“We Need to Hire Someone!” – Or Do You?

When an employee drops The Hiring Bomb on your desk, there’s good news and bad news.

✅ Good news: Your practice is growing—cue the confetti!
❌ Bad news: Your employee thinks payroll is funded by the Tooth Fairy.

Before you rush to post a job listing, let’s take a step back. Is this a real capacity issue, or just perceived overload? Because here’s the truth: most employees operate based on feelings, while you—being the financially responsible practice owner—operate based on numbers.

Step 1: Diagnose Before You Hire

Hiring someone to fix inefficiencies is like buying one of those online night guards to cure sleep apnea—it doesn’t work that way. Ask yourself:

If inefficiencies are eating up time, adding another salary won’t fix it—it’ll just make payroll Monday extra painful.

Step 2: Consider the 25% Salary Rule Before Hiring

A financially healthy general practice keeps total payroll (wages, taxes, benefits) at 25% or less of revenue (collections).  A sleep and TMJ practice should probably be more like 20%.

 DON’T base payroll on production—that’s like booking a five-star vacation on the assumption you’ll win the lottery.
✅ DO track payroll as a percentage of collections (aka actual money in your bank account).

If payroll creeps past 25%:

What Counts in That 25%?

It’s not just hourly wages and salaries. When calculating your total payroll percentage, be sure to include:

These add up quickly, and if you’re not careful, your payroll costs could silently eat into your profits like internal resorption.

How to Keep Payroll at 25% (or Less) of Revenue

If you’re pushing that 25% limit but still need help, outsourcing or hiring a virtual assistant might be the smarter move.

Step 3: When to Outsource Instead of Hire

Before committing to another full-time salary, ask: Can this job be done remotely or more cost-effectively? If so, a virtual assistant (VA) or outsourcing service might be the perfect fit.

Tasks Ideal for a Virtual Assistant or Outsourcing Service

Essentially, anything that doesn’t require a physical presence in the office can be outsourced—often at a fraction of the cost of an in-house hire.

When NOT to Outsource

 If Your Office Has a Communication Breakdown – If your team is already disorganized, adding a VA won’t fix it. Get your internal systems running smoothly first.

 If You Expect a VA to “Read Your Mind” on Day One – Virtual assistants are great at following processes, but they won’t replace an experienced office manager’s deep knowledge of your practice dynamics.

 If You’re Not Willing to Train – Even outsourced help needs clear expectations and onboarding. If you don’t have time to train, you won’t get the results you expect.

Step 4: Optimize First, THEN Hire (If Necessary)

The Bottom Line

Hiring should be a strategic investment, not a knee-jerk reaction to Karen at the front desk feeling overwhelmed. So, the next time someone says, “We need to hire someone!” just smile and say:

“Great! Show me the numbers.”

Your profit margins will thank you. Your stress levels? Even more so.

Michael

P.S.  If you’d like more information on the virtual assistant company that I’ve used for 5 years, message me.​