The educated hiring of qualified dental assistants, hygienists, and front
office staff can help dentists prevent costly drops in production income.
by Feridoon AminiTwenty years of managing people and dealing with HR issues for a number of large IT organizations prepared me surprisingly well for my first-hand work in the front end of a two-doctor dental office. The lessons learned carry over to address some of the challenges of running a successful practice.Prime among these challenges is the never-ending quest to fill vacant office positions. Complicating this issue is the increasing reliance on part-time and temporary help, and the difficulty in identifying truly qualified candidates."In six short years I've had employees quit suddenly, not even show up, and embezzle funds, but it happens to all dentists I talk to," says Mojan Safavi, DDS, who practices in McKinney, Tex. "My colleagues and I struggle with these issues on a regular basis, hoping to find a solution so our practices aren't hijacked by our staff."Dr. Safavi is just one of the dentists I have met with that have similar experiences. However, by applying successful strategies from the corporate world and harnessing the power of the Internet, practitioners can regain control of their offices to prevent devastating drops in productivity caused by employee vacancies.Develop a written process that anyone can followOne thing I've noticed in the dental industry — especially in smaller offices — is too great a reliance on individuals."I've had days when I'm fully booked with patients, but five minutes before the day begins, the dental assistant calls in sick," says Dr. Safavi. "What do you do? Without them, it's hard to do procedures like cement a veneers. You aren't even sure where some of the dental products are, so you have to cancel most of your patients. All that potential income vanishes."The absence of a hygienist proves equally as costly."A sudden loss of a hygienist can cause a doctor a $20,000 to 30,000 a month loss in production," says Fariba Dadgostar, general manager for the Dossett Dental chain located in the greater Dallas, Tex., area. "A delay in securing a dental-insurance specialist can be equally as financially devastating."In contrast, large organizations usually don't rely on individuals. Instead, there are processes in place. Everyone's job is well documented. Large organizations can replace a person — with only a minor hiccup — and continue with the work as before.I would advise office owners to have a strategy in place where employees document the processes they use to perform their jobs. It should be written so that anyone can follow those steps.Utilize technology to find qualified employeesThe ability to identify fill-in employees who meet the exigent employment needs of a successful dental office can help practitioners concentrate on the more profitable process of performing procedures rather than filling job positions. Yet, to my amazement, many dentists still resort to calling up traditional temporary agencies when they need help."I used to call a temporary agency to send me people who were supposed to be the best," recalls Dr. Safavi. "But they'd come to my office without knowing how to take film X-rays, let alone digital. Or, in the case of a front office person, they hadn't a clue about the walkout process using our software or how to deal with insurance issues. The temp worker might argue, 'Well, I used to work the insurance desk at a podiatrist's office.' A lot of good that does me!"I've observed two different types of temporary workers:
1) Those that can't keep a permanent job because no one wants them around for more than a week; and
2) Solid people who have other things to do with the rest of their time and just like to work occasionally.
One way to separate the two and avoid surprises is to find a website that incorporates a rating system to assess qualifications before you hire the worker.
DentalSpots.com has built into its portal a means to allow dentists or office managers to rate recently-acquired employees that other offices can review to help determine a good hire. A five-star rating system is used, along with comments by the reviewing doctor. While seemingly a benefit only to employers, such practices also act as a benefit for well-performing employees in their job searches. They get recognized for the good work they do.
Keep staff levels at a necessary minimum
Another problem I've come to see is that, despite the downturn in the economy that has depressed the patient load of many dentists, some still maintain a bloated head count in hopes that things will pick up again. They might employ two back office and two front office assistants, when the office really only needs one of each. This folly can waste thousands of dollars each month.
A better strategy consists of holding onto a solid core of permanent employees, and relying on temporary workers only when needed.
If, for example, you realize that you're routinely fully booked on Tuesdays, you should be able to quickly hook-up with a temporary worker for that one day. Use the temporary person for the four days in a given month that you might get swamped, and avoid the expense of keeping an additional person on the payroll for 30 days. Some job-board sites facilitate such match-ups.Potential dental employees may actually post their preference to only work on certain days.
Keep acquisition costs to a minimum
Given the inexpensive resources found on the Internet, it is now hard to justify calling on costly brick and mortar temporary agencies.
"The agencies I used in the past would charge me charge me $30 to $50 a day as their cut," says Dr. Safavi. "Even worse, the hourly pay the temp gets is usually more expensive than what your own help is getting. Additionally, if the agency sends you someone who is very skilled, and you want to hire that person permanently, you might have to pay as much as $2,000 to the agency for that privilege."
From what I've seen in the corporate world, buyers have learned to reduce the impact of the middle man as much as possible. Similarly, using a website that allows you to screen prospective employees for free, paying a nominal fee only when you are interested in interviewing the person, and then nothing else if you do hire them, can literally save thousands.(We allow them to see only certain information and we only charge them when they confirm which means they are hiring the temp worker for that opening. This is usually a temp position for a day and not a permanent hire.)
"Using the Dental Spots site, we have little to lose because they only charge us when we find someone we want," notes Dossett Dental's Dadgostar. "Even at that, the fee is only ten dollars."
Utilize local talent
In some large organizations, the HR department is given a mandate to not hire anyone that lives beyond a defined distance from the job site, no matter how qualified. Dentists can take a page from this book.
"Once, a temp agency sent us a hygienist that we fell in love with; she was fantastic," says Dr. Safavi. "We hired her, but after two months, she quit because she decided it was too far to drive."
A practitioner is well advised to utilize a website that facilitates the hiring of help who are proximate to the practice location. Some of the best offer a map for easy assessment of the distance involved. At some sites, employees can even declare, in advance, how far they are willing to drive, so the person doing the hiring can quickly rule them in or out.
Develop a sense of community with your
potential pool of employee candidates
As we all know, vacancies pop up at a moment's notice. To fill these spots on equally short notice, take proactive steps to stay in touch with qualified workers who you can call on immediately.
Take advantage of dental-industry specific websites that can double as a social networking site. Limiting that on-line community to dental practitioners and their employees makes everything all the more personal, in contrast to job-aggregation sites like CareerBuilder.com, etc."
"Let's say a Frisco, Tex., hygienist wants to relocate to San Francisco. Within one website portal, she can research the dental offices in the new city to find out which practices share her sensibilities in terms of working conditions and hours. Then, with one click, she can send off her resume and a cover letter, even if a job hasn't been posted yet. Doctors immediately receive notification of this "newbie" in town. In this sense, the site makes it easy for dental professionals to get to know each other not just by posting jobs, but by building relationships."
There really are a lot of good resources out there. All you really need to do is to connect to them.