August 8, 2022
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With the hiring/employment crisis currently being experienced by dental practices around the country, the issue of WHOM to hire has become a pressing question for many dentists. Do I hire for experience, skills or other, less tangible, or measurable qualities?

Many consultants recommend hiring for ATTITUDE, APTITUDE, and CULTURAL FIT, rather than for experience and skills.

That’s easy to say but more difficult to implement, as the matter of training comes into question.

• Who is going to train?
• How is training going to take place?
• What is training going to cost?
• When is going to happen?
• Where is going to happen?

All these are valid concerns and must be answered. Even for the most skilled and experienced hire, it’s unlikely that all these will mesh 100% with your practice. Some training will always be required. People are not Plug ‘n Play.


Without well designed processes (systems) in place to deal with these training issues, dentists tend to hire people who might not be cultural fits but rather present requisite skills or the hope that experience will enable an employee to become immediately productive.

Too often such a strategy backfires. While someone might know how to use the specific programs being utilized in the practice, if they can’t get along with the rest of the team, does it really matter?

One of the reasons Dentists prefer to hire based on experience is the high cost of training. There’s also the fear that should the employee leave, that investment would be for naught. Couple that with the current practice of other dentists poaching employees by offering sign-on bonuses and high salaries, the risk of investing in an employee could seem overwhelming.

Have you heard of a hygienist leaving a practice and patients following? I have.

According to a recent article in the NEJM, there’s a potential solution.

Employment Agreements

“Even direct investments (in such areas as training, recruitment and moving services, and credentialing) that an employer makes in its employees could be recouped using approaches that are better targeted than blanket NCAs (non-compete agreements). Training-reimbursement agreements, for instance, can require departing employees or their new employer to compensate employers for the cost of training if the employee leaves within a certain period after the training.” (August 6, 2022 DOI: 10.1056/NEJMp2205013)

Few dental practices employ such agreement other than with professional associates. Perhaps that should be reconsidered (with the help of an attorney, of course), especially when it comes to certain key positions in a dental practice such as hygienist or employees responsible for generating referrals or communicating with referring doctors or other valuable sources worthy of protection.

And of course, training programs should be in place to accommodate the option of hiring more for attitude, aptitude, and cultural fit than for specific skills and experience.

One of the ways to systematize training is to video how things are currently being done in the practice. This might mean hiring a high-school student (with tiktok video-making experience) to shadow specific team members and record what and how they perform their daily tasks. Such videos can become a valuable asset for the practice.

The skills necessary to provide the highest level of care and service to patients change. Technologies and techniques change. Training and retraining are no longer options, they are necessities. Having a systematized training strategy with deployable assets in a survival need for dental practices.

Still, the most common reason for a new hire failure is poor cultural fit. Regardless of whether the existing culture is defined or not, there is one. It might not have been engineered and it might have been developed by the staff, without much owner input. That would be a mistake.

Cultural misfits are energy vampires. They suck out the enthusiasm and promote stress in the workplace. A miss-hire can result in good team members leaving.

Having a positive culture that is well-articulated and based on clearly defined CORE VALUES, will enable a hiring process that more likely assures a positive fit.

Need help designing or defining your culture? Get the Culture Guide and Workbook now!

What’s $149 when compared to the drama of a single bad hire? Just one miss-hire could cost $10’s of thousands!

To excellent hires and cultural fits,

Practice Success Insights

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Dr. Michael Goldberg is one of the leading educators on dental practice management in the United States.

Michael ran and sold a prestigious group practice in Manhattan and has been on Faculty at Columbia University and New York-Presbyterian Medical Center for 30 years including Director of the GPR program and Director of the course on Practice Management.

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