Save Time and Money by Dana Pardue Salisbury

Dentaltown Magazine

The top reasons for failed anterior and posterior restorations—and how to address them

by Dana Pardue Salisbury

When did it become OK to quit your job via text message?

Are you stuck with an insolent but “irreplaceable” employee? Can you separate your team into people who work and people who take advantage of their seniority? Do you tell yourself things would be better if you had the “right” team?

You aren’t alone. Remember, you didn’t take “How to Hire the Perfect Dental Team 101” as an elective in dental school. You’ve had zero preparation for this. To get off the hamster wheel of high turnover and toxic work environments, you need a hiring process that’s as successful as your clinical work.

When you finish this article, you will:

  • Understand the connection between employee turnover and financial loss.
  • Have a pocket full of strategies to attract the right people to your practice.
  • Have the building blocks of an efficient and effective hiring process you can put in place today.

As a bonus, you’ll stop using Google and your dental buddies as your HR department.

How employee turnover affects your bottom line
The U.S. Bureau of Labor Statistics reported that in 2018, 41 million people left their jobs. A modest estimate of the cost to replace an employee is 10–30% of their annual salary,1 so if a $60,000-a-year hygienist quits, it will cost you anywhere from $6,000 to $18,000 to replace her. I’m sure there are more valuable places you’d like to spend $18,000 in your office!

Some statistics show the cost to replace employees with specialty skills to be more like 200% of their salary. If you can do a lot with $18,000, I can’t imagine what you could do with an extra $120,000.

These figures represent the direct costs of employee turnover, such as:

  • Severance pay.
  • Job listing service fees.
  • Signing bonuses.
  • Training time and expense for the new employees.
  • Administrative time to interview candidates.

Direct costs like these hit you right in the bank account, of course. But don’t forget about the indirect costs—things like:

  • Decreased team morale, “turnover trauma.”
  • Lost productivity.
  • Knowledge loss.
  • Lost patients who loved the employee who quit.
  • Lost productivity because of new employee error.

You can see where this is going. The cost to you as a business owner is financial, yes, but it also goes deeper. It can lead to all kinds of team issues, or what we in the biz like to call “drama.” Unfortunately, when one person is unhappy, the negativity can spread like a virus. You aren’t imagining it: Practices with high attrition rates beget more attrition. People tend to leave places other people leave.

If you don’t know what your attrition rate is, a simple equation can help you figure it out: Take the total number of employees who worked for you last year and divide that by the number who left. Then, multiply that number by 100. For example, if your practice employed 17 team members and lost three, then your attrition rate is (3 ÷ 17) x 100, or 17.6 percent. As a general rule, anything over 10 percent should be worrisome. If each of those three employees made $60,000 a year, you’re looking at a loss of anywhere from $54,000 to $360,000. Ouch!

We’ve established that it’s expensive to lose employees, so how do you go about avoiding it? To safeguard your practice, you need a solid hiring protocol. You can’t expect the best team if your hiring practices are lax. A new employee will lose respect for you and your practice if the hiring and onboarding process isn’t spot-on and compliant. Due diligence is the name of the hiring game. We’ll hit the major milestones of the process here. Follow the free tools to get more information.

How to prehire the best employees
It should be easy to find good people to work for you. After all, there are limitless ways to find people these days: online job boards, fairs, social networks, professional associations. Or, word-of-mouth and Craigslist—even local newspapers still post jobs. So why does it seem so hard to find someone with the skill set and go-getter attitude you need? It begins in the prehiring process.

1. Assign a hiring manager.

It’s worth the time and energy to have one person focused on the hiring process. If the office manager takes on the role, let her do it. Trust her to find the top candidates, and then join her for the final interviews.

Give the hiring manager autonomy and the resources to become the expert. Time is one of the most valuable tools you can give this person to do the job well. Let her research state laws, join forums and take online classes to stay up to date. Then, trust her judgment. Remember, you can’t wing it and find the perfect candidate.

The Society for Human Resource Management has one of the most robust and valuable sites to help hiring managers. There you can find state hiring laws, templates, interview questions and more.

2. Determine the knowledge, skill and ability gaps you need to fill.

HR professionals refer to these as “KSAs.” In reality, KSA should be KSAP: knowledge, skills, abilities and personality. I’d add special emphasis on the P, because you want to search for someone with spark. According to, top performers share the following attributes:

  • Good communication.
  • Self-directed.
  • Open to feedback.
  • Strives for innovation.
  • Positive attitude.
  • Leadership.

Don’t get caught up in college names or dental experience. Above all, the new hire needs to have the right temperament, values and skills to fill a gap. You can hire the most experienced scheduler on paper, but if she is introverted and doesn’t like talking on the phone, she isn’t a good fit. There are many personality and work values tests such as the DISC Personality Assessment and the Myers-Briggs Assessment available online. Find one you like and ask potential new hires to provide you their score.

New research is emerging about another key feature to keep front of mind when hiring: diversity.2 Hiring a diverse team can improve patient rapport and your bottom line. Diversity refers to ethnic, skill, gender and schooling diversity. Instead of KSAs or even KSAPs, perhaps we should be hiring for KSAPDs.

3. Write a good job description.

Words are not all created equal. Think of writing a job description as you would describe your perfect date: Be detailed. Be interesting. Note, the job description is the longer version of the job posting. The posting, discussed in the next section, is a skeleton of the detailed description.

Harvard Business Review states men will apply for jobs when they meet 60% of the requirements, while women apply at closer to 100%.3 Keep this in mind when writing your job posting/description.

4. Start recruiting.

Once you have your job description in hand, you can begin recruiting. If you want recruits to fill out an application, run it by your attorney first. To write the best job listing, be clear and interesting and avoid business jargon. Job descriptions should sell your office and outline exactly who you want.

Consider these snippets from job posts below. Which would you apply for?

Dental office seeking organized and energetic office manager to join our team. Skills include organization, written and verbal communication and basic computer skills. Candidate must be willing to answer phones and welcome patients to the office.


Our dental office family is ready for an office manager who can keep us organized and productive! We are hardworking, patient-focused and always go above and beyond. We need someone who is passionate about the details.

Office Manager Responsibilities
Maintains team and operations cohesion with a growth mindset.

Job Duties
• Communicate with different types of people.
• Create spreadsheets and other organizational documents.
• Convert incoming phone calls into scheduled patients.
• Jump in whenever needed to help patients or the doctor.
• Not be afraid to cross-train and continue learning.
• Contribute to the team effort by accomplishing results as needed.

Skills and Qualifications
• Supervisory skills.
• Managing processes.
• Encouraging team cohesion.
• Managing through analytics.
• Managerial experience preferred, but not required.

Minimum Qualifications
Associate’s degree or two years’ experience in a dental or medical office setting.

Special/Physical Qualifications
This position requires sitting for extended periods during the day. In addition, this position requires the physical ability to use a telephone and computer equipment, and requirement to work on premises.

What is it about the second post that draws you in? An accurate picture of what the team and duties will involve is sure to entice more qualified applicants to apply, as well as others who may not have considered you as a potential place of employment. Have established job description outlines for each position in the practice and revisit them regularly to remain compliant. Segments of the job description outline essentially become your job postings. Then post away!

Here are a few popular ways to find the best applicants:

  • Create a landing page on your website.
  • Word-of-mouth.
  • Social media: LinkedIn, Facebook, Instagram, Twitter.
  • Job recruitment sites: Monster, Indeed, local newspaper, Craigslist.
  • Dental specific sites like Dentaltown.
  • Job fairs.

You should start getting quality résumés once you post, so make sure to be ready! Your hiring manager will need to keep all résumés for one calendar year. Next, begin reviewing candidates.

5. Review résumés

Be prepared to get 50–100 résumés. The hiring manager should go through and flag résumés red, yellow and green: Red are those you reject; yellow are those the hiring manager needs to go through again, or get more information on; green are those that are top-notch and will make it into the preinterview phase.

How much time do you have to preinterview and interview? Be sure to whittle down the applicant pile to a manageable amount. As a courtesy, email the red applicants and let them know they were not selected.

Dentaltown Magazine

How to preinterview like a pro
For those who make it to the preinterview, call them to schedule a firm 10-minute video preinterview. Your time is valuable. A preinterview is a smart way to get to know applicants without spending the time of a formal interview. The call can clear up confusion and answer questions about experience. It’s also a good time to get a sense of personality and professionalism. Are they on time? Are they dressed like a professional? Do they smile? If you have a lot of qualified applicants, it’s a good idea to ask them to take a Wonscore assessment, which will give you some metrics for cognitive aptitude, motivation and personality. Your top few candidates can then get a formal interview request. Fair warning: The test must align with the position. If an applicant shows there is a less discriminatory metric available, they can win in a court case.

Do working interviews work?
Working interviews are like a spontaneous Las Vegas wedding. You may think you know the person, but when you wake up the next morning, you realize that you’ve put yourself at risk. If you bring someone in for a day, how do you know they are who they say they are? What criminal history are they bringing into the office? What happens if they become injured on the job? Have you checked the references? Then there’s HIPAA, OSHA and all the other policies employees need to know. If you preinterview well, working interviews are unnecessary. Even if you are one of the few who are still married after a trip to Vegas (mazel tov!), don’t test your luck with a working interview.

Teaming up for the interview
By the time you reach the formal interview, you should have a few solid candidates to choose from. For the interview, I suggest having several team members and the doctor join. They can ask job-specific questions, role-play and get a sense of the applicant’s temperament. Have a system to rate each applicant. The final selection can and should be a team effort. The top candidate should then get a conditional offer. (I’ve created a template for a conditional offer letter that Dentaltown readers can download for free, through the link found on the digital version of this article at The offer is contingent on the applicant passing all the required verifications.

Congratulations! You have hired a great-fit employee for your team. Hiring the right people the right way will save you time and money. While the process may appear complex at first, once your protocol is set, most of the work for the next hire is already done!


Check it out!

Download your free template for a conditional offer letter
Once you’ve finally found the perfect employee to bring on board you need to provide her with a flawless offer letter that details the terms and conditions of the new position. Dana Pardue Salisbury has created a sample conditional offer letter to provide your new hires, which can be downloaded and customized for your practice. Click here to download.

Author Bio
Author Dana Pardue Salisbury, MBA, SHRM-CP, has been in the dental industry for more than 20 years and is the chief operations officer and the leadership and human resources consultant at Classic Practice Resources. Salisbury specializes in team development, change management, human resources and the implementation of strategic business processes. Her professional goal is to improve workplaces everywhere.

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