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Tiff and Kristy discuss the ongoing challenges of hiring, including how incentives and mentalities have shifted over the past five years — and what you, as someone hiring, can do about it. Part of the discussion includes the pros and cons of how to pay team members.
Episode resources:
Subscribe to The Dental A-Team podcast
Schedule a Practice Assessment
Leave us a review
Transcript:
The Dental A Team (00:02)
Hello, Dental A Team listeners. We are back today. I have Ms. Kristy again with me and we are just having a good old time over here recording ⁓ Love and Life and getting our time in together. I think you guys have heard us say it before. This is like, and I know Dana says the same thing, this is some of the only one-on-one time that we get in our lives. I don't know if you guys know this or not, but we are a completely virtual company, meaning we are all at our homes.
We don't have like a workspace that we come to and then if you're a client of ours, you know, we're on calls or in offices quite a bit as consultants or our consulting team. We really just don't get a ton of time together. So these couple of hours that we bust out some podcasts are near and dear to our hearts and I just adore you Kristy and I appreciate you blocking out the time when your schedule always for it and for always just putting so much value into everything that you do.
with your clients, with your podcasting, everything that you do. So Kristy, thank you so much. Thank you for being a part of the Dental A Team. Thank you for being here today. How are you? How are things going over there?
DAT Kristy (01:09)
Good, thank you for having me. It's wonderful. I love what I do serving people and it just brings great joy. So happy to be here with you.
The Dental A Team (01:18)
Amazing. Good.
Thank you. And I have a question that I haven't asked you yet. How are, how's your family adjusting to the heat to being here and your puppy who's not necessarily a puppy anymore, but he'll always be a puppy. All your dogs, I guess, both your dogs, but how's everybody, how's everybody doing kind of getting settled into Arizona?
DAT Kristy (01:40)
Yeah, everybody's loving it. Thank goodness there's pools around so we can get cooled off. the dogs, they're definitely staying indoors right now. It's especially the little Frenchie, you know, that you have to be careful because they will overheat really easy. He's I can tell he's missing his walks right now, but they'll swim.
The Dental A Team (01:46)
Thank you.
Yeah.
Yeah, good, good.
I had a black lab that hated water, like couldn't be anywhere near water, which is so not allowed. And summers were rough. He would get hot, but he wanted to be out there, but he was an Arizona born dog, so he was fine. But I was just thinking about earpups this morning, like, gosh, they're not used to not being able to just go outside and chill in the backyard for a couple hours. Well, I'm glad that they swim. I'm glad that they're enjoying that.
DAT Kristy (02:25)
So true.
The Dental A Team (02:31)
⁓ and yeah, we're just, we're excited to bring you some information this, this day. We've got, gosh, what four podcasts for recording. So I'm super excited for them all to release and you guys, we always want you to know that these podcasts are for you. So if there's ever anything that you have hopes, wishes, desires, things you want us to talk about things that you want us to dive in deeper on, please just always reach out. [email protected]. We are always taking suggestions and we're always here to help.
And also if there's anything that we say on these podcasts that we're like, we'll get you that. We really do mean that as well. have clients that write in all the time and say, Tiff said, and I'm like, sometimes my marketing team is like, what were you talking about? I don't know, but we figure it out. Whatever it is that we say that you can have, we want you to have it. We are here to deliver massive amounts of information to the dental community in the best ways possible and that.
comes with a ton of free resources. That's our podcast, that's our sheets, our documents, our website. We have all kinds of stuff everywhere, our ⁓ social media, we're on Instagram and Facebook, like wherever you can find us, you're gonna find a slew of information. So we're here for you and when you're ready for one-on-one consulting and not just getting all the information on your own via the web, please reach out, [email protected]. We are so excited to serve all of you guys in whatever way fits you the best today. Kristy.
I wanted to chat this podcast today. I've had, well, number one, I've had a lot of hiring in all of my practices. So I actually chatted with a doctor yesterday, a very successful doctor in Colorado, and he was like, Tiff, what the heck? Like, we lost another one. We just filled our hygiene spots and now we're in front office. And like, what is it? What's going on? He's like, just as soon as I feel like I'm making progress, someone leaves. And I said, you know what?
And he's like, it's hard to not take it personally. That's what he said. And I said, you know what? I understand that. And I, and I feel that. And on the level of, you know, being a lead on a team, I don't own this company, but I have a lot of vested interest in this company and its success. And it's hard. And I said, we come from, we come from a time of, of being employees, right? When we were employees and we were working and, and our work ethic.
Not even ethic, I don't even think it's ethic. Just like our tendency to stick around one place longer, is, it was there longer than it is now. So we just, we didn't leave. We stayed where we were. We became part of the family. We allowed work to become a bigger piece of our lives than it does for a lot of people in this day and age, in my opinion. I think that we,
made work our, like we tied our identity to work. And so leaving was a bigger ⁓ undertaking than it is when you're not so tied to what your job is, your title is, or the place is. And it's much easier to say, you know what, I can, I want to grow into something different. I want to be someone different. I want to change. And so they do, they leave more easily. And I think from
our point of view, it makes it really hard because we tied so many emotions to our job and our identity to our job that we're like, gosh, do they not like us? Do they not like where they work? Am I not doing good enough as an employer? But the reality is we've actually created an environment and ⁓ a social standing that people identify with who they are as a human outside of work better.
than we ever have in our lives. So it's like a catch-22, no matter what, there's a pro and a con to everything. And the pro is that they're not so identity attached to their jobs or their titles. The con is that it's easy for them to jump ship and try something new. We're much more apt to dip our toes in and try that new thing. And so I think the hiring has just over the last, realistically five years, has had a lot more turnover and we spent a lot more time hiring.
than we ever have in the past. And I could be making all of that up. That's my opinion. That's not like scientifically proven, but it's just something that I've noticed by studying people and studying myself as well. Like how am I transitioning? How am I changing my identity tools and all of those pieces as I watch the climates change so much. Kristy, what are your thoughts on that? I know we both have a lot of clients. I have experienced a lot of hiring this year. What are you seeing?
DAT Kristy (07:11)
100 % exactly what you said Tiff and it is hard. It's a hard reality. I think ⁓ Back in college. I took sociology not that I really liked it But now I'm like man I wish I would have dug into it more because I think there is something with the new generation and ⁓ Not to go woo-woo, but I think there is something with those personalities. You know what I mean and It's kind of funny and listening to you talk about it because our generation is
always like speaking to work-life balance, work-life balance, and I think the new generation actually has it figured out better.
But we're angry at it. We want it and they're doing it. And I get it. And I also get it because of being in a, in a practice administration role. Like it's hard hiring and training and retraining and hiring. And so I think ⁓ we've got to find a way to maneuver around that easier versus ⁓ taking it so personal and choosing to see it as a good thing. Maybe not necessarily a thing, but yeah.
The Dental A Team (07:50)
Mm-hmm. agree.
Yeah, that
was beautifully said.
You're totally right. I love that you said you pointed out the work life balance because I agree and I whenever I hear the words work life balance now I think of that like yeah, I'm like it's like that live laugh love that we had all over our houses like every room had a live laugh love sign somewhere and it's like so outdated and overplayed when I hear the words work life balance. I'm like, my gosh, like stop saying that just have balance. just have balance balance balance. If you continue separating work and life.
and not understanding that it's one, you're one person, you're gonna continue to be out of balance. So just have balance. And I think you're right. think they've, lot of people have found that balance where neither tips the scale and they just understand their boundaries and their priorities a little better than maybe we did when we were their ages. So there's our spiel on that. But one of the...
DAT Kristy (09:10)
I was gonna tell you, it's kind
of ironic, I'm spilling the beans and being vulnerable now, but my daughter's in dentistry, you I roped her into it. And so I hear it from her often, mom, it's not my life, like it is yours. And I was like, ⁓ stab me, right? Like, it's so true. So I'm living it.
The Dental A Team (09:32)
Yes, it is. Yeah.
Yeah, so
you're seeing it firsthand. You're seeing it with your practices and just watching, but then also within your own home. So I totally get that. And I have a actually happy practice out in Rhode Island near and dear to my heart. The office manager's daughter is their billing rep. And I see the same kind of conversations, the office manager and like stop taking work home, like just do it at work. And then her daughter is like, why are you working at home? Like put it away. And so I do, I see that same dynamic there. And I think, I actually think the ages are
about the same, like you guys are both in the same spaces there. ⁓ So it's interesting, but I think with that conversation, doctors oftentimes and office managers are like, what can we do more of? What can we do better? How can we offer things differently? And the hygiene market is wild still, okay? It's 2025, I don't know when you're listening to this, but I hope if it's years from now, things are better.
Because the hygiene market is still a little wild. It's just still hard to find hygienists So if you're listening to this now like go apply to hygiene school because the demand is high Go get your degree go do your thing and come out a hygienist, but we oftentimes get asked for provider information on pay, right? And so we have a couple of different scenarios a couple different options. I Mean dollar per hour still near and dear to my heart when it comes to employees. I think that it just
I just, for me, it's an ease of life. It's just easier. And so I love dollar per hour, but I do like the stipulation that a provider should be making three to 3.5 times their rate of pay in order to pay for themselves so that the overhead doesn't get out of control. So dollar per hour, three to 3.5 times their rate of pay. You've got to do the digging on what your area.
is hiring at or what they're paying their hygienist or their dental assistants, whomever, because it does change, it does differ by area. More rural is going to be maybe a little less, city life is probably going to be a little more, Indianapolis compared to Phoenix, compared to San Francisco, compared to, I don't know, New Mexico, right? They're all going to be very different rates of pay. So I can always, you know, we can always spew out some numbers to you, but Google is a really fantastic tool and Salary.com gets it right every single
So go check those for sure dollar per hour and then I really wanted to chat a little bit and we talked about this a little bit ahead of time me and Kristy did on paying based off of production or collections and in my opinion I've seen this I've seen this and in my opinion it's kind of the same structure that you would give to an associate so Don't over complicate it a lot of practice owners a lot of office managers like to over complicate it so just don't do that and
pay like you would an associate? What would that look like? What would those stipulations be? What would the percentage of production or collections look like? ⁓ And pay based off of that. There are pros and cons, right, to everything. And I think there are pros and cons to paying off of production or collections. And Kristy, I think I'd love to hear from you on that production-based pay, because I know that you've seen that and worked with some clients that have done that. What are some things that you've seen that work well? Why?
Some clients, like I've had clients recently ask, should I move to a percentage structure rather than a salary or a dollar per hour? What do you see work well within that percentage structure on production or collections? Like you said earlier, I do think collections is a little bit more difficult for providers, especially for hygienists that don't have a lot of say in that, but production-based maybe as well. Kristy, what are your thoughts?
DAT Kristy (13:08)
Yeah.
To be honest with you, this is something a little near and dear to my heart. And I think we will probably see ⁓ a little more of it just with, ⁓ I don't want to get in the political things, but we know that there are some states looking at assistance getting into hygiene. so with that being said, we all know that hygienists come out of school and they take their boards and they're all expecting to come in at that same level. Right. And just like associates, we know
they
all do their testing as well, come out with their doctorate and get their license. But we know they likely aren't going to produce at the same level, right? So hygienists are no different. Usually your seasoned hygienist can carry conversations different than, you know, somebody brand new. And their skill set is likely a little bit different, whether they've gone through more CE or not. So to be honest with you, I do
I'm a huge proponent of paid for performance ⁓ Yet I also feel in hygiene ⁓ Paying them a good going rate like you said, you know know what they're in your area and Give them that good going rate but just like you mentioned tiff with associates if somebody's performing and when I say performing I'm not just talking like production numbers or monetary That's just a side effect, but I'm talking like
moving your patients to health, getting them healthy, calling perio perio and having those different, you know, difficult conversations with patients. If they're willing to do that, why wouldn't we compensate them for that?
The Dental A Team (14:52)
Yeah, I think that's fantastic. That is a very good point too. And that is something I think that comes up a lot for practices is that perio space. And if I've got one hygienist who's just rocking it out and having those difficult conversations and diagnosing correctly for our patient's health and not just for the production or just for the accolades, but really, really doing due diligence for our patients, how do I repay them? And I think that is a great point that that production-based pay
is.
an effect of that. think that's fantastic. I also see practices that will do dollar per hour and bonuses. So if you go above and beyond that 3.5%, they can get, you know, a one or 2 % or whatever you decide you want your bonus to be of what's above that. So one mistake I do see practices make with this, I'm going to give you a caveat, is that they'll do it the bonus based off of the total. And I typically would do the bonus based off of what was above and beyond the threshold. So we don't total it, we say this was our threshold, anything above
that is what you get the bonus off of. So any bonus programs is that's typically how I'm gonna run it because that's your excess. This is your overhead, this is your excess. So we're only bonusing off of excess and then also a small caveat, I did talk to an office the other day that was, they're making some transitions and they're like, do we change the structure? And I'm looking at it and I'm like, well.
they wanted to lower the threshold. And I said, well, no. Number one, no, never do that. ⁓ Number two.
You also didn't add in my overhead caveat and you're at 66 % I think overhead for the year, but the team's been bonusing. And so we're digging in trying to figure out like what's going on. I have a couple offices going through this right now. This one kind of East Coast stern was like a little topsy turvy upside down. So I think no matter what you do, you've got to make sure that it's going to work the best for your practice for your overhead. So if dollar per hour right now is the best bet and you're able to manage and control your overhead with
that, do that. If you've got a team that you're like, want to, I want to make this more production based and Kristy, like you were saying, like really give that energy to what we're pushing for and kind of pay them back right for the work that they're putting in. You have that flexibility and that level with the percentage on production collections and or bonuses. I love the, if you're asking me either or I would say
in my opinion, production-based over-bonusing. ⁓ It just is easier. Again, I want easier, and it's easier, and it's like tailored for this position, this person. It doesn't have to be across the board for the full practice if we're not to a point that we're ready for that yet. So cons. ⁓
I think there's cons to everything. There's cons to dollar per hour because often times, especially in the ⁓ temperature that we're in right now with the dollar per hour, it is hard to do three to three to point five times their rate of pay. I tell hygienists and I tell doctors all the time, I'll pay you whatever you're asking for. I'll pay you whatever you want. If you can make it work with the numbers. If you can do three to three point five times that rate of pay in production per hour, you've earned it. That's the point is that the overhead has to match.
and for our team members that are listening, I just need you guys to really hear me when I say doctors can't pay you from nothing. So if we're upside down in our overhead, we're not making profit on the company, the business is not profiting.
It's not just for the doctor to profit. It's not just for the doctor to go buy a house or whatever you think is actually happening behind the scenes. It's to ensure that things are paid for. And so if we're upside down in payroll, it's got to come from somewhere else. So then we got to pull it from supplies or from labs or from somewhere. And so the pay always just has to make sense. So if you can make it make sense, I don't care what it looks like. So there's pros and cons to all of it.
So there's the dollar per hour making sure that you're staying in line. There's you know, collections production based and then there's the accelerated which we're not going to spend a ton of time on the accelerated. kind of feel like it's a dying breed in this.
day and age. I love accelerated myself and I loved being hygiene assistant to accelerated hygiene, but that's a really great space too. I do have a hygienist that I know out in like the Chicago area who does accelerated and she's paid on production. She kills it. She is making really pretty numbers over there, but there's pros and cons to everything and it kind of runs the doctor a little ragged, so you just have to have the right system
for that and to make sure that it all just makes sense. And Kristy, you've got a ton of practices too in this same space. What would you have seen like really working or not working within any of this, whether it's associates or hygienists, really just what do you see that works really, really well?
DAT Kristy (20:08)
Yeah, honestly, Tiff, I'm gonna say the one that I've seen work the best is a combination, right? ⁓ Again, a good going pay rate and then incentivizing them on.
I'm going add in it's more of a profit share model, right? Because like you said, it has to make sense with the numbers and be profitable. ⁓ And again, I do see a lot of ⁓ accelerated, but I will caution there too. The ones that I've seen work the best is when you give them a very good assistant that can perform. You know what I mean? Don't give them an entry level person that can't carry conversations. And I shouldn't say can't, but is
as developed right and or let them hand pick them and develop them right so that they work in tandem together and I've seen it work very well in both models but you have to have the right personality and desire there.
The Dental A Team (20:57)
Yeah.
I think that's a fantastic point and to that point I've seen it work really well. ⁓
with the right assistant as well. And oftentimes what we do is we hire a hygiene assistant who's like the low level training, not quite the doctor's assistant yet. And the reality is it needs to be someone who knows how to run a schedule, how to talk with the patients, how to sell treatment, how to take the x-rays correctly and really give that concierge service because we've got to make up for not having as much time with the hygienist, right? So the hygienist does all of that in your hour appointments, but when you're
shortening them and they're doing accelerated, the hygienist is only in there for 30, 40 minutes, right? You're losing a lot of value there from the hygienist transitioning. So that assistant definitely has to be top level, top notch. And we make that mistake a lot. I've made that mistake in my own office and hiring many, many times. So it's kind of opposite and you really need a skilled assistant to be your hygiene assistant. I agree. That's a great point. Awesome.
DAT Kristy (22:15)
And you know
what, Tiff, you mentioned earlier that the margins are getting hard, especially with PPO and they're not reimbursing. You made a good point about the co-diagnosis aspect. Make sure you're factoring that in. Like look at what's coming out, know, track it and see, because that also needs to be factored into the pay scale, right? It may not just be 100 % hygiene services. You almost have to look
The Dental A Team (22:37)
Yeah.
DAT Kristy (22:45)
at hygiene sometimes as part of your marketing strategy in a way, you know? So.
The Dental A Team (22:48)
Yeah, that's a great point. I totally agree.
Yeah, I love it.
Thank you, Kristy. ⁓ I think there's some great ideas in here. You guys know we did not give you the do this answer because it is really case by case. I mean that with every ounce of my being, it is dependent on what's going to work best for your company. If you want help diving into that, figuring out what might be best for you or your company model, we are more than happy to help you on a one-on-one basis. Reach out. [email protected]. We'll be happy to get on a call with you to dive into your practice statistics.
sticks and needs with you. Again, no, I don't have a do this, do that, but we can help you. [email protected] and we are so happy to help any of you guys. We are all here for it. We have a team standing by, always ready to hop on a call with you.
Kristy, thank you for your amazing words of wisdom and for your vulnerability. And we have more to record, you guys. We got more coming up for you. And we are just so excited to deliver you so much amazing content this month. Please drop us a five-star review below letting us know how helpful this was. If you have ideas, if you have things that you've done that worked or didn't work, send them in. You can put them within your review. People really do go through and read those. Or [email protected]. You can send them over to us and we'll be happy to
with you or put that information out for others to read as well. So go find us, Instagram, Facebook, all the places, and we'll catch you next time. Thanks guys.
4.9
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Tiff and Kristy discuss the ongoing challenges of hiring, including how incentives and mentalities have shifted over the past five years — and what you, as someone hiring, can do about it. Part of the discussion includes the pros and cons of how to pay team members.
Episode resources:
Subscribe to The Dental A-Team podcast
Schedule a Practice Assessment
Leave us a review
Transcript:
The Dental A Team (00:02)
Hello, Dental A Team listeners. We are back today. I have Ms. Kristy again with me and we are just having a good old time over here recording ⁓ Love and Life and getting our time in together. I think you guys have heard us say it before. This is like, and I know Dana says the same thing, this is some of the only one-on-one time that we get in our lives. I don't know if you guys know this or not, but we are a completely virtual company, meaning we are all at our homes.
We don't have like a workspace that we come to and then if you're a client of ours, you know, we're on calls or in offices quite a bit as consultants or our consulting team. We really just don't get a ton of time together. So these couple of hours that we bust out some podcasts are near and dear to our hearts and I just adore you Kristy and I appreciate you blocking out the time when your schedule always for it and for always just putting so much value into everything that you do.
with your clients, with your podcasting, everything that you do. So Kristy, thank you so much. Thank you for being a part of the Dental A Team. Thank you for being here today. How are you? How are things going over there?
DAT Kristy (01:09)
Good, thank you for having me. It's wonderful. I love what I do serving people and it just brings great joy. So happy to be here with you.
The Dental A Team (01:18)
Amazing. Good.
Thank you. And I have a question that I haven't asked you yet. How are, how's your family adjusting to the heat to being here and your puppy who's not necessarily a puppy anymore, but he'll always be a puppy. All your dogs, I guess, both your dogs, but how's everybody, how's everybody doing kind of getting settled into Arizona?
DAT Kristy (01:40)
Yeah, everybody's loving it. Thank goodness there's pools around so we can get cooled off. the dogs, they're definitely staying indoors right now. It's especially the little Frenchie, you know, that you have to be careful because they will overheat really easy. He's I can tell he's missing his walks right now, but they'll swim.
The Dental A Team (01:46)
Thank you.
Yeah.
Yeah, good, good.
I had a black lab that hated water, like couldn't be anywhere near water, which is so not allowed. And summers were rough. He would get hot, but he wanted to be out there, but he was an Arizona born dog, so he was fine. But I was just thinking about earpups this morning, like, gosh, they're not used to not being able to just go outside and chill in the backyard for a couple hours. Well, I'm glad that they swim. I'm glad that they're enjoying that.
DAT Kristy (02:25)
So true.
The Dental A Team (02:31)
⁓ and yeah, we're just, we're excited to bring you some information this, this day. We've got, gosh, what four podcasts for recording. So I'm super excited for them all to release and you guys, we always want you to know that these podcasts are for you. So if there's ever anything that you have hopes, wishes, desires, things you want us to talk about things that you want us to dive in deeper on, please just always reach out. [email protected]. We are always taking suggestions and we're always here to help.
And also if there's anything that we say on these podcasts that we're like, we'll get you that. We really do mean that as well. have clients that write in all the time and say, Tiff said, and I'm like, sometimes my marketing team is like, what were you talking about? I don't know, but we figure it out. Whatever it is that we say that you can have, we want you to have it. We are here to deliver massive amounts of information to the dental community in the best ways possible and that.
comes with a ton of free resources. That's our podcast, that's our sheets, our documents, our website. We have all kinds of stuff everywhere, our ⁓ social media, we're on Instagram and Facebook, like wherever you can find us, you're gonna find a slew of information. So we're here for you and when you're ready for one-on-one consulting and not just getting all the information on your own via the web, please reach out, [email protected]. We are so excited to serve all of you guys in whatever way fits you the best today. Kristy.
I wanted to chat this podcast today. I've had, well, number one, I've had a lot of hiring in all of my practices. So I actually chatted with a doctor yesterday, a very successful doctor in Colorado, and he was like, Tiff, what the heck? Like, we lost another one. We just filled our hygiene spots and now we're in front office. And like, what is it? What's going on? He's like, just as soon as I feel like I'm making progress, someone leaves. And I said, you know what?
And he's like, it's hard to not take it personally. That's what he said. And I said, you know what? I understand that. And I, and I feel that. And on the level of, you know, being a lead on a team, I don't own this company, but I have a lot of vested interest in this company and its success. And it's hard. And I said, we come from, we come from a time of, of being employees, right? When we were employees and we were working and, and our work ethic.
Not even ethic, I don't even think it's ethic. Just like our tendency to stick around one place longer, is, it was there longer than it is now. So we just, we didn't leave. We stayed where we were. We became part of the family. We allowed work to become a bigger piece of our lives than it does for a lot of people in this day and age, in my opinion. I think that we,
made work our, like we tied our identity to work. And so leaving was a bigger ⁓ undertaking than it is when you're not so tied to what your job is, your title is, or the place is. And it's much easier to say, you know what, I can, I want to grow into something different. I want to be someone different. I want to change. And so they do, they leave more easily. And I think from
our point of view, it makes it really hard because we tied so many emotions to our job and our identity to our job that we're like, gosh, do they not like us? Do they not like where they work? Am I not doing good enough as an employer? But the reality is we've actually created an environment and ⁓ a social standing that people identify with who they are as a human outside of work better.
than we ever have in our lives. So it's like a catch-22, no matter what, there's a pro and a con to everything. And the pro is that they're not so identity attached to their jobs or their titles. The con is that it's easy for them to jump ship and try something new. We're much more apt to dip our toes in and try that new thing. And so I think the hiring has just over the last, realistically five years, has had a lot more turnover and we spent a lot more time hiring.
than we ever have in the past. And I could be making all of that up. That's my opinion. That's not like scientifically proven, but it's just something that I've noticed by studying people and studying myself as well. Like how am I transitioning? How am I changing my identity tools and all of those pieces as I watch the climates change so much. Kristy, what are your thoughts on that? I know we both have a lot of clients. I have experienced a lot of hiring this year. What are you seeing?
DAT Kristy (07:11)
100 % exactly what you said Tiff and it is hard. It's a hard reality. I think ⁓ Back in college. I took sociology not that I really liked it But now I'm like man I wish I would have dug into it more because I think there is something with the new generation and ⁓ Not to go woo-woo, but I think there is something with those personalities. You know what I mean and It's kind of funny and listening to you talk about it because our generation is
always like speaking to work-life balance, work-life balance, and I think the new generation actually has it figured out better.
But we're angry at it. We want it and they're doing it. And I get it. And I also get it because of being in a, in a practice administration role. Like it's hard hiring and training and retraining and hiring. And so I think ⁓ we've got to find a way to maneuver around that easier versus ⁓ taking it so personal and choosing to see it as a good thing. Maybe not necessarily a thing, but yeah.
The Dental A Team (07:50)
Mm-hmm. agree.
Yeah, that
was beautifully said.
You're totally right. I love that you said you pointed out the work life balance because I agree and I whenever I hear the words work life balance now I think of that like yeah, I'm like it's like that live laugh love that we had all over our houses like every room had a live laugh love sign somewhere and it's like so outdated and overplayed when I hear the words work life balance. I'm like, my gosh, like stop saying that just have balance. just have balance balance balance. If you continue separating work and life.
and not understanding that it's one, you're one person, you're gonna continue to be out of balance. So just have balance. And I think you're right. think they've, lot of people have found that balance where neither tips the scale and they just understand their boundaries and their priorities a little better than maybe we did when we were their ages. So there's our spiel on that. But one of the...
DAT Kristy (09:10)
I was gonna tell you, it's kind
of ironic, I'm spilling the beans and being vulnerable now, but my daughter's in dentistry, you I roped her into it. And so I hear it from her often, mom, it's not my life, like it is yours. And I was like, ⁓ stab me, right? Like, it's so true. So I'm living it.
The Dental A Team (09:32)
Yes, it is. Yeah.
Yeah, so
you're seeing it firsthand. You're seeing it with your practices and just watching, but then also within your own home. So I totally get that. And I have a actually happy practice out in Rhode Island near and dear to my heart. The office manager's daughter is their billing rep. And I see the same kind of conversations, the office manager and like stop taking work home, like just do it at work. And then her daughter is like, why are you working at home? Like put it away. And so I do, I see that same dynamic there. And I think, I actually think the ages are
about the same, like you guys are both in the same spaces there. ⁓ So it's interesting, but I think with that conversation, doctors oftentimes and office managers are like, what can we do more of? What can we do better? How can we offer things differently? And the hygiene market is wild still, okay? It's 2025, I don't know when you're listening to this, but I hope if it's years from now, things are better.
Because the hygiene market is still a little wild. It's just still hard to find hygienists So if you're listening to this now like go apply to hygiene school because the demand is high Go get your degree go do your thing and come out a hygienist, but we oftentimes get asked for provider information on pay, right? And so we have a couple of different scenarios a couple different options. I Mean dollar per hour still near and dear to my heart when it comes to employees. I think that it just
I just, for me, it's an ease of life. It's just easier. And so I love dollar per hour, but I do like the stipulation that a provider should be making three to 3.5 times their rate of pay in order to pay for themselves so that the overhead doesn't get out of control. So dollar per hour, three to 3.5 times their rate of pay. You've got to do the digging on what your area.
is hiring at or what they're paying their hygienist or their dental assistants, whomever, because it does change, it does differ by area. More rural is going to be maybe a little less, city life is probably going to be a little more, Indianapolis compared to Phoenix, compared to San Francisco, compared to, I don't know, New Mexico, right? They're all going to be very different rates of pay. So I can always, you know, we can always spew out some numbers to you, but Google is a really fantastic tool and Salary.com gets it right every single
So go check those for sure dollar per hour and then I really wanted to chat a little bit and we talked about this a little bit ahead of time me and Kristy did on paying based off of production or collections and in my opinion I've seen this I've seen this and in my opinion it's kind of the same structure that you would give to an associate so Don't over complicate it a lot of practice owners a lot of office managers like to over complicate it so just don't do that and
pay like you would an associate? What would that look like? What would those stipulations be? What would the percentage of production or collections look like? ⁓ And pay based off of that. There are pros and cons, right, to everything. And I think there are pros and cons to paying off of production or collections. And Kristy, I think I'd love to hear from you on that production-based pay, because I know that you've seen that and worked with some clients that have done that. What are some things that you've seen that work well? Why?
Some clients, like I've had clients recently ask, should I move to a percentage structure rather than a salary or a dollar per hour? What do you see work well within that percentage structure on production or collections? Like you said earlier, I do think collections is a little bit more difficult for providers, especially for hygienists that don't have a lot of say in that, but production-based maybe as well. Kristy, what are your thoughts?
DAT Kristy (13:08)
Yeah.
To be honest with you, this is something a little near and dear to my heart. And I think we will probably see ⁓ a little more of it just with, ⁓ I don't want to get in the political things, but we know that there are some states looking at assistance getting into hygiene. so with that being said, we all know that hygienists come out of school and they take their boards and they're all expecting to come in at that same level. Right. And just like associates, we know
they
all do their testing as well, come out with their doctorate and get their license. But we know they likely aren't going to produce at the same level, right? So hygienists are no different. Usually your seasoned hygienist can carry conversations different than, you know, somebody brand new. And their skill set is likely a little bit different, whether they've gone through more CE or not. So to be honest with you, I do
I'm a huge proponent of paid for performance ⁓ Yet I also feel in hygiene ⁓ Paying them a good going rate like you said, you know know what they're in your area and Give them that good going rate but just like you mentioned tiff with associates if somebody's performing and when I say performing I'm not just talking like production numbers or monetary That's just a side effect, but I'm talking like
moving your patients to health, getting them healthy, calling perio perio and having those different, you know, difficult conversations with patients. If they're willing to do that, why wouldn't we compensate them for that?
The Dental A Team (14:52)
Yeah, I think that's fantastic. That is a very good point too. And that is something I think that comes up a lot for practices is that perio space. And if I've got one hygienist who's just rocking it out and having those difficult conversations and diagnosing correctly for our patient's health and not just for the production or just for the accolades, but really, really doing due diligence for our patients, how do I repay them? And I think that is a great point that that production-based pay
is.
an effect of that. think that's fantastic. I also see practices that will do dollar per hour and bonuses. So if you go above and beyond that 3.5%, they can get, you know, a one or 2 % or whatever you decide you want your bonus to be of what's above that. So one mistake I do see practices make with this, I'm going to give you a caveat, is that they'll do it the bonus based off of the total. And I typically would do the bonus based off of what was above and beyond the threshold. So we don't total it, we say this was our threshold, anything above
that is what you get the bonus off of. So any bonus programs is that's typically how I'm gonna run it because that's your excess. This is your overhead, this is your excess. So we're only bonusing off of excess and then also a small caveat, I did talk to an office the other day that was, they're making some transitions and they're like, do we change the structure? And I'm looking at it and I'm like, well.
they wanted to lower the threshold. And I said, well, no. Number one, no, never do that. ⁓ Number two.
You also didn't add in my overhead caveat and you're at 66 % I think overhead for the year, but the team's been bonusing. And so we're digging in trying to figure out like what's going on. I have a couple offices going through this right now. This one kind of East Coast stern was like a little topsy turvy upside down. So I think no matter what you do, you've got to make sure that it's going to work the best for your practice for your overhead. So if dollar per hour right now is the best bet and you're able to manage and control your overhead with
that, do that. If you've got a team that you're like, want to, I want to make this more production based and Kristy, like you were saying, like really give that energy to what we're pushing for and kind of pay them back right for the work that they're putting in. You have that flexibility and that level with the percentage on production collections and or bonuses. I love the, if you're asking me either or I would say
in my opinion, production-based over-bonusing. ⁓ It just is easier. Again, I want easier, and it's easier, and it's like tailored for this position, this person. It doesn't have to be across the board for the full practice if we're not to a point that we're ready for that yet. So cons. ⁓
I think there's cons to everything. There's cons to dollar per hour because often times, especially in the ⁓ temperature that we're in right now with the dollar per hour, it is hard to do three to three to point five times their rate of pay. I tell hygienists and I tell doctors all the time, I'll pay you whatever you're asking for. I'll pay you whatever you want. If you can make it work with the numbers. If you can do three to three point five times that rate of pay in production per hour, you've earned it. That's the point is that the overhead has to match.
and for our team members that are listening, I just need you guys to really hear me when I say doctors can't pay you from nothing. So if we're upside down in our overhead, we're not making profit on the company, the business is not profiting.
It's not just for the doctor to profit. It's not just for the doctor to go buy a house or whatever you think is actually happening behind the scenes. It's to ensure that things are paid for. And so if we're upside down in payroll, it's got to come from somewhere else. So then we got to pull it from supplies or from labs or from somewhere. And so the pay always just has to make sense. So if you can make it make sense, I don't care what it looks like. So there's pros and cons to all of it.
So there's the dollar per hour making sure that you're staying in line. There's you know, collections production based and then there's the accelerated which we're not going to spend a ton of time on the accelerated. kind of feel like it's a dying breed in this.
day and age. I love accelerated myself and I loved being hygiene assistant to accelerated hygiene, but that's a really great space too. I do have a hygienist that I know out in like the Chicago area who does accelerated and she's paid on production. She kills it. She is making really pretty numbers over there, but there's pros and cons to everything and it kind of runs the doctor a little ragged, so you just have to have the right system
for that and to make sure that it all just makes sense. And Kristy, you've got a ton of practices too in this same space. What would you have seen like really working or not working within any of this, whether it's associates or hygienists, really just what do you see that works really, really well?
DAT Kristy (20:08)
Yeah, honestly, Tiff, I'm gonna say the one that I've seen work the best is a combination, right? ⁓ Again, a good going pay rate and then incentivizing them on.
I'm going add in it's more of a profit share model, right? Because like you said, it has to make sense with the numbers and be profitable. ⁓ And again, I do see a lot of ⁓ accelerated, but I will caution there too. The ones that I've seen work the best is when you give them a very good assistant that can perform. You know what I mean? Don't give them an entry level person that can't carry conversations. And I shouldn't say can't, but is
as developed right and or let them hand pick them and develop them right so that they work in tandem together and I've seen it work very well in both models but you have to have the right personality and desire there.
The Dental A Team (20:57)
Yeah.
I think that's a fantastic point and to that point I've seen it work really well. ⁓
with the right assistant as well. And oftentimes what we do is we hire a hygiene assistant who's like the low level training, not quite the doctor's assistant yet. And the reality is it needs to be someone who knows how to run a schedule, how to talk with the patients, how to sell treatment, how to take the x-rays correctly and really give that concierge service because we've got to make up for not having as much time with the hygienist, right? So the hygienist does all of that in your hour appointments, but when you're
shortening them and they're doing accelerated, the hygienist is only in there for 30, 40 minutes, right? You're losing a lot of value there from the hygienist transitioning. So that assistant definitely has to be top level, top notch. And we make that mistake a lot. I've made that mistake in my own office and hiring many, many times. So it's kind of opposite and you really need a skilled assistant to be your hygiene assistant. I agree. That's a great point. Awesome.
DAT Kristy (22:15)
And you know
what, Tiff, you mentioned earlier that the margins are getting hard, especially with PPO and they're not reimbursing. You made a good point about the co-diagnosis aspect. Make sure you're factoring that in. Like look at what's coming out, know, track it and see, because that also needs to be factored into the pay scale, right? It may not just be 100 % hygiene services. You almost have to look
The Dental A Team (22:37)
Yeah.
DAT Kristy (22:45)
at hygiene sometimes as part of your marketing strategy in a way, you know? So.
The Dental A Team (22:48)
Yeah, that's a great point. I totally agree.
Yeah, I love it.
Thank you, Kristy. ⁓ I think there's some great ideas in here. You guys know we did not give you the do this answer because it is really case by case. I mean that with every ounce of my being, it is dependent on what's going to work best for your company. If you want help diving into that, figuring out what might be best for you or your company model, we are more than happy to help you on a one-on-one basis. Reach out. [email protected]. We'll be happy to get on a call with you to dive into your practice statistics.
sticks and needs with you. Again, no, I don't have a do this, do that, but we can help you. [email protected] and we are so happy to help any of you guys. We are all here for it. We have a team standing by, always ready to hop on a call with you.
Kristy, thank you for your amazing words of wisdom and for your vulnerability. And we have more to record, you guys. We got more coming up for you. And we are just so excited to deliver you so much amazing content this month. Please drop us a five-star review below letting us know how helpful this was. If you have ideas, if you have things that you've done that worked or didn't work, send them in. You can put them within your review. People really do go through and read those. Or [email protected]. You can send them over to us and we'll be happy to
with you or put that information out for others to read as well. So go find us, Instagram, Facebook, all the places, and we'll catch you next time. Thanks guys.
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