fusco – With the joint purpose of finding out more about the shortage and access to dental care. Thank you in advance for your input. We appreciate your time and efforts to contribute to this study.**

I was a dental assistant for 12 years right out of high school and I have maintained an interest in dental workforce issues ever since. After completing my bachelors and masters degrees, I worked in non-profits where I devoted my time to dental workforce issues. I am now working at a dental school and I’m a PhD candidate in the dissertation phase with a topic focused on dental workforce shortages affecting access to care.

I’m interested in finding out if experience with dentistry prior to and during dental school affects how a person feels about their dental skills and abilities, and then finding out if these experiences (such as community outreach) influence practice preference. I believe the results of my study will help with dental admissions processes and with dental clinic recruitment and hiring. I’m focusing on dentists who have graduated between 2006 and 2011 to complete a short (10 minute) survey. I’ll share the results of my research with those who are interested.

Anyone interested in learning more about the research study and taking the survey please go to: https://catalyst.uw.edu/webq/survey/mpfusco/142155

Thank you, in advance, for your participation!
Mary Fusco, MA, PhD ABD

Whether you just graduated from dental school, finished a residency program or specialty training, the majority of young dentists begin their careers as associates. The road to becoming an associate is full of variables, and knowing the “lay of the land” can help you make wise decisions. The journey begins with choosing the practice that is right for you.

Consideration #4 – Communication…Communication

Hopefully, you and your employer share values and philosophies on patient care and the important role you each will play in the success of the practice. Like any relationship based on mutual respect, trust, and honesty, associates and employers must engage in ongoing communication to address needs, expectations, and issues that arise.

Take advantage of “learning the ropes” from your employer. Whether you remain with the practice as a future partner or leave to purchase or start a practice, the lessons learned from the non-clinical side of an associateship relationship can have a big impact on the success of your career.

Whether you just graduated from dental school, finished a residency program or specialty training, the majority of young dentists begin their careers as associates. The road to becoming an associate is full of variables, and knowing the “lay of the land” can help you make wise decisions. The journey begins with choosing the practice that is right for you.

Consideration #3 – Compensation

Compensation can be structured in many ways, but should be fair and adequate to meet your personal budget needs.

Compensation methods may include:

Per Diem Rate. Part-time associates are typically offered per diem rates of $400 to $600 per day, depending on geographic area, or a variation of a rate that includes a minimum daily “guarantee” and an extra percentage based on extra clinical production per day. The variable per diem rate can be attractive as your productivity and proficiency increase.

Salary. Full time associate salaries range from $5,000 to $7,500 per month based on the geographic area. It is not unreasonable to begin an associate relationship with a guaranteed
salary, since employers may place limitations on the clinical procedures, especially with recent graduates. After the initial probationary period is complete, the guaranteed salary is usually replaced with a draw.

Monthly Draw. A draw is a monthly salary but it is not guaranteed. It is an advanced payment for future services rendered. The draw is credited against a commission arrangement.
Most practices pay on a percentage of collection but some will use net production. Compensation rates vary throughout the country but normally range between 30-40% of collections.
If the commission relates to net production, the rates vary between 28-37%. Lab charges are usually made against your compensation at the same percentage of your commission.

When you are paid a draw, you’ll need to reconcile what you have been “advanced” versus what you actually produced or collected over a defined period. This reconciliation is usually done on a monthly or quarterly basis. Reconciliation payments are recorded as additional salary. If there is a shortfall between your draw and what was produced or collected, your draw may be lowered for the next period, since you were essentially overpaid. However, this can be avoided if you monitor your monthly production or collections.

Fringe Benefits. Many practices provide full-time associates with single coverage health insurance. Additionally, we recommend that a continuing education allowance of $1,000 to $1,500 per year be provided to help associates further develop their skills. When practices provide pension plans for full-time employees, associates can be included. However, participation in these plans usually occurs after employment of one-to-two years. Provisions for vacation time, sick time, and personal time also should be spelled out. In most instances, associates do not receive paid vacation or sick days.

About 45% of general practices pay for malpractice insurance premiums. In specialty practices, they often pay the full premium. Some employers will pay your malpractice premium and charge it against your salary, since you normally cannot take this expense as a deduction on your personal tax return. If you receive a comprehensive fringe benefits package, the compensation rate that you receive may be lower than those associates who receive no fringe benefits.

Whether you just graduated from dental school, finished a residency program or specialty training, the majority of young dentists begin their careers as associates. The road to becoming an associate is full of variables, and knowing the “lay of the land” can help you make wise decisions. The journey begins with choosing the practice that is right for you.

Consideration #2 – Employment Relationship

Do not enter into a relationship without a written contract. A well-designed employment agreement will address many issues, including your role in the practice, non-competition agreement (if applicable), non-solicitation agreement, your compensation, and possible option to purchase. Additionally, realize that non-solicitation and non-compete clauses are common business practices, which protect the employer dentist from unscrupulous tactics. Non-solicitation means that you may not directly solicit any patients or staff for a specified period after you leave the practice.

Non-compete clauses may vary. Moreover, in some states they are not enforced. For those states that enforce non-compete clauses, they have to be crafted fairly. The geographic limitations in covenants are based on local convention in a specific area and must be considered to be reasonable. For example, a 10-mile covenant restriction in a major metropolitan area would probably not be enforceable for a general dentist, whereas one-to-two-miles would be considered reasonable. Restrictive covenants for specialties tend to have a larger geographic range since the number of specialists is fewer. The duration of a non- compete ranges between one-to-two years.

When you join a general dental practice, a non-compete clause stipulation should not take effect completely until you are employed for 12 months. A gradual approach, which allows the first 6 months of employment to be free of covenant and penalty, with subsequent periods of increasing restriction, is more appropriate. In cases of specialty practices where the employer is introducing the associate to the referral base, the graduated approach would be modified and have a shorter timeframe for increasing restriction.

Read more on Becoming an Associate at http://www.thenewdentist.net/Library/index.htm