Simon Palmer, June 2007 - The shortage of dentists in Australia and New Zealand has been widely reported for several years now. One of the lesser-reported impacts of this shortage is that practices looking to employ a dentist aren’t finding it as easy as they once did to find the right candidate. Most practices know how to write an advertisement and where to place that advertisement. What practices usually don’t know is how to make their practice stand out among the pack of offers that are out there. How are they going to attract the ideal candidate to take a placement with them over the other guys down the street?

Practices need to realise that what they are looking for is in short supply, and that they are essentially competing against each other. The most successful practices will be the ones that have a strategic and creative approach to their recruitment process, one which empathises with the candidates and caters to their motivators.

Employee Dentist Motivator 1: Remuneration
The standard private practice dental remuneration package in Australia and New Zealand is a commission of collections less lab fees multiplied by a rate between 30 - 40%. The only problem with commission remuneration packages like this is that by itself it doesn’t tell you much. What dollar amount can you expect with a rate of 35%? There is no answer to that question without knowing how much and what kind of work the dentist will be doing. Put yourself in the shoes of an employee dentist looking for a job. Being offered a standard 30-40% will mean that:

1. Until you’ve spent some time working in the practice your remuneration will be unpredictable. It will depend on how busy your practice is from one period to the next and on the procedures that you are doing from one period to the next.
2. You cannot compare remuneration rates from one practice to another. If you were an employee dentist looking for employment in a practice and was offered 35% in Acme Dental and 40% in Central Dental which would you think is offering you more money? Without knowing more information there is no way of knowing, despite the fact that often it could be Acme that gives the employee dentist a bigger income.

At the end of the day the practice is asking the candidate to take a leap of faith, and have trust that at the commission rate offered, the candidate will be able to meet their financial obligations, responsibilities and goals. In my experience, many dentists (and especially dentist graduates) are risk averse. If the practice can illuminate the remuneration somehow and is able to give the candidate a better idea of the dollar amount, then they will probably have an advantage over the other practices. How you do this may take some creativity but here are some suggestions:

1. If this new candidate is to replace an exiting employee dentist, you can tell the candidate about the previous employee’s role - how busy he/she was, what type of work he/ she was doing and approximately what they were earning. If the last employee left on good terms you may be able to use him as a reference for the practice.
2. The practice could offer the candidate a retainer or minimum daily rate for a limited period of time. This retainer should be the minimum that the practice feels the candidate should be earning when they are settled at the practice. It should be agreed upon in advance that there will be a review after 2-3 months, and if the candidate is earning the minimum at that time both parties should consider the trial period a failure.
3. Many practices wanting to increase their chances with a candidate dentist will simply raise the percentage that they are offering (37% instead of 35%). This increase may help a little but it won’t convince the more risk-averse. I recently heard about a practice offering the same deal in a more effective way. The practice calculated that the extra 2% over 18 month would be $X and offered the candidates 35% plus $X as a bonus if the candidate was still there in 18 months (among other performance and production goals).

Employee Dentist Motivator 2: Busy-ness
If you can’t show the candidate a more definite dollar amount that they can expect to earn at your practice, the next best thing is to be able to show them how busy they will be. Give the candidate access to the appointment book. If you’re asking the dentist to join a practice that doesn’t yet have quite enough busy-ness, you could commit to a marketing budget that the practice will spend every month to get new patients. Show that you have given consideration to their sensitivities and put together a plan to transfer patients from either yourself or other existing providers in your practice. Prepare some scripts for the front office staff on how to introduce the new dentist.

Employee Dentist Motivator 3: Upskill
Recently graduated dentists will appreciate the opportunity to be genuinely mentored and up-skilled, both on a clinical level and on a practice-management level. You could gain a competitive advantage over other practices by committing your practice and yourself to this education process.
Clinical skills

• Commit to regularly (once a week or once a month) putting time aside to mentor the candidate on their clinical cases. Review their patients, their diagnosis from x-rays, their study models, their impressions for C + B, etc.
• Commit to upskilling the successful candidate on any clinical area that you feel particularly competent in (endo, extrations, ortho, implants, etc).

Practice Management Skills

• Commit to regular mentoring for the employee dentist on practice management issues like staff management, patient management, leadership and practice figures.
• If your practice participates in practice management courses, mention upfront that the successful candidate will be exposed to this training, at no cost to them. It will be part of your commitment to their development.
• Have an allowance in their remuneration package for continuing education. I have seen clauses in dentist employment agreements that offer to match the employee dentist dollar for dollar up to $1500 per year. The practice should see this money spent as an investment in making sure that it is a state of the art practice.

Employee Motivator 4:“…with view”.
Many practices advertise for an “employee with view” position. For those of you unfamiliar with this term, it means that the practice is looking for an employee who (if everything works out over time) will buy equity in the practice later. Employee dentists are attracted to this if they eventually want to own a practice, and are happy working as an employee for now while they gain experience and finances.

If you are a practice that is looking for an “employee with view”, the best way to add a competitive advantage is to add clarity to what is on offer. Most “employee with view” positions are offered vaguely and without contracts, timelines or value discussed until much later. If you as a practice are able to show that you have a definite plan for how the transition will take place (including letters of understanding with timelines, when and how the practice will be valued, the contracts that will be involved and how your relationship will look afterwards) you will be miles ahead of the other “with view” offers that are out there.

Conclusion
More and more practices (especially in non-metropolitan areas) are finding it difficult to fill positions for clinicians. Put yourself ahead of the game, by thinking of what will attract or motivate an employee dentist to come to your practice. Think outside the square. Make sure what your offering will put your practice at the top of the list of desired practices to work in.

{Published in Australasian Dentist Magazine, Issue 20, August 2007}