The strongest practices understand that the hygiene team comprises critical partners in patient health and practice success. Attracting and retaining the right team members will help ensure practice continuity, while also inviting innovation and collaboration to keep your business moving forward.
But if you’re like most dentists, you’ve had hygienists depart, which causes disruption for both you and your patients. When a hygienist leaves, not only do you and the remaining team have to pick up the slack, putting more pressure and stress on those who remain, your patients also may be disappointed because they’ve bonded with that staff member.
Securing and retaining hygienists is particularly challenging right now. The ADA’s Health Policy Institute’s 2023 research found that a stunning 94.5% of dentists said it was very or extremely challenging to find qualified hygienists. With a labor market that tight, it might be a while before you get someone else in the door. It’s far easier to keep the team you already have.
Although you can’t prevent every hygienist from moving on, you can have more of an impact than you might think. According to Gallup, 52% of people who voluntarily leave a job said that their manager could have “done something” to keep them.
Burnout, Backaches and Better Offers
Understanding the current challenges hygienists face is key to better hiring and retention practices.
Top challenges are cross-industry issues – pandemic impact and burnout. According to a study coauthored by the American Dental Hygienists’ Association and the American Dental Association, there are now 3.75% (7,500) fewer hygienists across the United States than before the pandemic.
“During the pandemic, many dentists had the financial security to be out of work for a while, but hygienists were often not as fortunate,” said Kevin Simpson, chief operating officer at talent consultancy Arthur Marshall in Irving, Texas. “Those hygienists got pushed to the wayside, and what happened is a lot of those folks left the industry.”
Burnout also plays a role in hygienist turnover. Physical demands, such as repetitive back, neck, arm and hand movements, are a significant factor. According to a study by Saccucci and colleagues, dental hygienists are at higher risk than dentists of developing a musculoskeletal disorder in the wrists, hands, upper extremities and lower back due to lengthy periods of repetitive work such scaling and root planing.
Then there are the emotional factors – managing a heavy patient load, dealing with difficult patients (and sometimes difficult team members), and feeling unappreciated by both dentists and patients alike.
In short, it can be painful and stressful to be a hygienist – but you can help.
Start with the Right Hiring
If you’re replacing a hygienist or adding a new one, you likely want someone in the office now. And that level of pressure can cause dentists to make poor hiring decisions, trading quality for speed.
Take the time to think about the current culture of your hygiene team. If you’ve been intentional about building a team that shares your vision and your values, this isn’t the time to throw it away with a panic hire.
Create a job listing that doesn’t just talk about the hard skills required for the role. Capture the spirit of your team and your practice. Talk about what you’re trying to achieve for patients. Use that as a launching pad for listing your new hire’s ideal soft skills, such as being caring and empathetic, a good communicator and a team builder.
When you interview candidates, craft questions that will help draw out whether they truly possess the skills that will match the culture you have and may even help elevate it. Ask them about what their ideal role looks like. Ask about the current dynamic among the hygienist team and between dentists and hygienists. And ask about how they manage stress and ward off burnout. Then really listen to their responses. Beware of candidates who tell you what you want to hear but won’t have experiences or details to back it up. Watch for what makes their eyes light up.
Then, when you have your candidates whittled down, be sure that not only your leadership team speaks with them, but so do members of your hygiene team. You may get a completely different perspective – and ultimately a hire who thrives in your practice.
Align Your Compensation Model
There’s a reason such a strong perception exists across industries that you have to change jobs to make more money. Many businesses are on autopilot when it comes to raises, giving perhaps a cost-of-living bump if anything at all. However, inflation has hit many people hard, including your hygiene team. The money they make is worth less now and just doesn’t go as far.
According to U.S. News & World Report, hygienists made a median salary of $81,400 in 2022, a number strengthened by the fact that in that same year, 79.9% of practice owners had raised pay for their hygienists within the past year – with 18.1% reporting increasing wages by 10% or more.
Simpson said the hygienists who stayed in the industry throughout the pandemic advocated for change when they returned to work. “When they came back, a lot of them really knew their value,” he added, and championed pay increases. Perhaps you’re among those who realigned salaries, so you might not have the budget for another significant increase for a while. However, compensation goes beyond the net pay line on a pay stub. It also includes benefits.
Would you call your benefits package – including paid time off and health and other insurances – generous? Consider adding a continuing education allowance or even profit sharing to really create an offering that would be hard to turn down or walk away from. You also may want to talk to the team about whether the practice is supportive enough of their work/ life balance needs. You may not be able to accommodate every request, but team members will appreciate knowing that you’re open to schedule swaps or occasionally giving them a few hours to attend or handle something important to them.
Get creative. Think about those musculoskeletal risks. Do you want to bring in a yoga teacher once a week? Can you invest in more ergonomic options for your team?
Remember, your total compensation package is an investment in your team and ultimately in the patients they support you in caring for.
Simpson said that hygienists who stayed through the pandemic also realized that they didn’t need to be tied to just one practice, so you may have much more competition than you realize. Some hygienists, like nurses, now take contract jobs at different practices, so they have multiple workplaces. “Instead of being employed, they said, ‘I’ll just travel around and do it and they’re going to pay me more, and I’ll have more flexibility and more variety,’” Simpson explained.
Does your compensation model account for that?
Transforming the Day-to-Day
Employees certainly will take advantage of an opportunity that comes with better compensation, but more money rarely is the only, or even most important, reason someone leaves a role. They’re not just going toward something – they’re frequently going away from something else.
According to the Society for Human Resource Management, 58% of employees quit a job due to a toxic workplace culture. Such a culture is dominated by bullying, favoritism, harassment and other behaviors that put employees on unequal footing.
How can you ensure your culture is a healthy one where people feel comfortable and able to be their best selves? The most important first step is communication. Meet at least monthly one-on-one with each hygienist to talk about:
- Your goals for the practice
- Their goals and appetite to grow in their role
- Your mission and vision for the practice
- How you see them helping to achieve your mission and vision
- What professional development opportunities they’d like to pursue
During your one-on-one sessions, ask about the team dynamic to ensure no one is being mistreated. Ask them about whether they’re feeling burned out. Is there a class they want to take or a technology they want to learn? And ask for candid feedback about you as a leader. Do they feel you’re a micromanager or that you’re too removed from the day-to-day operations? How could you be a better leader to them?
Also consider holding a monthly or quarterly meeting with the full hygiene team to talk about how they’re feeling about the culture. Use this time to also help them get further invested in the direction and future of the practice. Share top-line updates on practice performance, and help them connect their role to the health of the practice.
Another area where you may find room for improvement is in interpersonal relations. How respectful are you to your hygienists when you’re with a patient? How respectful are you when you’re not? Ask your team if they have any concerns in this area and encourage them to be candid. Remember, they’re your partners in providing care, and should be treated as such.
Recognition
According to a Gallup poll on recognition in the workplace, cross-sector employees said the most memorable recognition typically comes from an employee’s manager (28%), followed by a high-level leader or CEO (24%). If you hold both roles, you’re responsible for nearly half of that breakdown.
You can easily start building or growing a culture of recognition by leveraging the organic opportunities that exist. For instance, the second week in April is Dental Hygienist Appreciation Week and October is Dental Hygiene Month. Whether you have a staff celebration at a local restaurant or bring in some treats for the team, make an effort to connect the reward with the work they do every day.
At the individual level, you can reward employees with birthday celebrations, an extra day of time off, or a personal note that talks about how they contribute to improved patient health and the success of the practice. If a patient compliments a team member to you directly, ask that patient to record a quick video to share with the hygienist, the hygiene team and even on social media.
Remember, recognition doesn’t have to be expensive to be meaningful. But it does need to be heartfelt and authentic.
With a strong team and a strong culture, your hygienists are more likely to feel engaged in their role and their future at your practice.
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HR Support
Patterson Dental has identified multiple high-performing business partners in the staffing solutions space to address a range of needs. These firms have proven track records in providing dental practices with critical human capital and human capital support, enabling practice leadership to keep their focus on the clinical side of dentistry and patient care.
If you need assistance in HR services or talent management, speak to your Patterson Dental representative.
Arthur Marshall and Swiss Monkey
Patterson Dental works with talent consultancy Arthur Marshall, headquartered in Irving, Texas, to source a variety of dental roles across the United States. “We are the biggest and the best there is,” said Kevin Simpson, chief operating officer.
When the company launched in 2002, it focused more on physicians, but the market has changed so dramatically that now 95% percent of its efforts are in dentistry. Dental practices that engage Arthur Marshall have a variety of needs.
“Maybe they’re looking for succession planning. Maybe they’re so busy that they can’t take a vacation. Perhaps they’ve lost a very important team member,” Simpson said. Regardless, what the company first does is learn more about the practice and what talent would help them thrive.
And while Arthur Marshall can source any opening, sometimes what a practice wants is just impossible to obtain.
“What we find with a lot of practice owners is more often than not they want a clone of themselves,” Simpson said. “That’s where a critical part of the consulting element comes in – highlighting that what might be best for the practice is someone with a different but complementary skill set to help the practice become more well-rounded and positioned for growth.”
Simpson said the candidates his firm works with are looking for competitive compensation, as well as transparency about available growth opportunities. “They also want to feel like they’re part of a welcoming family-like environment,” he noted.
Even still, finding the right person can be a challenge on both sides. “You’re always going to be surprised at really how difficult it is to match two seemingly different people together,” Simpson said.
“They took the time to get to know our situation, business model and expectations, and they produced an outstanding hire for us three months later,” said Bruce Foster, chief executive officer at Florida Dental Implants & Oral Surgery in Lakeland.
If your challenges are related to front desk staffing and productivity, Patterson Dental partner Swiss Monkey can help. Swiss Monkey boasts an average 3.2 weeks to hire and an 88% retention rate.
ALLIANCEHCM
For a complete payroll and HR solution, Patterson partners with AllianceHCM, headquartered in Woodland, Texas. On the hiring side, the company handles recruiting, onboarding and training. For existing employees, AllianceHCM handles payroll, retention and engagement tasks.
Vickie Sorokin, AllianceHCM’s vice president of sales, explained that the company supports employees from hire to retire, ensuring employees have the HR tools they need while on the job and access to the forms and documents they require before and after their tenure at a practice.
AllianceHCM can support practices of all sizes, but specializes in multilocation operations that have more complicated payroll needs. If payroll work is too time-consuming or duplicative, Sorokin and Matt Umholtz, president of AllianceHCM, want dentists to know that efficiencies probably exist in workforce management that will benefit them.
When it comes to hiring, AllianceHCM enables customers to use an applicant tracking portal to view a dashboard of applicants and where they are in the recruiting process, Umholtz said. AllianceHCM also leverages the power of artificial intelligence to draft job postings, summarize a candidate’s suitability for a role and more.
Umholtz pointed out that employees have access to an employee portal app that helps them self-manage direct deposit, time off and more. “That really reduces the amount of administrative burden for their employer, HR department or payroll department,” he said. Umholtz added that providing employees with a positive payroll experience can have a favorable impact on employee engagement.
“Payroll is probably one of the most critical things for a lot of employers. It’s their largest expense and it’s a person’s livelihood.”
To learn more about these options, speak to your Patterson Dental representative or visit pattersondental.com/navigate
REFERENCES
American Dental Association Health Policy Institute. Economic outlook and emerging issues in dentistry. July 11, 2022. https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/resources/research/hpi/july2022_hpi_economic_outlook_dentistry_report_main.pdf
Bintliff C. The Big Quit: Dental industry staffing struggles during the pandemic and beyond. DentistryIQ. September 16, 2022. https://www.dentistryiq.com/front-office/article/14282694/the-big-quit-dental-industry-staffing-struggles-during-the-pandemic-and-beyond
Crozier S. Recruiting hygienists, assistants still challenging for practice owners. American Dental Association. July 10, 2023. https://adanews.ada.org/ada-news/2023/july/recruiting-hygienists-assistants-still-challenging-for-practice-owners
Ebert S. Retaining your dental staff through the Great Resignation. American Dental Association. https://www.ada.org/resources/careers/career-transitions/articles/retaining-your-dental-staff-through-the-great-resignation
Gallup. The importance of employee recognition: Low cost, high impact. January 12, 2024. https://www.gallup.com/workplace/236441/employee-recognition-low-cost-high-impact.aspx
Mirza B. Toxic workplace cultures hurt workers and company profits. Society for Human Resource Management. September 25, 2019. https://www.shrm.org/topics-tools/news/employee-relations/toxic-workplace-cultures-hurt-workers-company-profits
Moore H. The importance of staff retention in dental offices: Why it matters. Oral Health. August 28, 2023. https://www.oralhealthgroup.com/blogs/the-importance-of-staff-retention-in-dental-offices-why-it-matters/
Morrissey RW, Gurenlian JR, Estrich CG, et al. Employment patterns of dental hygienists in the United States during the COVID-19 pandemic: An update. J Dent Hyg. 2022;96(1):27- 33. http://jdh.adha.org/content/96/1/27
Saccucci M, Zumbo G, Mercuri P, et al. Musculoskeletal disorders related to dental hygienist profession. Int J Dent Hyg. 2022;20(3):571-9. doi:10.1111/idh.12596
U.S. News & World Report. Dental hygienist salary. https://money.usnews.com/careers/best-jobs/dental-hygienist/salary#:~:text=How%20Much%20Does%20a%20Dental,%2Dpaid%2025%25%20made%20%2475%2C100
Editor’s Note: This article was originally published in the Fall 2024 issue of Advantage by Patterson Dental magazine.
