Researching Team Retention

Here is an article that I authored that was published in the Arizona State Dental Association monthly magazine, Inscriptions, in November, 2011. It addresses some of the predominant reasons why some practices experience extended team longevity where others suffer from constant turnover.

Uncovering the Mystery of Dental Team Retention

Operating a successful dental practice requires patience, knowledge, structure, and foresight.  Ask any dentist anywhere in the country (or for that matter the world) to name the single greatest challenge in overseeing their business effectiveness and the almost universal response is, “the team.”

How do some practices keep their team members in place while others suffer from constant  turnover?

During my tenure as both an owner of a local and national dental placement agency, I conducted a study on dental team longevity.  The study’s goal was to uncover the “secrets” and commonalities among practices that linked employer/dentist to dental team members and kept them together for exceptionally long periods.

After conducting interviews with thousands of dental job seekers and team members, the primary reasons that loyalty and longevity is alive and well in many dental practices became strikingly evident.

–Not about the money

Employees repeatedly expressed that their loyalty to “their” practice was not wrapped around salary. Surprisingly, very high, over-market wages are often a red flag for many “savvy” dental employees. Dental team applicants ask themselves, “Why is this doctor paying so much more than comparable offices?” Often the answer was that the employer did not conduct proper due diligence as to what is fair compensation, or the employer felt that in order to find good, strong, capable, loyal employees they had to pay more than their peers.  The idea that employers could only find capable, loyal employees was to pay them more could not be further from the truth. In fact, as long as the position’s wages were in line with the market and compatible with the job description and responsibilities, excessive compensation will NOT yield more talent or assure employee loyalty.  In fact, offering initial wage levels that are too high can often inhibit an employee’s motivation, particularly as they settle in to their position. Practices that achieved high employee retention provided increases over time and offered special acknowledgements to employees that attained seniority.

–Interactive integration

An effective, organized interview process, as you might guess, also contributed to employee longevity. Practices that were the most successful at retaining employees took their time during the interview process. They hosted a number of interview meetings, and a few practices arranged lunches with the existing team as part of the protocol (team only, no employers present). Practices that had a hiring system and structure in place achieved a higher level of employee longevity. Practices that tried to “wing it,” did not.

Other commonalities among practices that scored high employee retention included: open communication, providing information for the job candidates to review, and asking the interviewees pertinent questions about themselves, their career interests, and their strengths and challenges.

–Skill assessment

I also found that high employee retention is connected to practices that conducted “working interviews,” or skill assessment days.  NOTE: if you include this with your interview protocol make sure they have structure and that you DO compensate them for their time. The employer is required to pay at least minimum wage for this trial period. This is a Federal Law. It is also recommended that you check with your financial advisor or accountant as to how you should orchestrate this payment to the job candidate.

–Hiring protocol

More than half the practices that achieved high employee retention had a formal letter of hire prepared. This letter clearly lists all the particulars of the position so that both parties [employer and applicant] knew what was expected going forward. It establishes a level of expectation. Successful practices also conducted proper legally sanctioned reference checking (with permission of job candidate). They also took the time to integrate the new employee into the practice: proper introductions to patients and vendors and total support of the current team members.

–Attitude is key

Employees that felt their doctor communicated with them with honesty and sincerity had a much higher rate of longevity.  Many said, “Even if he/she had a bad day, the doctor would never take it out on the dental team.” Open and healthy communication and dialog was a constant in all the offices that were able to retain employees for a long time. Employees of these practices also indicated that they felt the dentist(s) had no “favorites.” Everyone was treated equally.

In regard to the dentist, and his/her mindset: doctors that really enjoyed their profession and maintained positive energy were able to hang on to employees longer.  In fact, hearing how much they were appreciated and valued (often in front of patients) was a factor in employees remaining with a practice.

It should be noted that these signs of appreciation were NOT in the form of monetary rewards but rather sincerely spoken from the heart.  There were regularly scheduled reviews and salary increases based on the value these team members held within the practice, but it was the consistent words of encouragement and positive reinforcement that were universally the most important catalyst for all the team members.

–Patience and more patience

Patience during the hiring process, patience during the integration process, patience when the day is a rough one, patience when the bonding agent fails when working with a difficult patient all contribute to the success of a loyal team.  For the dentist, it is really a matter of tempering the practice’s pace and realizing where and when not to overreact.  NOTE: consider talking things out as a group as a means of supporting each other, especially when things are not going as planned.

Basic steps to help create long-term relationships with your employees:

  • Create an ad that delineates and makes your specific needs unique to only your practice. If you are using or a similar online approach, short descriptive words work well.
  • Develop a clear and concise job description with your team prior to starting the interview process.
  • Compose a comprehensive practice overview and include as much as you can to educate the candidates on your particular practice style.
  • Make sure your skill assessment days have structure, including a blueprint for the job candidate to reference regarding what is expected of them.
  • Whenever possible, assign a team member serve as a “buddy” during work assessment days to work alongside them.
  • Avoid rushing your hiring decisions, and be sure to incorporate your team’s thoughts and opinions when picking the final employee.
  • Have a thorough job offering proposal in place so that there are no surprises for either you or employee down the road.
  • As you would do with your patients, be certain to “recare” your team members on a regular basis by checking in on what they need and the feedback they have to share.

There are some amazing long-term dental business relationships out there and it is possible for you to create that as well!


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