Professional Courtesy: Money-Saving Manual Transmissions by Dr. Thomas Giacobbi

Professional Courtesy: Money-Saving Manual Transmissions

by Thomas Giacobbi, DDS, FAGD, editorial director

One of the message boards featured this month highlights a timely discussion about raises for team members. This can be a difficult topic for dental practices that have team members who are already close to the top of the wage chart, and is further complicated by the fact we’re facing inflation in every aspect of our lives. Employers feel pressure to increase wages so their team members can maintain their current standard of living, and while we could raise fees to match inflation, insurance reimbursements will rarely match the schedule or amount of our increases. As an owner, I’m the last one to get paid, so this current situation leads to a pay cut for “the big guy.”

Usually, the wage pressures from inflation and the threat to your bottom line would be counterbalanced by a robust workforce. Team members who aren’t happy with their current salaries have the option of leaving the practice for a better offer, and you could probably fi nd a new team member who would work for the wage you’re willing to pay.

At this point, I expect your first thought was that hiring a new team member is a significant expense of time and money, which should be weighed against any expected raise. If you have been blessed with a stable team, you may not be aware of the current hiring crisis in the dental industry: There’s a significant shortage of quality team members for all positions. Your mileage may vary, but many online discussions suggest that the quality and quantity of applicants is at a low point. So when it comes time to fill an open position in your office, you’ll likely need to expand your search to a broader group of candidates and be willing to pay a competitive wage. In many parts of our country, the de facto minimum wage is $15/hour and the Amazon minimum wage is at $18/hour plus benefits.

Some people use the round figure of $10,000 to represent how much a new team member costs. This accounts for lost production during the search, employment advertising, time for training and diminished trainer productivity. Regardless of whether or not you are looking to fill a position, this column is your reminder to reflect on your current method of training new members of your team. Many offices don’t face this situation with any regularity, so their default method of training is to have the new team member shadow someone with the same position and learn as they go. One of the obvious challenges to this approach is the fact that the trainer will work slower as they teach and if your best (assistant, front office or hygienist) is the position you are filling, who will set the example?

Your best option to solve this problem is to work on an operations manual for the key positions in your office. This document describes every process and procedure for each particular position on your team. (The entry for a dental assistant, for example, might say, “Handles the new-patient appointment from start to finish. This includes greeting patients in the reception area and escorting them to the front desk to check out.”) If you currently have job descriptions for your team members, these documents are a good place to start; if not, you can develop both documents in parallel.

The best time to start is before you need to replace a team member, because your current all-stars will provide the best information to build your operations manual. You can simply start by sitting down with your team to make a list of all the procedures completed daily. From that outline, they can fill in the details.

A well-written operations manual should bring a new team member up to standard quicker than shadowing, and the reference document will support them as they face new situations in the practice. Furthermore, that new team member can improve the manual by providing feedback and adding detail or adjusting as needed. If you are overwhelmed at the prospect of creating this document, many dental consultants can help you with the process.

When someone leaves our team, it is often unexpected, and I hope the tips I’ve shared in this column help you have a plan in place.

Please share your thoughts and comments below. I can also be reached by email at

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